Surgical management of inflammatory bowel disease

Inflammatory bowel disease of the colon and gastrointestinal tract predominantly includes ulcerative colitis and Crohn's disease, both of which have characteristic features. The management of these conditions is essentially medical; surgical treatment is reserved for the management of complications or failure of medical therapy. This contribution discusses the principles of surgical management. The basis of surgery for ulcerative colitis is simple: no colon = no colitis. The surgical options include subtotal colectomy, panproctocolectomy with permanent end ileostomy or ileoanal pouch reconstruction. The principles of management of Crohn's disease include conservative surgery (preserve functional bowel length by minimal resection), drainage of sepsis and the preservation of continence.