What are the indications for colon resection (colectomy) in patients with inflammatory bowel disease (IBD)?

Updated: Apr 05, 2021
  • Author: David E Stein, MD, MHCM; Chief Editor: Vikram Kate, FRCS, MS, MBBS, PhD, FACS, FACG, FRCS(Edin), FRCS(Glasg), FIMSA, MAMS, MASCRS, FFST(Ed)  more...
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Answer

Ulcerative colitis

Total proctocolectomy is the only curative treatment for ulcerative colitis. It is indicated when medical management fails or is intolerable owing to the side effects of the medication. In addition, surgical treatment is indicated in patients who develop dysplasia or colon cancer. Surgery alleviates symptoms and eliminates the risk of colonic adenocarcinoma. [12] As in LAR, a J pouch is made (in this case with small intestine) to improve the patients' quality of life postoperatively by restoring intestinal continuity.

Crohn disease

There is no cure for Crohn disease. Although colectomy does not cure Crohn disease, it is indicated for refractory Crohn colitis, colonic strictures, or fistulas that affect the overall well-being of the patient. It is imperative that as much of the small intestine is preserved as possible. Patients with Crohn disease are often young and will likely require additional surgeries at later stages of life.


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