Ulcerative Colitis: Surgery May Be the Best Choice

Ulcerative colitis patients who had surgery lived longer than those who took medication

(RxWiki News) Sometimes going under the knife can be a good thing.

A new study from the University of Pennsylvania (UP) found that ulcerative colitis (UC) patients who opted for surgical treatment tended to live longer than those who only chose medication.

“UC is a chronic disease that most physicians opt to treat with medications, as opposed to surgery,” said lead study author Meenakshi Bewtra, MD, PhD, an assistant professor of medicine and epidemiology at UP, in a press release. “This new finding highlights a potential unrecognized advantage of a surgical approach to the disease.”

UC is an inflammatory bowel disease, which can cause pain, bleeding and diarrhea. According to the Crohn’s & Colitis Foundation of America, the disease affects as many as 700,000 US patients. Men and women are equally affected, with most patients diagnosed by their mid 30s.

Surgery for UC — such as a colectomy, where a portion of the large intestine is removed — has been considered a last resort in the past.

However, many medications used to treat UC have significant side effects. Steroid medications may increase the risk for infection, while immune-suppressing medications may increase the risk for both infection and cancer.

These medications also don’t control the disease in many patients, according to Dr. Bewtra and team.

Dr. Bewtra and team looked at more than 32,000 patients with UC. Of those patients, 830 had an elective colectomy surgery. The remaining patients were managed with medications.

Those patients who had surgery tended to live slightly longer than those treated with medications. In older patients, these benefits were even more pronounced.

“With this new knowledge, physicians should be empowered to begin a dialogue about surgery earlier in their patients’ course of treatment,” Dr. Bewtra said. “Many patients are afraid of surgical therapy for UC. This study should help them to understand that the benefits of surgery may extend beyond just reducing the symptoms of uncontrolled UC.”

This study was published in the July issue of the journal Annals of Internal Medicine.

The National Institutes of Health and the Agency for Healthcare Research and Quality funded this research.

Dr. Bewtra disclosed a grant from the National Institutes of Health. Study author Mark T. Osterman, MD, disclosed fees from Janssen Pharmaceuticals and Takeda Pharmaceutical Company. Study author Jeffrey R. Curtis, MD, disclosed grants and fees from Roche/Genentech, UCB, Janssen Pharmaceuticals, CORRONA, Amgen, Pfizer, Bristol-Myers Squibb, Crescendo Pharmaceuticals and AbbVie.

These companies may manufacture medications used in the treatment of UC.


Review Date: 
July 13, 2015