Surgery for IBD
IBD sometimes requires surgery as a means of controlling symptoms or dealing with IBD-related complications such as abscesses and fistulae. Historically, surgery has been a common treatment option, however, advances in treatments such as the increasing use of various biologics (e.g., infliximab, adalimumab) has meant that surgery rates have decreased. Although surgery is considered a more ‘drastic’ intervention, it is an effective means of removing diseased tissue, treating complications, and can result in long periods of remission, or in the case of ulcerative colitis, potentially permanent symptom relief. Other potential advantages include avoiding having to take drugs and their side effects, and less dietary restriction (i.e., you may be able to eat foods that previously exacerbated or triggered symptoms).
The types of surgery available for a patient with IBD depends on the characteristics of the diagnosis, i.e., the location and severity of affected areas, as well as the presence of any complications. Surgery is considered an option when:
- There is little/poor response to drug treatments
- Strictures have formed (i.e., narrowing of the bowel) obstructing the passage of food/waste through the bowel
- The patient has developed complications such as abscesses or fistulae
- There are emergency complications such as bowel perforation or obstruction