Surgical indications in ulcerative colitis and Crohn disease

Despite the progress made in recent years, treatment of chronic inflammatory bowel disease remains problematic. The highly individual spontaneous course of such conditions always makes an interdisciplinary management strategy mandatory. In view of the fact that continence-preserving procedures are possible in ulcerative colitis as well as bowel-preserving procedures in Crohn's disease, elective interventions in patients who fail to respond to what is accepted as suitable medication may be considered supplementary to the therapeutic spectrum. A consideration of all the factors involved suggests that too many reservations vis-a-vis surgery are no longer justified.