When is surgery necessary for ulcerative colitis

Correct assessment and optimised medical treatment are prerequisites for surgery on accurate indications and good surgical results. Therefore, close interactions between gastroenterologists and colorectal surgeons are mandatory for optimal patient outcome. Abstract Surgery continues to play an important role in the therapeutic arsenal in ulcerative colitis. Publication types Review. Slow growth or other serious complications occur in a child. Compare your options.

Compare Option 1 Have surgery to remove your colon Keep taking medicine. Compare Option 2 Have surgery to remove your colon Keep taking medicine. Have surgery to remove your colon Have surgery to remove your colon Surgery is often done in two parts, up to 2 weeks apart. After each surgery, you will stay in the hospital for several days.

Recovery from surgery takes 1 to 2 weeks at home. After surgery, depending on the type, you may wear an ostomy bag to remove waste. Surgery cures ulcerative colitis. Surgery prevents colon cancer or can cure it if the cancer has not spread beyond the colon.

Problems that can occur during or after surgery include: Blockage of the small intestine. Swelling in the pouch created from the small intestine. Leakage of stool. An infection in the pelvis or belly. Trouble with bladder control incontinence.

All surgeries carry risks, such as bleeding, nerve damage, and anesthesia. Your age and your health can also affect your risk. Keep taking medicine Keep taking medicine You take medicines, including steroids, for symptoms, to control the disease, or to keep it in remission.

You may need to try different kinds of medicines to find the right ones that work for you. You will keep seeing your doctor as recommended while your condition is stable and more often if you're having problems. Medicine can relieve symptoms and help you control the disease.

You avoid the risks of surgery. You may not be able to control all of your symptoms with medicines, especially if they are very bad. Some medicines for ulcerative colitis can cause side effects, such as cataracts or osteoporosis. Medicines do not cure ulcerative colitis or prevent colon cancer. Personal stories about surgery to cure ulcerative colitis These stories are based on information gathered from health professionals and consumers.

What matters most to you? Reasons to choose surgery Reasons to keep taking medicine. I can't control my symptoms with medicine. Medicine controls my symptoms. I accept the risks of surgery. I'm worried about the risks of surgery. I'll do whatever it takes to get rid of this disease.

I don't want to have surgery for any reason. I want to remove any risk of getting colon cancer. My other important reasons: My other important reasons:. Where are you leaning now? Having surgery Taking medicine. What else do you need to make your decision? Check the facts. Yes You're right. Most people who have mild colitis can control their symptoms with medicine. No Sorry, that's not right. I'm not sure It may help to go back and read "Get the Facts.

There is a cure for ulcerative colitis. It's surgery to remove the colon and the lining of the rectum. Surgery removes the risk of colon cancer. Yes Sorry, that's not right. Preparing for colectomy surgery may be different for each person. There will be several steps that might be taken before having surgery. Check with a physician about how to prepare to have this surgery. Most people who have surgery for ulcerative colitis are referred from their gastroenterologist. The surgeon that will complete the surgery is most often a colorectal surgeon , who specializes in surgery of the digestive system.

An enterostomal therapy nurse ET nurse will be helpful before and after surgery to place an ileostomy. An ET nurse will help decide where the stoma will be placed and will make suggestions on which type of appliance will work best. Surgeries for ulcerative colitis are performed in a hospital.

There will be a hospital stay of several days after the surgery and for each step if a j-pouch is being created. Comfortable clothes should be worn. You will wear a hospital gown, but you may want to bring your own socks, slippers, and a robe or comfortable pants. Because this is surgery on the digestive system , there will be a need to fast beforehand.

There might also be a prep prescribed , in which the bowel is cleaned out with special laxatives. After surgery, there may be one or more days of fasting or drinking only clear liquids. Your diet will gradually expand. Before surgery, you may have to stop taking some medications.

You may need to start other medications, such as antibiotics, prior to surgery. The surgeon will give a complete list of what to do concerning your current medications and prescribe any that are needed before surgery. It's important to tell your medical team about all the medications and supplements you take.

Even over-the-counter vitamins and herbal remedies. It might be necessary to stop certain supplements in the days leading up to surgery.

Because a hospital stay is involved, patients will want to bring some items, such as eyeglasses, a cellphone and charger, headphones, and a book or other activity to pass the time. Patients will not be able to drive, so someone will be needed to take them home after being discharged.

Patients will be encouraged to stop smoking before surgery. In some cases there may a need to make other changes, such as focusing on nutrition and weight management. As surgery for ulcerative colitis requires at least one and possibly three hospital stays, it comes at a higher cost than procedures that can be done as outpatient surgery. Check with your insurance provider to find out how much will be covered and what co-pays may be required.

Using a hospital and surgical team in your plan's network is key to preventing any unexpected charges. On the days leading up to surgery, you will be in touch with the surgical team and other healthcare professionals. Patients will have their vital signs, such as blood pressure, heart rate, and temperature, taken and monitored before surgery and throughout the process.

An intravenous IV, through a vein line will be started to administer fluids and any medications that are needed. Patients will be wheeled from the presurgical area into the operating room. General anesthesia will be given. There may also be an epidural given for pain control. Each of the surgeries will take several hours.

The surgery to create the j-pouch will be the longest surgery. Patients will spend some time in a recovery area before being taken to a hospital room.

If an ileostomy is placed, patients will wake up with a stoma. There will be an ileostomy appliance over the stoma to collect waste. The hospital staff will help in emptying the pouch and in teaching you how to change it over the course of the hospital stay. Patients often will have pain management with a pain pump connected to their IV. The nursing staff will give instructions on how to use the pump.

After surgery to connect a j-pouch, patients will be encouraged to try to use the bathroom. Diet will be advanced from liquids to solids as recovery continues. The surgeries to treat ulcerative colitis are major abdominal operations.

Recovery takes place over several weeks. It's important to talk to your medical team about getting back to driving, housework, and other activities that might engage the abdominal muscles.

For open surgery, you will have a large incision that requires care , including changing a dressing. For laparoscopic surgery, there will be several smaller incisions. Baths might not be recommended until the incision has somewhat healed. UC usually is mildly active but it can be a life-threatening condition because of colonic and systemic complications, and later in the disease course due to the development of colorectal cancer. Interestingly, even if pathogenetic features detected in patients with sporadic CRC can be also found in UC-related colorectal cancer UC-CRC , this latter is, usually, driven by an inflammation-driven pathway rising from a non-neoplastic inflammatory epithelium to dysplasia to cancer.

Thus, a long-term follow-up with colonoscopy surveillance has been recommended. The initial treatment strategy in UC typically follows the traditional step-up approach.