Does Surgery For Crohn’s Or Ulcerative Colitis Improve Quality of Life?

It is not a surprise for anyone with Crohn’s disease or ulcerative colitis (UC) to read that the conditions can impact a person’s quality of life. For some, IBD may be well-controlled and manageable. However, for many others, quality of life can be incredibly affected, and not in a positive way.

A variety of treatment options can be used to attempt to better control IBD. Some of these are medical or non-invasive, including medicines, supplements, and more. Other options are aggressive, including surgery.

Even within the category of surgery, there are a variety of different procedures for IBD. Each type of surgery can carry its own risks and benefits and impact quality of life differently.

We conducted our 5th Annual IBD In America Survey to gain a better understanding of the surgical procedures and outcomes that affect people with Crohn’s and UC. More than 1,200 people completed the survey and provided an interesting look at how those procedures and outcomes impact the quality of life.

How many people with IBD have surgery?

Overall, about 43 percent of survey respondents reported having some sort of surgery to treat their IBD. More specifically, more than 60 percent of those with Crohn’s said they had surgery, while 16 percent of those with UC reported the same.

Most common surgeries performed for Crohn's and UC

Those who reported having surgery for their Crohn’s or UC had a variety of different procedures for treating their condition or its symptoms. In some cases, respondents had more than 1 procedure.

The most common surgery those with IBD reported having was a colectomy (bowel resection). Colectomy, ileostomy, and hemorrhoid surgery were tied for the most common procedures for those with UC.

Most common surgeries for Crohn’s

• Colectomy (bowel resection) – 42 percent
• Abscess drainage – 24 percent
• Bowel obstruction repair – 22 percent
• Fistulotomy (surgical treatment for fistulas) – 18 percent
• Ileostomy – 14 percent
• Lysis of adhesions (removal of scar tissue) – 13 percent
• Stricturoplasty – 13 percent

Most common surgeries for UC

• Colectomy (bowel resection) – 4 percent
• Ileostomy – 4 percent
• Hemorrhoid surgery (such as hemorrhoidectomy, stapling) – 4 percent
• Ileal pouch-anal anastomosis (IPAA) or restorative proctocolectomy – 3 percent

Other surgical procedures reported by respondents included colostomy, proctocolectomy, and lateral internal sphincterotomy (fissure repair).

The most common treatment options used prior to surgery for those with both Crohn’s and UC included:

• Corticosteroids
• Antibiotics
• Biologic drugs
• Immunosuppressants or immunomodulators
• Aminosalicylates (5-ASA)
• Pain medicines, including NSAIDs

Common non-IBD-related surgeries reported by survey respondents included appendectomy, gallbladder removal, and hysterectomy.

Why do people with IBD get surgery?

Choosing to undergo surgery is a complicated decision that depends on a variety of factors. Over 50 percent of respondents who underwent surgery did so after their healthcare provider recommended it. This was the most common reason for having an operation.

The next most common reasons were that it was for an emergency or because symptoms were no longer bearable. These 2 reasons were cited by about 40 percent of all respondents. About 25 percent underwent surgery because they felt it had a high chance of treating their symptoms.

Additionally, more than 10 percent of respondents with UC said they underwent surgery to reduce their chances of developing colorectal cancer in the future.

Improvement in quality of life after surgery

Ultimately, regardless of the type of surgery experienced, nearly 66 percent of respondents reported having at least some improvement in their quality of life following their procedure. Quality of life was significantly improved for 37 percent of those with Crohn’s and 27 percent of those with UC after surgery.

These results suggest that although many different surgeries can be pursued for IBD and for a variety of different reasons, overall satisfaction is relatively high.

The 5th Annual IBD In America survey was conducted online from June to September 2020. 1,260 people with IBD completed the survey.