Ulcerative Colitis Surgery (Ileostomy, Colitis Surgery)


Surgery is one of the many treatment options available for qualifying patients with ulcerative colitis (UC). Some people may opt for lesser invasive treatments first and then have surgery later as and if the disease progresses. 


UC is manageable through medication and changes in diet. Over time, the initial treatments prescribed might no longer work or may become less effective. The symptoms and side effects of UC could become  severe . Upto one-third of people with UC will need surgery at some point. A person might also need surgery if they have colon cancer or precancerous changes in the colon. Having ulcerative colitis increases the risk of colon cancer in affected individuals, especially when the patients are affected by ulcerative colitis for more than eight years. At times, people with ulcerative colitis need emergency surgery if they have a hole in the colon or bleeding that would not stop.


The two main types of surgery for UC comprise the removal of colon and rectum through  proctocolectomy. A proctocolectomy is performed in the hospital as an inpatient operation. You’ll receive general anesthesia and will be hospitalised during the procedure and for part of post surgery recovery. After proctocolectomy, the patient will have an ileostomy or an IPAA. In most cases, both surgeries are clubbed on the same day to minimise the need for general anesthesia twice.

  1. Ileostomy: Removing the large intestine (colon and rectum) and anus is the first step while performing this surgery. Eventually, moving the end of the small intestine (the ileum) to a spot in the lower abdomen of the patient, usually, is done on the right side of the lower abdomen. The doctors then make an opening in the lower abdomen known as a stoma. This brings the end of the ileum through the stoma and attaches the intestine to the skin, creating an opening from the small intestine to the outside of the body of the patient

After the surgery is performed, a bag known as ostomy is attached to the opening, which allows waste from the small intestine to drain into the pouch. A person would be responsible for emptying the bag at regular intervals throughout the day.

  1. Ileo pouch-anal anastomosis (IPAA): This second type of procedure is sometimes called a J-pouch. Unlike with an ileostomy, a pouch is constructed at the end of your ileum and attached to your anus that eliminates the need for an ostomy pouch. Medications may help adapting in controlling the function of the pouch. Initially some people may experience incontinence, or accidently pass waste or  experience inflammation or irritation in the pouch ( pouchitis). Women may become infertile as a side effect. 


Just after surgery, the patient would go to a recovery area and might have drainage tubes attached to their abdomen, as well as a catheter for the release of urine. The patient has to stay in the hospital for 3-7 days for recovery and to monitor any evident signs of complications. Both sets of procedures will require  4-6 weeks of recovery period under the close monitoring of your surgeon, doctor, and an enterostomal therapist. 

Following shall help you to improve your recovery:

  • Good nutrition intake to maintain your levels of nutrients.
  • Drink min 6 -8  glasses of water in a day.
  • Staying active is  great as you recover, but not too much. Speak with your doctor.
  • Avoid  stress.

Authenticated by:

Dr. Gaurav Sharma

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