What is IBD?
Inflammatory bowel disease (IBD) is a chronic, or life-long, condition that causes your immune system to attack the digestive tract, creating inflammation and sometimes painful or disabling symptoms. About 3 million Americans live with IBD, and numbers are rising worldwide. There are two main types:
- Crohn’s disease – can affect any part of the GI tract
- Ulcerative colitis – affects only the colon (large intestine)
IBD flares (relapse) mean times when symptoms worsen. Remission means your symptoms are controlled.
Common symptoms include:
- Diarrhea (sometimes with blood).
- Abdominal pain or cramping.
- Rectal bleeding.
- Fatigue.
- Weight loss.
Why might you be hospitalized for IBD?
Empowering you with information from the latest AGA Clinical Practice Update (Cohen-Mekelburg et al., 2026)
Hospitalization for IBD is less common these days, but sometimes needed when:
- Symptoms get very severe.
- Complications arise (like bowel obstruction, perforation, abscess).
- Nutritional concerns (failure to thrive or dehydration).
Typical reasons for admission:
- Severe disease not responding to routine treatment.
- Suspected serious complications.
- Significant nutritional risk.
Your hospital care team might include:
- Gastroenterologists.
- Surgeons.
- Advanced practice providers (nurse practitioners and physician associates).
- Dietitians.
- Nurses and pharmacists.
- Other specialists as needed.
What should you expect during hospitalization?
AGA’s updated clinical practice advice stresses a team-based approach and shared decision-making. Here’s what you should expect.
- IV fluids and electrolyte management
- Treatment for anemia
- Nutrition screening and referral
- Blood tests for vitamin deficiencies (B12, D, iron)
- Stool tests for C. difficile (a GI infection that may mimic or worsen to flare symptoms)
- Possible testing for cytomegalovirus (CMV, a virus that takes advantage of immunosuppressed patients) if symptoms persist or worsen
- Blood tests for markers of inflammation (CRP, leukocyte count, platelets, albumin)
- Possible flexible sigmoidoscopy or colonoscopy
- Focus on treating underlying causes (e.g., bowel obstruction, abscess, inflammation)
- Preference for non-opioid pain medicines
- Use non-steroidal anti-inflammatory drugs (NSAIDs) with caution, as they may worsen bowel inflammation in some individuals with IBD.
- Neuromodulators may be used for chronic pain
You will receive blood thinners (medicine to help prevent clots, such as venous thromboembolism/VTE)
Special hospital treatments by diagnosis
- Intravenous (IV) corticosteroids to quickly reduce inflammation
- Assessment over 3-7 days for improvement
- Rescue therapy (infliximab, cyclosporine, JAK inhibitors) if steroids don’t work
- Surgical consult if colectomy (surgical removal of colon) may be needed (10% of hospitalized UC patients)
- Intestinal blockage: Bowel rest, IV fluids, nasogastric decompression, possibly steroids or surgery
- Abscess: Antibiotics, drainage if possible, nutritional support, and possibly IV nutrition
- Perianal disease: Combined medical/surgical treatment, antibiotics, anti-TNF therapy
Take an active role: Communication & shared decisions
You are the most important member of your care team!
Planning for discharge: Lowering your risk for readmission
To ensure your safety after you leave the hospital:
- Your care team will stabilize your condition before discharge.
- You’ll receive a transition plan, including medication changes, follow-up appointments, and resources to address your questions about medications, costs, and transportation.
For more information
Talk with your medical team about any concerns or questions—your participation is key to your health and comfort!
Learn more about IBD and hospitalization:
Stay informed, stay active, and don’t hesitate to ask—because an educated patient is an empowered patient!
Written by
Shirley Cohen-Mekelburg, MD, MS
Assistant professor, Division of Gastroenterology & Hepatology, Department of Internal Medicine, Michigan Medicine, Ann Arbor
Reference
- Cohen-Mekelburg et al. AGA Clinical Practice Update on Inpatient Management of Adults with Inflammatory Bowel Disease: Expert Review. Gastroenterology 2026: 170; 408-417. https://www.gastrojournal.org/article/S0016-5085(25)05986-4/fulltext
Written February 2026