Marita Kametas, DNP, MPH, on Caring for the Surgical IBD Patient

Marita Kametas, cochair of the AIBD NP-PA Institute 2026, reviews key points for advanced practice providers to keep in mind when caring for IBD patients who have undergone surgery, from resection to IPAA to permanent ostomy.

Marita Kametas, DNP, MPH, MSN, APN, FNP-BC, COCN, is an Inflammatory Bowel Disease Advanced Practice Nurse, director of the Advanced Practice Provider IBD Fellowship, and manager of Gastroenterology Advanced Practice Provider Services at The University of Chicago Medicine in Chicago, Illinois. 

Hi, my name is Marita Kametas. I'm the director of the Advanced Practice Program at the Inflammatory Bowel Disease Center at University of Chicago, Director of Chat APP and co-chair of the AIBD NPPA Institute. And today I'd love to talk to you about surgery and IBD.

So when we think about our patients living with inflammatory bowel disease, we think about our medical options to treat them, but sometimes our patients also require surgical intervention. And for those patients, we have to be very thoughtful about surgical considerations, including nutrition, timing of surgery, and the quality of life implications that surgery can have for our patients living with IBD.

There are many different types of surgery in IBD, including strictureplasties, small bowel resections, colonic resections in Crohn's disease, as well as operations in the perianal area to help relieve some of those perianal symptoms, as well as diversion, including ileostomy creation, to help cool down that perianal disease in patients living with Crohn's disease.

In ulcerative colitis, we think about patients that are resistant to medical therapy or patients that have developed dysplasia or malignancy in the colon that require colectomy. That can be done in several stages, and patients will live either permanently or temporarily with an ileostomy, and then may pursue J-pouch creation, which is creating a small bowel reservoir for stool, kind of remnant of a rectum, and thinking about how patients can then defecate on the toilet as they're used to, or many patients end up choosing to live with an ileostomy permanently.

So for our patients with surgery, we have to think about what type of surgery they're undergoing and the timing of surgery as well. We have to be thoughtful about perioperative steroid utilization and what complications that could yield for our patients, as well as nutritional optimization and prehabbing their nutrition in order to give them the best chance possible to be healing after surgery.

So with our patients having surgery, we have to be very thoughtful. We have to think about them comprehensively in terms of their quality of life and their considerations outside of their IBD. And we have to really have that wraparound care from the preoperative, intraoperative, and postoperative setting for our patients. So if you'd like to hear more about surgery and IBD, please join me on the NPPA Institute AIBD page or at our live or virtual conference coming up. Thanks.