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"Can surgery cure Inflammatory Bowel Disease?"


I feel extreme pain because of my IBD. I am considering surgery. Is this a good fix?


Inflammatory bowel disease (not to be confused with Irritable Bowel Syndrome) generally refers to two main conditions: Crohn's Disease and Ulcerative Colitis. Based on which of these two you have (or rarely, a combination/mix of the two), surgery can offer some options. Both of these disease processes are complex.

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One of the key differences for Crohn's and Ulcerative colitis is which part of the bowel these diseases effect. Crohn's disease most commonly presents in the terminal ileum (the last part of the small intestine, before it joins the colon) as well as anus, but can occur anywhere along the GI tract, including stomach, colon, other parts of the intestine, etc. In contrast, ulcerative colitis, is generally limited to the colon only (does not involve anus, small intestine, stomach, or esophagus). Due to this key difference, surgery is considered "curative" in the case of Ulcerative colitis, but not in Crohn's. In Ulcerative colitis, the colon can be taken out and because it does not occur in any other part of the GI tract, it is considered "curative." This is in quotations, because there are possible other extraintestinal effects of Ulcerative colitis that may or may not improved if you have them (e.g. associated arthritis usually improved, whereas the risk of primary sclerosing colangitis does not). For Crohn's, surgery is generally reserved for complications of the diseases such as perforations and fistulas, and is not curative. I strongly urge you to talk to your colorectal surgeon and gastroenterologist regarding your IBD and explore all medical and surgical options prior to making any decisions.

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