Surgical Management of Ulcerative Colitis

Ulcerative colitis is a lifelong disease arising from an interaction between genetic and environmental factors, observed predominantly in the developed countries of the world. The precise etiology is unknown and therefore medical therapy to cure the disease is not yet available. Patients may live with a considerable symptom burden despite medical treatment (66% describe interference with work and 73% with leisure activities) in the hope that the etiology of ulcerative colitis will shortly be revealed and a cure emerge. Despite randomized trials there will always be many questions that can only be answered by the exercise of judgement and opinion, ⁽¹⁾.

Currently several national guidelines are available, most of which are not updated. The guidelines committee of GDG decided in 2025 to develop a national guideline for the surgical management of ulcerative colitis and its complications, acknowledging that it will be a compromise of American Society of Colon and Rectal Surgeons (ASCRS) guidelines, ⁽⁴⁾, European Crohn’s and Colitis Organization (ECCO) guidelines, ⁽⁵⁾ and the Mexican consensus on the diagnosis and treatment of ulcerative colitis 2018, ⁽⁶⁾.