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Background Colectomy for IBD significantly impacts the psycho-social aspects &amp; quality of life. Methods Electronic records were retrospectively analysed for colectomy rates &amp; parameters of interest. Results 68 patients (Men 37:Women31), median age 30 years had colectomies. Annual colectomy rates remained constant;7 (2015), 20 (2016), 11 (2017) &amp; (2018) each and 19 (2019). 28% had colectomy within 1 year of diagnosis and only 63% received a biologic agent. Over half, (54%)had emergency surgeries &amp; 37% experienced infections, re-laparotomy and ileus (20% each). Conclusion There is an opportunity to risk-stratify patients at diagnosis based on the risk factors (men, younger age, severe/extensive disease) to a top-down therapy &amp; treat to target strategy to reduce colectomy rates.

journal of crohn's and colitis

P253 Are we doing enough to prevent colectomy in Inflammatory Bowel Disease (IBD) patients? A 5-year review of colectomy rates in Shropshire and Mid-Wales UK (2015–2019)