What surgery is available to treat ulcerative colitis?
Surgery may be necessary for unremitting chronic disease that would otherwise make the person an invalid or chronically dependent on high doses of corticosteroids. In rare cases, severe colitis-related problems outside the intestine, such as blue-red skin sores containing pus (pyoderma gangrenosum) or severe blood clotting in deep veins of the legs or arms, may make surgery necessary. Surgery for ulcerative colitis usually involves removing the entire colon and the rectum.
Removal of the colon and rectum is the only permanent cure for ulcerative colitis.
Surgery for ulcerative colitis involves removal of the entire colon, regardless of whether all or only a portion of the colon is diseased. Because the colon is being removed, eliminating solid food waste will change. The colon acts as a storage area for waste to be held while water is reabsorbed into the body. Without the colon, stool is eliminated as a more liquid product. Depending on the type of reconstruction done after the surgery, stool is either eliminated through the anus or through an opening in the side of the abdomen called an ostomy
The most common surgery is a proctocolectomy with ileostomy, which is done in 2 stages. The surgeon removes the colon and rectum, then creates a small opening in the abdomen, called a stoma, and attaches the end of the small intestine, called the ileum, to it. Waste will travel through your small intestine and exit your body through the stoma. The stoma is about the size of a quarter and is usually located in the lower right part of the abdomen near the beltline. A pouch is worn over the opening to collect waste. You empty the pouch as needed.
An alternative is the continent ileostomy. In this operation, the surgeon uses the ileum to create a pouch inside your lower abdomen. Waste empties into this pouch, and you drain the pouch by inserting a tube into it through a small, leakproof opening in your side. You must wear an external pouch for only the first few months after the operation. Possible complications of the continent ileostomy include malfunction of the leakproof opening, which requires surgical repair, and inflammation of the pouch (pouchitis), which is treated with antibiotics.
A procedure that is becoming increasingly common is the ileoanal anastomosis, or pull-through operation. It would allow you to have normal bowel movements because it preserves part of the rectum. The surgeon removes the diseased part of the colon and the inside of the rectum, leaving the outer muscles of the rectum. The surgeon then attaches the ileum to the inside of the rectum and the anus, creating a pouch. Waste is stored in the pouch and passed through the anus in the usual manner. Bowel movements may be more frequent and watery than usual. Pouchitis is a possible complication of this procedure.
For people with ulcerative proctitis, surgery is rarely needed, and life expectancy is normal. In some people, though, the symptoms may prove exceptionally resistant to treatment. Toxic colitis is an emergency that may require surgery. As soon as a doctor detects it or suspects impending toxic megacolon, all antidiarrheal drugs are discontinued, the person is given nothing to eat, a tube is inserted through the nose and into the stomach or small intestine and attached to intermittent suction, and all fluids, nutrition, and drugs are given intravenously. The person is monitored closely for signs of peritonitis or a perforation. If these measures fail to improve the person's condition in 24 to 48 hours, emergency surgery is needed: All or most of the large intestine is removed.
It is important to recognize that none of these alternatives makes a patient with ulcerative colitis normal. Each alternative has perceivable advantages and disadvantages, which must be carefully understood by the patient prior to selecting the alternative which will allow the patient to pursue the highest quality of life.
More information on inflammatory bowel diseases (ulcerative colitis, Crohn's disease)
What are the inflammatory bowel diseases? - Inflammatory bowel disease (IBD) is a chronic disorder that causes an inflamed and swollen digestive tract or intestinal wall.
What causes inflammatory bowel diseases? - The cause of inflammatory bowel disease is not known. Chronic inflammation present in the intestines of persons with both forms of IBD damages the bowel.
What are the symptoms of inflammatory bowel diseases? - Symptoms of inflammatory bowel diseases can include chronic diarrhea, abdominal cramps or pain, fever, and blood or mucus in the stool.
How is inflammatory bowel disease diagnosed? - To make a diagnosis of inflammatory bowel disease, a doctor must first exclude other possible causes of inflammation.
