Indications for surgery
With ulcerative colitis, emergency surgery is indicated for: (1,2)
- haemorrhage
- perforation
- toxic megacolon
- severe flares which have failed course of high dose steroids, complete bowel rest and intravenous feeding
- development of colonic carcinoma
Elective surgery is indicated for:
- intractable symptoms
- long-standing active disease which increases the risk of carcinoma
- intolerable side effects of medical treatment
- development of mucosal dysplasia
- diagnosis of carcinoma
- colonic stricture
- growth retardation in children
Reference
- NICE. Ulcerative colitis: management. NICE guideline NG130. Published May 2019, reviewed February 2025
- Rubin DT, Ananthakrishnan AN, Siegel CA, et al. ACG clinical guideline: ulcerative colitis in adults. Am J Gastroenterol. 2019 Mar;114(3):384-413.
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