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Ulcerative Colitis (cont.)

Ulcerative Colitis Surgery

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.
Medically Reviewed by a Doctor on 12/11/2014
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