IBD Surgery

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Contact the Inflammatory Bowel Disease Center

  • 1-617-355-6058
  • International: +01-617-355-5209

We understand that no one wants to hear that they or their child may need surgery. We make that recommendation only when absolutely necessary to make a patient well.

Patients with IBD who opt for surgery are in the hands of a surgery team with unmatched skill and expertise. Our pediatric GI surgeons consistently rank no. 1 in the country, according to US News & World Report.

When is IBD Surgery Necessary?

Expert drug therapy and nutrition counseling are the cornerstones of the treatment plans we develop for every patient.

However, in severe or complex cases we may recommend surgery when we feel a patient’s quality of life is severely impacted by their condition – due to constant pain and discomfort or the potential for severe internal damage.

There are many reasons why we may recommend surgery as the next step. You or your child may:

  • Not respond to medication
  • Stop responding to medication – even if it worked previously for a period of time
  • Have significant side effects from medications
  • Experience life-threatening complications from his IBD

The decision to have surgery is a joint one, made between the patient, family members, your gastroenterologist and the surgeon.

Ulcerative Colitis Surgery

About 20 percent of children with ulcerative colitis will eventually need surgery – either as a teen or young adult. When patients opt to move forward with surgery, they often find relief from their symptoms and go on to lead normal, healthy lives.

Many of our ulcerative colitis patients who underwent surgery have shared their personal treatment stories with us. Read our IBD patient stories.

The decision to move ahead with surgery is a significant one, as it requires undergoing and recovering from two surgeries several months apart.

Proctocolectomy and J-pouch reconstruction

Proctocolectomy is a surgical procedure that removes the colon and rectum. Traditionally, it resulted in the creation of a stoma – a small opening in the abdomen through which waste collects in an external pouch called an ostomy bag.

At Boston Children’s, our goal is for you or your child to avoid the need for a permanent ostomy bag.

We perform ileal anal anastomosis (IPAA), also called J-pouch reconstruction, to preserve the ability to use the bathroom normally without the need for an external bag.

  • Stage 1: The surgeon removes the colon and rectum and uses a small section of the intestine to create a J-shaped pouch to replace the rectum. You or your child will have a temporary ileostomy (hole in the abdominal wall) through which the lower intestines will drain waste into an ostomy bag.
  • Stage 2: Two or three months later, the surgeon removes the ileostomy and attaches the lower intestines to the rectum, which allows for normal bowel movements.

Pediatric Crohn’s Surgery

Surgery for Crohn’s disease can keep patients feeling well and minimize damage to the intestine. It is not a cure, because the inflammation caused by this disease can re-occur anywhere along the digestive tract.

Surgeries your IBD team may recommend include:


Patients with Crohn’s may suffer from painful obstructions called strictures that make it difficult for food to pass through the bowel. Strictureplasty is a minimally invasive, bowel-sparing alternative to removing a section of intestine. Instead, our surgeons widen the section of bowel narrowed by strictures and remove the scar tissue.

Partial intestinal resection

Intestinal resection is one of the most common surgeries performed on patients with Crohn’s disease. Partial resection is a procedure in which the surgeon removes a section of the intestine affected by Crohn’s and re-attaches the two healthy segments (an area called an anastomosis). Our surgeons utilize laparoscopic (minimally invasive) techniques whenever possible. This approach leads to faster recovery times, less pain, fewer incisions and minimal scarring.

Fistula surgery for Crohn’s

The intestinal inflammation caused by Crohn’s can lead to sore and ulcers called fistulas, through which gastric fluid may leak. We always use medicine first to heal these infections, but in some cases, it does not work. In these cases, surgery closes the intestinal holes and prevents further drainage of gastric fluid.

Surgery to drain abscesses

Patients with Crohn’s may develop abscesses – a collection of pus along the digestive tract or anal area that can lead to abdominal pain and uncomfortable bowel movements. In most cases, our IBD team treats these abscesses with antibiotics. In some cases, we may recommend surgically draining the area for better healing.

Make an Appointment

For more information, appointments or a second opinion, please call the Boston Children’s IBD Center at 617-355-6058 or request an appointment online.

Boston Children’s is so much more than a hospital—it’s a community of researchers, clinicians, administrators, support staff, innovators, teachers, patients and families, all working together to make the impossible possible. ”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital
300 Longwood Avenue, Boston, MA 02115
For Patients: 617-355-6000
For Referring Providers: 844-BCH-PEDS | 844-224-7337