Inflammatory bowel disease (IBD) is a general term for a group of chronic conditions that cause inflammation and swelling in the digestive tract. Although both involve inflammation, they affect different parts of the gastrointestinal tract and behave differently over time, explains Dr. Kellie Mathis. Crohn's disease primarily affects the small intestine and often involves the deeper layers of the digestive tract, and it is also associated with weight loss. "Some people have a mild form of the disease, while in others it can be debilitating and lead to potentially fatal complications," adds Dr. Mathis. "However, surgery may become necessary when medications are no longer effective, are not well-tolerated, or when complications arise." In the case of ulcerative colitis, a colectomy, the removal of the entire colon and rectum, is performed when medications are not working or when complications such as perforation, obstruction, or cancerous changes occur, says Dr. Mathis. Surgery may also be necessary for problems like fistulas, intestinal obstructions, or perforations. "Surgical decisions are individualized and must be made in collaboration between the patient, the gastroenterologist, and the surgeon," adds Dr. Mathis. Kellie Mathis, a colorectal surgeon at Mayo Clinic, explains the symptoms, diagnostic methods, and treatment options for patients with inflammatory bowel disease. Ulcerative colitis typically affects the colon and rectum and leads to the development of sores called ulcers. During this procedure, the surgeon removes the damaged part of the digestive tract and reattaches the healthy sections. The goal is always to improve your quality of life, reduce symptoms, and prevent complications," says Dr. Mathis. "Most people with IBD are initially treated with medications. But, in most cases, there is time for careful discussion and planning, says Dr. Mathis." "Sometimes, the creation of this internal pouch is not possible; in these situations, a permanent surgical opening in the abdomen, called an ileostomy, is created, explains." "Up to two-thirds of people with Crohn's disease will require at least one surgery in their lifetime," states Dr. Mathis. To confirm the diagnosis, her medical team may recommend: Blood tests to detect signs of inflammation, anemia, or infection; Stool tests to rule out infections and detect markers of inflammation; Endoscopic procedures, such as: Colonoscopy, which allows doctors to visualize the entire colon and take biopsies, or flexible sigmoidoscopy, used when the colon is too inflamed to perform a full colonoscopy; Upper endoscopy, if symptoms involve the upper gastrointestinal tract; Video capsule endoscopy, in which a small camera is swallowed to examine the small intestine; Balloon-assisted enteroscopy, which is used to explore deeper parts of the small intestine. A biopsy, a small sample of tissue taken during an endoscopy, is essential to confirm the diagnosis and distinguish IBD from other causes of inflammation, states Dr. Mathis. Factors influencing the decision include: The severity and location of the disease; The response to medications; The overall health and nutritional status; Quality of life and personal preferences; In urgent situations, such as a bowel perforation or severe bleeding, surgery must be performed immediately. "If you are facing surgery for IBD, know that you are not alone — and that you are not without options, says Dr. Mathis. Seek care at centers like Mayo Clinic, which have extensive experience in treating IBD and offer collaborative and compassionate care, tailoring the treatment plan to your specific needs."
