Is a Small Bowel Resection?
Your small intestines are very important for maintaining good digestive
health. Also called the small bowel, they absorb nutrients and fluid that you
eat or drink. They also deliver waste products to the large intestine.
Problems with function can put your health at risk. You may need
surgery to remove a damaged section of your small intestines if you have
intestinal blockages or other bowel diseases. This surgery is called a small
Do I Need a Small Bowel Resection?
A variety of conditions can damage your small bowel. In severe
cases, your doctor may recommend removing part of your small bowel. Conditions
that might require surgery include:
- bleeding, infection, or severe ulcers in the
- blockage in the intestines, either congenital
(present at birth) or from scar tissue
- noncancerous tumors
- precancerous polyps
- injuries to the small intestine
- Meckel’s diverticulum (a pouch of intestine
present at birth)
Diseases that cause inflammation in the intestines may also
require surgery. Such conditions include:
- Crohn’s disease
- regional ileitis
- regional enteritis
Are the Risks of a Small Bowel Resection?
Any surgery has potential risks, including:
- blood clots in the legs
- breathing problems
- reactions to anesthesia
- heart attack
Your doctor and care team will work hard to prevent these
Risks specific to small bowel surgery include:
- frequent diarrhea
- bleeding in the belly
- pus collecting in the abdomen (this may require drainage)
- intestine pushing through the incision into your
belly (incisional hernia)
- scar tissue that forms an intestinal blockage
requiring more surgery
- short bowel syndrome (problems absorbing
vitamins and nutrients)
- leaking at the anastomosis
- problems with stoma
- incision breaking open (dehiscence)
- infection of the incision
Do I Prepare for a Small Bowel Resection?
Before the procedure, you’ll have a complete physical exam. Your
doctor will ensure that you’re receiving effective treatment for any other
medical conditions, such as high blood pressure and diabetes. If you smoke, you
should try to stop several weeks before surgery.
Tell your doctor if you’re taking any drugs and vitamins. Be sure
to mention any medicines that thin your blood. These can cause complications
and excessive bleeding during surgery. Examples of blood-thinning medications
- warfarin (Coumadin)
- clopidogrel (Plavix)
- ibuprofen (Motrin, Advil)
- naproxen (Aleve)
- vitamin E
Let your doctor know if you feel sick or have a fever just before
surgery. You may need to delay the procedure to protect your health.
Eat a good diet of high-fiber foods and drink plenty of water in
the weeks before surgery. Just before surgery, you may need to stick to a
liquid diet of clear fluids (broth, clear juice, water). You also may need to
take a laxative to clear your bowels.
Don’t eat or drink before the surgery (starting at midnight the
night before). Food can cause complications with your anesthesia. This may
lengthen your stay in the hospital.
Is a Small Bowel Resection Performed?
General anesthesia is necessary for this surgery. You will be
asleep and pain-free during the operation. The surgery can take between one and
There are two main types of small bowel resection:
- Open surgery requires a surgeon to make a 6-inch
incision in the abdomen. The surgeon finds the affected part of your small
intestine, clamps it off, and removes it.
- Laparoscopic surgery uses three to five much
smaller incisions. A surgeon will pump gas into your abdomen to inflate it.
This makes it easier to see. They’ll then use miniature lights, cameras, and
small tools to find the diseased area, clamp it off, and remove it. Sometimes a
robot assists in this type of surgery.
In either type of surgery, the surgeon will address the open ends
of intestine. If there’s enough healthy small bowel left, the two cut ends may
be sewn or stapled together. This is called anastomosis. It’s the most common surgery.
The intestine can’t be reconnected in some people. In this case,
your surgeon will make a special opening in your belly called a stoma. They’ll
attach the end of the intestine closest to your stomach to the wall of your
belly. Your intestine will drain out through the stoma into a sealed pouch or
drainage bag. This process is known as an ileostomy. It may be temporary to allow intestine further down the
system to heal completely, or permanent.
You’ll need to stay in the hospital for five to seven days after
the surgery. During your stay, you will have a catheter in your bladder. The
catheter will drain urine into a bag. You’ll also have a nasogastric tube. This
tube travels from your nose into your stomach. It can drain your stomach
contents if necessary. It can also deliver food directly to your stomach.
You may be able to drink clear liquids two to three days after
If your surgeon removed a large amount of intestine or if this
was emergency surgery, you may have to stay longer than one week in the
You will likely need to be on IV nutrition for some time if your
surgeon removed a large section of small bowel.
Is the Long-Term Outlook?
Most people recover well from this surgery. Even if you have an
ileostomy and must wear a drainage bag, you can resume most of your normal
You may have diarrhea if you had a large section of bowel removed.
You may also have problems absorbing enough nutrients from the food you eat.
Inflammatory diseases such as Crohn’s disease or small bowel cancer
will likely require further medical treatment before this surgery.