Inflammatory Bowel Disease V: Surgical Management

Surgical interventions for IBD include the following:

Strictureplasty treats small bowel strictures by widening narrowed sections while preserving intestinal integrity. If specific sections are severely affected, a small bowel resection may be performed, removing diseased parts and reconnecting the healthy bowel segment.

For severe ulcerative colitis, a proctocolectomy or total colectomy with ileostomy is often required.

A proctocolectomy removes the colon and rectum, while a total colectomy removes only the colon. An ileostomy is then performed, creating a stoma in the ileum to drain bowel contents outside the body.

Furthermore, in restorative proctocolectomy with ileal pouch-anal anastomosis, the colon and rectum are removed, but the anal sphincter is preserved. An internal pouch is then created from the small intestine to restore gastrointestinal continuity.

Lastly, continent ileostomy, another option, involves proctocolectomy. It utilizes 30 to 45 cm of the terminal ileum to create a Kock pouch, diverting a portion of the distal ileum to the abdominal wall and creating a stoma.