These three abstracts from the 2020 virtual meeting of the American College of Gastroenterology are highly relevant to the treatment of inflammatory bowel disease. The first study pertains to the one-third of patients with ulcerative colitis who still require colectomy, primarily due to refractory disease. As the study shows, biologic agents can significantly reduce the need for colectomy. Although use of biologics in people with ulcerative colitis has increased in recent years, it is my opinion that many patients with severe disease could benefit from earlier treatment with the drugs instead of repeated courses of corticosteroids and aminosalicylates. The findings of the study strongly suggest that for moderate to severe UC, colectomy rates are lower with the more effective biologic therapies, and we shouldn’t persist with the use of nonbiologics in these sicker patients.