What Is a Small Bowel Resection?

Here's the contrast that explains this operation. When a short stretch of small intestine is badly damaged, surgeons rarely try to patch it and hope — they cut the diseased section out completely and join the two healthy ends back together. Removing the segment is called a resection; the join is called an anastomosis. The video at the top of this page, "Bowel Resection and Anastomosis" (just under seven minutes), shows exactly that pattern carried out with surgical staples doing the joining — its own description sums it up as a "totally stapled" resection and anastomosis. The small bowel is the long, coiled middle portion of your intestine where most digestion and nutrient absorption happens, and because there's so much of it, losing a limited section is usually something the body adapts to well.

Why removing the segment beats repairing it

Diseased bowel doesn't heal like skin. A section narrowed by long-standing inflammation, starved of blood, blocked by a tumour, or damaged by injury tends to keep causing trouble — obstruction, bleeding, perforation, recurring pain — for as long as it stays in place. Taking it out removes the problem at its source, and the healthy ends on either side, which have a good blood supply, heal together far more reliably than inflamed tissue ever would. The reasons surgeons reach this decision vary: Crohn's disease that has scarred a segment into a tight stricture is a common one (our article on Crohn's disease covers that condition in full), along with blockages that don't settle, areas of bowel that have lost their blood supply, bleeding that can't be controlled any other way, and tumours — the great majority of them benign in the small bowel, but removed all the same so they can be examined. Often the final call is made during the operation itself, when the surgeon can see and feel the segment directly.

Small bowel versus large bowel: what changes

If you've read about colon surgery, the broad outline will sound familiar — our colectomy article describes the large-bowel version — but the details differ in ways that matter. The large bowel's main job is absorbing water, so a section of it can be removed with digestion largely unaffected. The small bowel is where food is actually absorbed, which is why surgeons are deliberately conservative here: they take the diseased segment and a small margin of healthy tissue, and no more than they need to. Length only becomes a concern when resections are very extensive or repeated, and preserving length is one reason Crohn's surgery in particular aims to remove as little as possible. Another difference is what comes before: the colon is usually examined directly beforehand with a camera test — see our colonoscopy hub — whereas the small bowel, tucked deep and many feet long, is more often assessed with scans, and the resection itself sometimes provides the first full look at the problem segment.

Two ways to join the ends: staples or stitches

Once the segment is out, the two ends have to become one tube again. In the stapled method — the one the anchor video demonstrates — a purpose-built surgical stapler lays down fine rows of staples that seal and join the bowel in a single action, quickly and evenly. In the hand-sewn method, the surgeon stitches the join with sutures, layer by layer; it's slower, but it works in places and tissue conditions where a stapler can't or shouldn't be used, and many surgeons combine the two. If you'd like to see the joining step on the small intestine itself, this short clip of a small intestine anastomosis focuses on just that moment. Whichever method is used, the join is the part of the operation everyone watches afterwards: it needs a good blood supply, no tension pulling it apart, and a few quiet days to seal — which is why eating restarts gradually rather than all at once.

When the ends aren't joined: the stoma question

Occasionally, joining the ends straight away isn't the safe move — if the bowel is badly inflamed, the patient is very unwell, or the tissue looks unlikely to heal. In that case the surgeon may bring the end of the small bowel out through the abdominal wall as an ileostomy instead, so waste collects in a bag worn on the skin while everything settles. Sometimes that's temporary, with a second operation months later to rejoin the bowel once it's healthy; sometimes, depending on how much bowel remains and why the surgery was needed, it's permanent. Being told a stoma is possible is understandably worrying, but it's a safety decision, not a failure — a protected bowel end heals without the risk that comes with a join made in poor conditions. The operation itself reaches the bowel either through one larger abdominal incision or by keyhole surgery with a camera and small incisions, sometimes with a small extraction cut to remove the segment; the choice depends on the segment's location, previous surgery, and how urgent the situation is.

Recovery: getting the bowel back to work

The gut tends to go quiet for a few days after it's been handled — surgeons call this an ileus — so you'll start with sips of fluid, build to soft food, and only then eat normally, guided by what your body tolerates rather than a fixed timetable. Most people are encouraged to get up and walk early and often; it genuinely helps the bowel wake up and lowers the risk of chest problems. The things you'll be watched for are the classic ones after any bowel join: a fever, worsening rather than improving abdominal pain, a racing pulse, vomiting, or a abdomen that swells and goes silent — any of those in the days after surgery should be reported to the surgical team straight away rather than waited out at home, because a leaking join needs prompt attention. Once you're eating comfortably, recovery continues at home over a few weeks, with lifting kept light while the incisions strengthen. Longer term, if only a limited segment came out, most people eat a normal diet; your team may check blood levels of certain vitamins from time to time, since the last stretch of small bowel absorbs some nutrients found nowhere else in the gut, and follow-up for the underlying condition — Crohn's, for instance — continues as before, because resection treats the damaged segment, not the disease behind it.

References & further reading

• MedlinePlus — Small bowel resection (Medical Encyclopedia): https://medlineplus.gov/ency/article/002943.htm
• MedlinePlus — Crohn's Disease: https://medlineplus.gov/crohnsdisease.html
• MedlinePlus — Intestinal Obstruction: https://medlineplus.gov/intestinalobstruction.html
• NHS — Ileostomy: https://www.nhs.uk/conditions/ileostomy/

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

Does removing part of the small bowel affect digestion?
Usually very little when the section removed is limited. The small bowel is long, and the remaining intestine adapts — it can take over much of the removed section's work over time. Problems mainly arise when a very large amount has been removed or with repeated resections, and your team monitors for that.

Will the join be stapled or stitched?
Either is possible. Staplers join the bowel quickly and evenly and are widely used, as the video on this page shows; hand-sewn joins are used where tissue or location makes stitching the better choice. Both are standard — your surgeon picks based on your bowel and the situation on the day.

Might I wake up with a stoma bag?
It's a possibility with bowel surgery, and your surgeon should discuss it beforehand. A stoma (ileostomy) is created when joining the ends immediately isn't safe; it may be temporary, with a later operation to reverse it, or occasionally permanent. It's a safety measure, not a complication.

How long is recovery after a small bowel resection?
You'll typically be in hospital for several days while eating restarts gradually, then recover at home over a few weeks with light activity. Full recovery varies with the reason for surgery and whether it was open or keyhole — your surgical team will guide the pace.

Can Crohn's disease come back after a resection?
Yes — resection removes the damaged segment but doesn't cure Crohn's disease, and inflammation can develop in other parts of the bowel over time. That's why Crohn's surgery removes as little bowel as possible and why medical follow-up and treatment continue after the operation.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. Fever, worsening abdominal pain, vomiting, or a swollen, silent abdomen after bowel surgery should be assessed promptly.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/09/26