Ulcerative colitis indications and timing for surgery

Surgery continues to have a major role in the management of ulcerative colitis because it may save the patient's life, eliminate the long-term risk of cancer, and most important, abolish the disease. Treatment of ulcerative colitis still remains the challenge despite growing knowledge about the disease, advances in medical treatment and surgical techniques. Indications and optimal timing for surgery are the mainstays of good outcome and are as important as the quality of medical therapy and surgery. Ulcerative colitis is a complex disease where medical and surgical treatment frequently overlap and clinical decision making should be in hands of well trained and experienced team consisting of surgeon, gastroenterologist, radiologist and pathologist. Recently developed drugs, with high potential in the treatment of severe attacks of ulcerative colitis brought some changes in therapy and indications for surgical treatment. Although as many as half of patients with inflammatory bowel disease require at least one surgical procedure to address complications derived from their disease, the decision in favor of a surgical approach and its timing is rarely an easy one.