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.
Ulcerative Colitis Other Therapy
If the patient has been on steroids for a long time, the person may have some added risk because this medication reduces the bone mass. High-impact exercise such as aerobics or running may put too much stress on the fragile bones causing stress fractures or broken bones. Lower-impact exercises may be more appropriate, such as cycling or swimming. A bone density screening arranged through a doctor can look at bone mass and assess if the patient is at risk. Strength training (resistance activity) with moderate weights or machines, even stretch bands, may help build bone density.
Traveling with ulcerative colitis can be a challenge if the patient feels the need to use the bathroom frequently. Sometimes you simply "can't wait," so experts have some prudent suggestions:
- Become aware of public toilets where you are traveling and plan your day's activities so you have a comfort level (and another adult to watch the children) in being close to a toilet facility.
- Carry a card that says I can't wait and explains that you have a medical condition in which you urgently need to use the bathroom. If you encounter a long line and are desperate, hand the card to the first person in line.
- Look for familiar and usually clean roadside toilet facilities such as at fast-food places.
- Airplane travel presents its own challenges. If you're not traveling first class, know that the toilet facilities up front are usually not as crowded as those in coach class. Explain your concerns to the flight attendants when you board: "I probably won't have to use the facilities up front, but in case I do, I have a medical condition, and I can't wait in line."
- If trip anxiety makes you even more anxious about accidents, do wear an adult diaper. Women may opt for a maxipad or panty shield. Pack and bring an extra change of underwear and pants in your carry-on and keep them with you in a day-pack while sightseeing.
- Some foods may be unfamiliar and their effects uncertain. Know what foods you are eating. Buy familiar items at local grocery stores and carry them with you on tours if you're just not sure you want to tackle the native cuisine or worry that it may trigger your condition.
More than 20% of patients will try alternative medicines to help treat ulcerative colitis. There is no evidence, as yet, that probiotics, fish oil, spices, and acupuncture are beneficial.
Medically Reviewed by a Doctor on 4/7/2016
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