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Surgical Management of Crohn’s Disease and Ulcerative Colitis

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Crohn's Disease and Ulcerative Colitis

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Abstract

Crohn’s disease (CD) and chronic ulcerative colitis (CUC) represent two ends of the spectrum of inflammatory bowel diseases (IBD). Many authors believe there is a complex interaction between genetics, environmental, dietary, and infectious agents that contribute to the onset and progression of both CD and CUC. Because the diseases affect the gut differently and in different places, surgical approaches are distinctly different between them. While in general, the surgical approach to patients with CD is one of conservation, the approach to patients with ulcerative colitis is extirpation of the colon with, in most patients, construction of a pelvic pouch, which facilitates defecation using the normal anatomic pathway. Operations for CD and CUC lend themselves to minimal access surgical techniques. The complications inherent in surgery for IBD are numerous and need to be understood when discussing the goal of surgery for both diseases. The use of anti-TNF biologic therapy has been a great boon to the management of patients with CD, but in patients with ulcerative colitis, its use may complicate definitive surgical management (IPAA). While our understanding of the etiology and medical treatment of both diseases is improving, there is a large and defined role for surgery in the long-term management of patients with both CD and CUC.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic College of Medicine, 200 First Street, SW, Rochester, MN, 55905, USA

    Robert R. Cima MD, MA & John H. Pemberton MD

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Correspondence to John H. Pemberton MD .

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  1. Medical School of the Humboldt Universit, Department of Medicine, Charité Medical Center, Virchow Hospita, Berlin, 13344, Germany

    Daniel C. Baumgart

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Cima, R.R., Pemberton, J.H. (2012). Surgical Management of Crohn’s Disease and Ulcerative Colitis. In: Baumgart, D. (eds) Crohn's Disease and Ulcerative Colitis. Springer, Boston, MA. https://doi.org/10.1007/978-1-4614-0998-4_45

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  • DOI: https://doi.org/10.1007/978-1-4614-0998-4_45

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