1. Ulcerative Colitis Slideshow Pictures
2. Digestive Disease Myths Slideshow
3. Take the Ulcerative Colitis Quiz

Medical Author:

Benjamin Wedro, MD, FACEP, FAAEM

Benjamin Wedro, MD, FACEP, FAAEM

Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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Medical Editor:

Bhupinder Anand, MD

Most people with ulcerative colitis will never need to have surgery. However, if surgery becomes necessary, the operation permanently cures ulcerative colitis since the disease only affects the colon and not other parts of the intestinal tract.

Sometimes the doctor will recommend removing the colon if medical treatment fails or if the side effects of corticosteroids or other drugs threaten the patient's health. For the 25% to 40% of people who eventually may have their colons removed because of massive bleeding, severe illness, rupture of the colon, or risk of cancer, various surgical techniques are used. The choice of surgical procedure is individualized based upon the needs of each patient. What is right for one patient may not be the best type of surgery for someone else.

• The most common surgery is a proctocolectomy with ileostomy, where the surgeon removes the whole colon, including the rectum. An ileo-anal anastomosis or pull through operation then connects the small intestine to the anus. This operation does not require a stoma, where the small intestine is pulled through the abdominal wall and empties into a pouch that is attached to the outside of the abdomen.
• The decision to perform the pull through operation as opposed to making a stoma depends upon the patient's situation.
• An ileo-anal anastomosis has the advantage that the patient does not pass the stools into pouch or a bag. However, the bowel movements tend to be more frequent and watery since there is no colon to reabsorb water from the stools.

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