Indications for Surgical Treatment in Ulcerative Colitis and Crohn’s Disease

Abstract

Ulcerative colitis and Crohn’s disease represent a disease spectrum with protean manifestations and complications. Although as many as half of all patients with inflammatory bowel disease require at least one surgical procedure to address complications derived from their disease, the decision in favor of a surgical approach and its timing is rarely an easy one. Important considerations entering in the final decision include the localization of the disease, the amount of diseased bowel, the length of grossly normal intestine, the feasibility of bowel-sparing procedures in Crohn’s disease, the likelihood that a temporary or permanent stoma may be necessary and the changes in the quality of life that surgery may produce. Other factors such as personal or work-related commitments may also influence timing of the surgical treatment. Due to the need to balance objective findings with personal considerations, it is essential that the patient, the gastroenterologist and the surgeon, assisted by the radiologist and the pathologist, partake in the decision of the optimal treatment plan for the patient.