Design: Systematic review and meta-analysis (1 RCT, 17 observational)
Population: Adults with IBD undergoing colorectal surgery
Primary outcome: Length of stay, readmissions, reoperations, complications
Effect: LOS −1.62 days (−2.03 to −1.21); readmission OR 0.83 (0.62–1.12)

A systematic review in Colorectal Disease included 18 studies — one randomised trial and 17 observational — comparing enhanced recovery (ERAS) pathways with conventional care in adults having colorectal surgery for inflammatory bowel disease.

Length of stay was shorter with ERAS (mean difference −1.62 days, 95% CI −2.03 to −1.21; moderate certainty). Readmissions (OR 0.83), reoperations (OR 0.68) and complications (OR 0.69) did not differ significantly, with low to very low certainty.

Patients with IBD have often been left out of ERAS evidence because of malnutrition, steroids and complex disease. This review suggests the pathways are safe to apply to them and shorten admission.

Include IBD patients in colorectal ERAS pathways.
Address nutrition, anaemia and steroid exposure before elective surgery.
Expect a shorter stay without more readmissions.
Most evidence is observational; procedure-specific pathways need testing.

Why it matters

IBD patients have been treated as exceptions to ERAS without evidence that they should be.

The statistics, in plain English

A mean difference of −1.62 days means stays averaged about a day and a half shorter. Odds ratios for complications below 1.0 with intervals crossing 1.0 mean no clear difference.