Surgery for Inflammatory Bowel Disease
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Experienced gastroenterologists such as those in the Aria's Division of Gastroenterology are the best specialists to manage care for patients with inflammatory bowel disease (IBD), usually Crohn's disease or ulcerative colitis. Specialists reserve surgical treatment for patients who have complications of IBD, such as infection, bleeding, or tissue that has become malignant.
Medical treatment for IBD has developed at a rapid pace. Treatments currently include anti-inflammatory compounds, steroids, antibiotics, immune modulators, and biologic therapies. The use of monoclonal antibodies has brought rapid improvement to many individuals who have severe disease, including patients for whom surgery would formerly have been required.
But if drug therapy and other noninvasive treatments fail to control IBD, surgery may be needed. In these procedures, surgeons remove sections of abnormal bowel (and then reconstruct and reconnect the remaining ends of the bowel to restore the continuity of the digestive tract). The goal is to stop intestinal bleeding, obstruction, or infection - and to return the patient to a better state of wellness. Specialized procedures can be added for specific areas such as the perianal and perirectal tissue.
Surgery for more extensive or involved disease can sometimes include other procedures. The use of permanent colostomy to treat IBD has decreased significantly with modern surgical techniques. Surgeons are now able to better judge the amount of bowel to remove, and in many cases, can minimize the amount of bowel lost in surgery. The use of an ileo-anal pouch operation allows surgical specialists to reconstruct an artificial rectum to maintain bowel continuity for patients who have undergone removal of their lower bowel or rectal area. Surgical treatment of IBD may also involve temporary colostomy, perforation repair, abscess drainage, or other procedures.
Surgery is not a cure for IBD, but is used to treat complications. This form of care often allows the patient to return to a more normal lifestyle, weight, appetite, and state of well-being.
Patients should discuss with their doctor and specialists all treatment options for IBD.