Challenges in the Medical and Surgical Management of Chronic Inflammatory Bowel Disease

Surg Clin North Am. 2015 Dec;95(6):1233-44, vii. doi: 10.1016/j.suc.2015.08.003. Epub 2015 Oct 23.


Inflammatory bowel disease patients will likely come to the surgeon's attention at some point in their course of disease, and they present several unique anatomic, metabolic, and physiologic challenges. Specific and well-recognized complications of chronic Crohn disease and ulcerative colitis are presented as well as an organized and evidence-based approach to the medical and surgical management of such disease sequelae. Topics addressed in this article include intestinal fistula and short bowel syndrome, pouch complications, and deep venous thrombosis with emphasis placed on optimization of the patient's physiologic state for best outcomes.

Keywords: Crohn's disease; Intestinal failure; Intestinal fistula; Intestinal pouch complications; Ulcerative colitis; Venothromboembolism.

Publication types

  • Review

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Anti-Inflammatory Agents / therapeutic use
  • Colectomy / adverse effects*
  • Colonic Pouches / adverse effects
  • Humans
  • Ileostomy / adverse effects
  • Inflammatory Bowel Diseases / complications
  • Inflammatory Bowel Diseases / drug therapy*
  • Inflammatory Bowel Diseases / surgery*
  • Intestinal Fistula / etiology
  • Intestinal Fistula / prevention & control
  • Short Bowel Syndrome / etiology
  • Short Bowel Syndrome / prevention & control
  • Venous Thrombosis / etiology
  • Venous Thrombosis / prevention & control


  • Anti-Bacterial Agents
  • Anti-Inflammatory Agents