Inflammatory bowel disease is a group of conditions that result in inflammation of the small and large intestines. This group of problems is most commonly managed by medical specialists called gastroenterologists.

The two most common types of inflammatory bowel disease in children are Crohn’s disease and ulcerative colitis.

Crohn's Disease

What are the reasons a patient may need surgery for Crohn’s disease?

Although Crohn's disease cannot be cured with surgery, many patients will require surgery at some point following their diagnosis.

Examples of when surgery may be needed include:

• Perforation (hole) in the intestines
• Significant bleeding, obstruction (blockage of the intestines)
• Abscess (pus) formation
• Fistula formation
• Unresponsiveness of the disease to maximal medical therapy

Johns Hopkins All Children's Hospital's Surgeons work closely with each patient's gastroenterologist and pediatrician to determine if the child will benefit from surgery.

What are the goals of surgery for Crohn’s disease?

• In most Crohn's disease cases, surgery is done to remove the piece of the intestine with the most severe disease. The goal is to relieve the symptoms, but the surgeon also aims to leave as much of the intestine behind as possible. 
• In some cases, an entire section of the intestine may need to be removed, and the ends of the healthy intestine are sewn back together. This is called intestinal resection. 
• If there is a small area of narrowing in the intestine that is causing the problem, a stricturoplasty can be performed. Stricturoplasty does not require portions of the intestine be removed, but instead widens the narrow area to relieve the symptoms.

Ulcerative Colitis

What are the reasons my child may need surgery for ulcerative colitis?

Ulcerative colitis can be surgically cured for both children and adults, in many cases. Reasons for surgery may include:

• Disease unresponsive to medical therapy
• Problems with growth
• Significant bleeding
• Perforation (hole) of the intestine
• Prevention of cancer growth

Johns Hopkins All Children's Hospital's Surgeons work closely with each patient's gastroenterologist and pediatrician to determine if the child will benefit from surgery.

What are the goals of surgery in ulcerative colitis?

To surgically cure ulcerative colitis, the entire colon and its lining must be removed, and the remaining intestine reconnected. Often times, an ostomy (intestine that opens on the abdominal wall) is needed for a temporary amount of time to obtain the best surgical results.