Surgery is usually reserved for certain complications and for times when inflammatory bowel disease symptoms do not respond to medical treatment.

Crohn's Disease

Elective Indications

  • Failed medical therapy
  • Recurrent disease
  • Fistula
  • Abdominal abscess
  • Stricture
  • Malignancy/prophylaxis
  • Failure to thrive in children

Emergency Indications

  • Acute obstruction
  • Peritonitis
  • Perforation
  • Toxic colitis/megacolon
  • Major hemorrhage

 

Ulcerative Colitis

Elective Indications

  • Failed medical therapy
  • Malignancy/prophylaxis
  • Severe extra-intestinal manifestations

Emergency Indications

  • Toxic colitis/megacolon
  • Major hemorrhage
  • Colonic perforation

In the setting of an emergency (e.g., hemorrhage, toxic megacolon, perforation), patients should receive the following:

  • Intravenous fluids for hydration
  • Broad-spectrum antibiotics
  • Intravenous corticosteroids

All orders for endoscopy, barium enema and anti-diarrheals are contraindicated in IBD emergencies.

 

To learn more about various aspects of surgery in IBD, please, go back to the IBD Surgery page

To go back to the IBD Unit main page click here

References and Acknowledgments