Inflammatory Bowel Disease

We are involved in the surgical management of inflammatory bowel disease, both Crohn's disease and ulcerative colitis.

The surgeon’s role in the management of ulcerative colitis is usually when there is a failure of medical management of the disease and despite optimal medical therapy the patient continues to be symptomatic.  The surgery involves removal of the entire colon, rectum, and creation of a J-pouch using the small intestine, which is then attached to the anal area thereby avoiding a permanent stoma.  Surgery is also done in case of complications from ulcerative colitis, which could result in life threatening situations if not treated promptly.  A further indication for surgery in long-standing ulcerative colitis is premalignant or malignant transformation of the colon, which necessitates surgery.

The surgery in Crohn’s disease is usually reserved for failure of medical management or complications from Crohn’s disease including abnormal fistulous communication between various regions of the bowel, between the bowel and the bladder, or between the bowel and vagina and abscesses in the abdomen.  Surgery is also done for Crohn’s disease involving the anal region where abscesses and fistulae are known to occur.  We were involved in both evaluation, as well as treatment of perianal Crohn’s disease.