Cleveland Clinic colorectal surgeons offer the latest surgical treatments for Crohn’s disease, with an emphasis on a conservative approach.

• A resection involves removing the diseased portion(s) of the intestine and reconnecting the two healthy ends.
• A strictureplasty is a surgical widening of sections of the intestine that have become narrowed due to scarring.
• The ileal pouch-anal anastamosis (IPAA) involves removing the colon, forming an internal pouch from the small bowel and joining it to the anal muscle.

Cleveland Clinic surgeons are also experienced in several other surgical treatments for ulcerative colitis for patients who cannot have the ileal pouch procedure.

Diverticular disease is a common condition, where small pockets develop on the outside the colon.

Diverticulitis is a condition which occurs when these pockets become inflamed. Medical management, generally using antibiotics, is successful in most cases of acute diverticulitis; however, some people require emergency surgery or drainage of an abscess. When emergency surgery occurs it frequently involves placement of a temporary colostomy.

Our surgeons in the Department of Colorectal Surgery have extensive training and experience in the management of anorectal disease. The typical symptoms of patients suffering from anorectal disease include: bleeding, pain, discharge and itch (or pruritus). Descriptions of the conditions commonly seen by specialists in anorectal disease are below.

Hemorrhoids - A normal part of the anal anatomy, which helps control bowel motions and gas. When enlarged they may cause discomfort or bleeding and need assessment. Treatment is usually performed in the office with either dietary instructions or application of local hemorrhoid treatments which can be performed at the time of the initial office visit. Larger hemorrhoids may require an operation.

Anal Fissure - Patients have severe pain and sometimes bleeding after passing a bowel motion. Generally, medical treatments can be prescribed in the office. For cases which do not respond to this, a minor surgical procedure can be performed in the office under local anesthetic.

Pilonidal Disease - Patients may develop abscesses between the buttocks, which can be treated in the office and, in rare cases, a general anesthetic required. Definitive later therapy may require a general anesthetic and subsequent wound care.

Anorectal Sepsis and Fistula - Patients may have severe pain and swelling caused by an abscess in the anal region. The usual initial treatment involves insertion of a small plastic drain under local anesthetic in the office. Some patients with an abscess will later develop a fistula, which requires further treatment. Patients who require further treatment or patients who have a fistula at their initial visit may require surgery under general anesthetic. These fistulas sometimes require more than one treatment to heal completely.

Malignant Tumors - In rare cases, patients develop a swelling or mass in the anal area which is caused by a cancer. Surgeons in this department are experienced at defining the treatment regimes for such tumors which may involve chemotherapy or radiation prior to surgery, or simply proceed with the surgery if needed.

Cleveland Clinic colorectal surgeons have extensive experience treating rectal cancer and offer treatment options available to save the sphincter and avoid the need for colostomy. These options include transanal excision and radical surgery with anastomosos of the colon to the anus incorporating a J-pouch or Coloplasty.

The Cleveland Clinic Digestive Disease Center houses one of the world’s largest collections of medical data. Our databases contain information that we use to continuously refine our approach to the treatment of colorectal cancer, diverticular disease, Crohn’s disease, ulcerative colitis, hepatitis and many other gastrointestinal diseases.