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Medical and Surgical Management of Chronic Ulcerative Colitis
Robert R. Cima, MD;
John H. Pemberton, MD
Arch Surg. 2005;140:300-310.
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INTRODUCTION
Idiopathic inflammatory bowel disease is divided into 2 major disease processes, Crohn disease (CD) and chronic ulcerative colitis (CUC). Often, both diseases are characterized by intermittent exacerbation of symptoms and periods of remission that may occur spontaneously or in response to treatment. The etiology of these diseases is unknown but most likely represents an interaction between the environment and host genetic susceptibility. Both medical and surgical treatment are used in the treatment of CD and CUC. However, given the different distribution of disease activity along the intestinal tract and the nature of the inflammatory process, the role and scope of medical and surgical management for each specific disease are different. Crohn disease may arise anywhere along the length of the intestine. It is characterized by transmural inflammation of the bowel wall. Such inflammation leads to a unique set of complications, including abscess . . . [Full Text of this Article]
AMINOSALICYLATES
GLUCOCORTICOIDS
IMMUNOSUPPRESSANTS
BIOLOGIC AGENTS
TREATMENT FOR SPECIFIC DISEASE ACTIVITY
SURGERY FOR CUC
EMERGENCY SURGERY
ELECTIVE SURGERY
Indications Ileal Pouch–Anal Anastomosis
CONTROVERSIES
Stapled or Hand-Sewn IPAA Diverting Ileostomy Age Fertility Laparoscopic IPAA
COMPLICATIONS AFTER IPAA
Early Complications Late Complications Pouchitis Pouch Failure
FUNCTIONAL RESULTS OF IPAA
CONCLUSIONS
AUTHOR INFORMATION
Author Affiliations: Division of Colon and Rectal Surgery, Mayo Clinic, and Department of Surgery, Mayo Clinic College of Medicine, Rochester, Minn.
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