Surgical treatment of inflammatory bowel disease: From the gastroenterologist’s stand-point

Table 2 Main indications for surgery in ulcerative colitis

Indications	Treatment
Emergency situations
Acute severe UC refractory to medical treatment	70% of patients will eventually need surgery
Uncontrollable sepsis
Colonic perforation	Surgery – antibiotics
Toxic megacolon	Emergency operation
Severe bleeding	Emergency operation. Colectomy should not be delayed
Elective indications
Dysplasia	Endoscopic surveillance with targeted biopsies for early detection. In cases of dysplasia endoscopic resection and continued surveillance. Surgery for unresectable dysplasia, and multi-focal low-grade dysplasia
Cancer	Surgical treatment
Medically refractory disease	Surgical treatment (preferably IAPA)

UC: Ulcerative colitis; IAPA: Ileo-anal-pouch anastomosis.