Twenty to 30 percent of people with ulcerative colitis will typically require surgery to remove sections of the colon and the rectum (colectomy). This can leave an individual with an altered quality of life, but treatment advances are offering options whereby surgery isn’t necessarily the go-to option

A 20-year study out of Lothian, Scotland, has shown a more than 90 percent drop in the number of people requiring this surgery.

Biologics and small-molecule drugs have reduced the need for surgery over the past two decades. By 2023 these surgeries had become uncommon and advanced therapy use grew.

These treatments, including newer options like vedolizumab and medications that block the activity of Janus kinases, are now often the first thing doctors try — especially for older patients.

And it’s not just about fewer surgeries. The study found that emergency operations also became less common, and there were no signs that newer meds made surgery riskier for those who still needed it.

While researchers can’t say for sure that the drugs were the reason for the drop in surgery, the timing lines up well.

Ultimately, ulcerative colitis care is improving, becoming smarter and significantly less invasive — thanks to modern medicine.

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