Crohn's Disease Surgery Specialist In Bozeman, Montana

What is Crohn’s disease?

Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the digestive tract from the mouth to the anus. It most commonly involves the end of the small intestine, the colon, or both.

Unlike ulcerative colitis, Crohn’s disease can affect the full thickness of the bowel wall and may occur in separate areas with healthy bowel between them. Over time, inflammation can cause scarring, narrowing, abscesses, fistulas, or perforation.

Symptoms may include abdominal pain, diarrhea, weight loss, fatigue, fever, poor appetite, malnutrition, rectal bleeding, and perianal abscesses or fistulas.

How is Crohn’s disease treated?

Gastroenterologists direct the medical treatment of Crohn’s disease using medications that control inflammation and maintain remission. Treatment may include corticosteroids, biologic medications, immunomodulators, small-molecule therapies, nutritional support, and endoscopic monitoring.

Dr. Zehnpfennig works closely with gastroenterology colleagues when surgical evaluation becomes appropriate. Early consultation does not mean that surgery is inevitable. It allows the care team to review imaging, assess complications, optimize nutrition and medications, and choose the safest timing if an operation becomes necessary.

When is surgery recommended for Crohn’s disease?

Surgery may be recommended when Crohn’s disease causes:

• Intestinal obstruction or a symptomatic stricture
• Abscess
• Fistula
• Perforation
• Persistent bleeding
• Severe symptoms despite appropriate medical therapy
• Medication intolerance or serious treatment complications
• Malnutrition
• Concern for cancer
• Recurrent hospitalizations or major impairment in quality of life

Surgery treats the part of the bowel causing the problem, but it does not cure Crohn’s disease. Continued gastroenterology care remains essential after the operation.

What operations are performed for Crohn’s disease?

The appropriate procedure depends on the location and pattern of disease, previous operations, and the amount of healthy bowel available.

Ileocolic or small-bowel resection

The diseased segment is removed, and the healthy ends of the bowel are reconnected. Dr. Zehnpfennig preserves as much normal intestine as possible.

Strictureplasty

A strictureplasty widens a narrowed segment without removing it. This bowel-preserving technique may be especially useful for patients with multiple strictures or previous resections.

Surgery for abscesses and fistulas

Crohn’s disease may create abnormal connections between the bowel and the bladder, skin, vagina, another segment of intestine, or other nearby structures. Treatment may require drainage, resection of diseased bowel, repair of involved organs, or a staged operation.

Surgery for perianal Crohn’s disease

Perianal Crohn’s disease can cause complex fistulas and recurrent abscesses. Treatment often combines drainage, seton placement, advanced fistula procedures, and medical control of the underlying inflammation.

Dr. Zehnpfennig coordinates these cases closely with gastroenterology because durable healing depends on both surgical drainage and control of active Crohn’s disease.

Can Crohn’s disease surgery be performed robotically?

Many Crohn’s disease operations can be completed using robotic or laparoscopic techniques, including selected patients who have undergone previous abdominal surgery.

Dr. Zehnpfennig uses minimally invasive surgery whenever it provides a safe and effective approach. The robotic platform offers enhanced visualization and instrument control for complex dissection, reoperative surgery, fistula management, and intracorporeal bowel reconstruction.

For most patients natural-orifice specimen extraction is possible and can eliminate the need for a larger abdominal extraction incision.

How is surgery coordinated with Crohn’s medications?

Medication timing is planned jointly with the treating gastroenterologist. The team considers active infection, steroid exposure, biologic treatment, nutritional status, anemia, and the urgency of surgery.

Whenever possible, patients undergo preoperative optimization before elective surgery. This may include abscess drainage, improvement of nutrition, treatment of anemia, smoking cessation, and adjustment of immunosuppressive medications.

What is recovery like after Crohn’s disease surgery?

Recovery depends on the operation, the severity of disease, nutritional status, medication exposure, and whether surgery is elective or urgent.

Dr. Zehnpfennig follows an enhanced recovery pathway emphasizing minimally invasive surgery, multimodal pain control, early reintroduction of diet, early ambulation, and careful fluid management.

After surgery, patients return to their gastroenterologist for ongoing medical treatment and surveillance designed to reduce the risk of recurrence.

Why is specialist collaboration important?

Crohn’s disease is best managed by a coordinated gastroenterology and colorectal surgery team.

The gastroenterologist directs medical therapy and long-term disease control. Dr. Zehnpfennig provides surgical judgment, operative planning, and advanced treatment of strictures, fistulas, abscesses, obstruction, and other complications.

The goal is to intervene at the right time, preserve bowel, avoid emergency surgery whenever possible, and restore quality of life.

Referring clinicians may contact the office directly to arrange consultation or coordinate care.