What're the treatments for inflammatory bowel disease? - Inflammatory bowel disease is treated with medication, exercise, and sometimes, surgery. Treatments for IBD are directed against the inflammation in the bowel.
What're the medications for inflammatory bowel disease? - Medications for inflammatory bowel disease include sulfasalazine, corticosteroids, immunosuppressives, and nonsteroidal anti-inflammatory drugs (NSAIDs).
What is Crohn's disease? - Crohn's Disease is a chronic illness that causes irritation in the digestive tract. Crohn's disease occurs in the last portion of intestine (ileum).
What types of Crohn's disease are there? - There are five subtypes of Crohn's disease, distinguished by the gastrointestinal area in which the disease occurs.
What causes Crohn's disease? - The cause of Crohn's disease is unknown. There is now evidence of a genetic link as Crohn's frequently shows up in a family group.
What are the symptoms of Crohn's disease? - The symptoms of Crohn's disease include abdominal pain, diarrhea, fever, loss of appetite and weight loss.
What are the complications of Crohn's disease? - Common complications of Crohn's disease include the development of an intestinal obstruction, pus-filled pockets of infection, and abnormal connecting channels.
How is Crohn's disease diagnosed? - The diagnosis of Crohn's disease is suspected in patients with fever, abdominal pain and tenderness, diarrhea with or without bleeding, and anal diseases.
What're the treatments for Crohn's disease? - Treatment for Crohn's disease is mainly symptomatic. Medications are very effective at improving the symptoms of Crohn's disease.
What medications cure Crohn's disease? - Medications for Crohn's disease sulfasalazine, Asacol, Pentasa and Dipentum. Mesalamine is useful both to achieve and maintain remission.
What's the surgery for Crohn's disease treatment? - Surgery to remove part of the intestine can help Crohn's disease but cannot cure it. The most used operation in Crohn disease is removing the diseased part of the intestine.
What Crohn's disease diet is suggested? - Diet may have to be restricted based on symptoms or complications of Crohn's disease. No particular food has ever been implicated in causing Crohn's disease.
Crohn's disease in children - Crohn's disease is most often diagnosed in young adulthood. Children facing Crohn's disease have significant self-image issues to deal with.
Crohn's disease and pregnancy women - Women with Crohn's disease who are considering having children can be comforted to know that the vast majority of such pregnancies will result in normal children.
What is ulcerative colitis? - Ulcerative colitis is an inflammatory disease of the bowel, that usually affects the distal end of the large intestine and rectum.
What types of ulcerative colitis are there? - Doctors categorize ulcerative colitis by the amount of colon involved. Variability of symptoms reflects differences in the extent of disease and the intensity of inflammation.
What causes ulcerative colitis? - The cause of ulcerative colitis is not known, but heredity and an overactive immune response in the intestine may be contributing factors.
What are the symptoms of ulcerative colitis? - The symptoms vary according to the extent of the disease. The most common symptoms of ulcerative colitis are abdominal pain and bloody diarrhea.
What are the complications of ulcerative colitis? - Bleeding, the most common complication of ulcerative colitis, often causes iron deficiency anemia.
How is ulcerative colitis diagnosed? - Diagnosis of ulcerative colitis is suspected based on the symptoms that a patient is experiencing. The most important method of diagnosis is endoscopy.
What are the treatments for ulcerative colitis? - Treatment of ulcerative colitis depends on the location and severity of a patient's disease, the presence of complications.
What ulcerative colitis medications are available? - Medications for ulcerative colitis include 5-ASA Compounds, anticholinergic drugs, steroids, and immunosuppressive drugs.
What surgery treats ulcerative colitis? - Surgery for ulcerative colitis involves removal of the entire colon, regardless of whether all or only a portion of the colon is diseased.
Collagenous colitis and lymphocytic colitis - Collagenous colitis and lymphocytic colitis are chronic diseases in which certain kinds of white blood cells infiltrate the lining of the large intestine.