IBD, Ulcerative Colitis and Crohn’s Disease Treatment

At Weill Cornell Medicine, we understand that living with Inflammatory Bowel Diseases (IBD), ie: Ulcerative Colitis (UC) and Crohn’s Disease (CD) can be physically and emotionally challenging. The disease often presents differently in individual patients, and a personalized approach is necessary.  Treatment may include some or all of the following: medications, surgery, nutrition, wound care/ostomy care, and various other subspecialties.  Our expert colorectal surgeons are here to provide compassionate and targeted surgical treatment in collaboration with a multidisciplinary team.  This unique multidisciplinary approach coordinates complex care, providing you with focused support.  Our goal is to conserve as much bowel as possible, lessen disease complications, and help you achieve the best possible quality of life.  Our team offers the most advanced and comprehensive surgical treatments available for these conditions, including minimally invasive colon and rectal surgical procedures.

Surgery is indicated for complications of the disease (eg: bleeding, perforation, obstruction, fistulas), for severe disease that does not respond to medical management, if medications are poorly tolerated, or as an alternative to medical management. You may consider surgery if your quality of life has been severely impacted despite medical treatment or if the side effects of the medications are significant.

For patients with Ulcerative Colitis (UC), surgery may be necessary if the patient experiences a sudden, severe UC attack that cannot be controlled with medication. Surgery usually involves the removal of the colon and rectum. This is called a proctocolectomy, which might be performed as a series of surgeries including:

• Total abdominal colectomy with end ileostomy:  The colon is surgically removed and an ileostomy is created through the abdominal wall (called a stoma).
• Proctocolectomy with ileal pouch-anal anastomosis: In this procedure, the colon and the rectum are removed, but the anus and anal sphincter muscles are preserved. The last portion of the small intestine (the ileum) is folded on itself and fashioned into a pouch, that acts as a reservoir to contain the stool prior to defecation.  This eliminated the need for the external bag.

For patients with Crohn’s disease (CD), surgery may be necessary if there is intestinal obstruction or blockage, excessive bleeding in the intestine, perforation of the bowel, or a fistula. The type of surgery needed will depend on the disease and the location of the disease in the gastrointestinal (GI) tract.

• Strictureplasty: A stricture (a narrowed section of the intestine due to chronic/recurrent inflammation that causes the GI tract walls to thicken or form dense, stiff, scar tissue) can lead to narrowing of the intestine, intestinal blockage. This surgical procedure repairs the stricture by widening the narrowed section without removing any part of the intestine.
• Small and/or large bowel resection: This procedure removes the damaged portion of the digestive tract and reconnects the healthy bowel upstream and downstream.
• Colectomy: The colon (large bowel) is surgically removed.
• Proctocolectomy: The entire colon and rectum is removed.
• Fistula surgery: Fistulas develop when inflammation causes extension through the bowel wall, creating an abscess, or a collection of pus.  These tracts may extend to neighboring structures.  Fistula removal surgery may be necessary to remove the diseased segment of the intestine and separate it from the neighboring structures (which may or may not require resection of the secondarily involved structure.

Perianal fistulizing disease develops from the anorectum to the surrounding perianal skin.  Abscesses (collections of pus) may require surgical drainage with incision and drainage. If there is incomplete healing or recurrent abscess formation, a persistent fistula tract is suspected and may require additional treatment.

When you choose Weill Cornell Medicine, you have access to specialists in gastroenterology and hepatology, colon and rectal surgery, radiology, laboratory medicine and pathology, and rheumatology, as well as skin and wound care and nutrition.

At Weill Cornell Medicine and NewYork-Presbyterian, we do everything we can to support our patients and their loved ones before, during and after treatment. Learn more about what to expect during your stay.

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Whether you visit us virtually through a video visit or you see us in person, you can be assured that we will deliver the highest standards of care with compassion. Our team has taken every step to keep our facilities safe for you to continue your care. Learn more about our safety measures and the changes we’ve made to enhance your patient experience.

To request an appointment, please fill out our form. Our staff will help you find the physician who best fits your individual medical needs.

Meet Our Surgeons

The physicians at the Weill Cornell Medicine Colon and Rectal Surgery Division offer patients the highest level of safety and care. As a top-ranked academic medical center, you have access to our extensive network of specialists who provide seamless care throughout your treatment — to promote long-term physical and mental health.