Timing of surgery for inflammatory bowel disease

doi:10.1136/bmj.39358.624005.BE

BMJ, doi: 10.1136/bmj.39358.624005.BE, (Published 30 October 2007)

Editorials

Timing of surgery for inflammatory bowel disease

Are thresholds for elective surgery too high?

The first 150 words of the full text of this article appear below.

In their paper on bmj.com, Roberts and colleagues used recordlinkage analysis to compare mortality rates after elective colectomy,emergency colectomy, and no colectomy in people admitted withinflammatory bowel disease.¹ The results are important and indicatethat thresholds for undertaking elective colectomy in clinicalpractice are too high.

The chronic inflammatory bowel diseases—ulcerative colitisand Crohn's disease—affect 1.4 million people in the UnitedStates and 2.2 million people in Europe.² They result in substantialmorbidity, lost days at work, and reduced quality of life. Despitea variety of advances in medical treatment, 20-30% of patientswith ulcerative colitis need surgery at some time,³ while thelifetime risk of surgery for Crohn's disease is as high as 80%.⁴In people with severe inflammatory bowel disease the long termeffectiveness of drugs, such as immunomodulators, rarely exceeds40%. Surgery can be regarded as a cure for ulcerative colitis,albeit an imperfect . . . [Full text of this article]

J D Sanderson, consultant gastroenterologist, G C Parkes, clinical research fellow and gastroenterology specialist registrar

Department of Gastroenterology, Guy's and St Thomas's Foundation Trust, London SE1 7EH

jeremy.sanderson@kcl.ac.uk

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Relevant Article

Mortality in patients with and without colectomy admitted to hospital for ulcerative colitis and Crohn's disease: record linkage studies: Stephen E Roberts, John G Williams, David Yeates, and Michael J Goldacre
BMJ 2007 335: 1033. [Abstract] [Full Text] [PDF]