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Last Updated: Jan 10, 2023
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Ulcerative Colitis - How Surgery Can Help Manage It?

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Dr. Sandeep JhaSurgical Gastroenterologist • 17 Years Exp.DNB (Surgical gastroenterology, MS( General Surgery), MBBS, Fellowship in Minimal Access Surgery, Diploma in Minimal Access Surgery, Fellow of International College of Robotic Surgeons
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Ulcerative Colitis is one of the severe and chronic forms of Inflammatory Bowel Disease (IBD) that can throw life in a jeopardy. The condition that mainly affects the rectum and the large intestine can cause severe inflammation, ulceration, and abscess formation. The ulceration or the inflammation of the colon and the rectum left unattended for too long can give rise to deleterious consequences including damage and perforation of the colon, osteoporosis. Various studies also suggest that ulcerative colitis can increase the risk of a person suffering colon cancer.

Like most of the IBD, there is no definite cure for ulcerative colitis. The illness is a chronic condition and can flare up or recur at any point in time. Though medications may help to control the damage and the complications triggered by ulcerative colitis, a surgery may be essential in case of

  • Severe damage to the colon.
  • The nonsurgical treatments could do little to improve the conditions.
  • There is an increased risk of colon cancer.
  • Ulcerative colitis has resulted in Toxic megacolon (a life-threatening condition where the large intestinal muscles have dilated with some swelling).
  • There are extreme discomfort and bleeding.

Surgeries to deal with Ulcerative Colitis

  • In the case of Ulcerative Colitis, the nature of the surgery depends on the extent to which the colon or the rectum or both have been affected and damaged.
  • In the case of extensive damage with a high risk of colon cancer, the surgeon may perform Proctocolectomy or colectomy
  • Colectomy may involve
    • Removal of all of the colon- Total Colectomy
    • Removal of the diseased part of the colon- Partial Colectomy.
  • Following the excision, the surgeon may carry out necessary rearrangements to reconnect the remaining portion of the colon to the abdomen through an opening known as stroma (the procedure is known as colostomy).
  • In case of Total Colectomy, the small intestine will be connected to the abdomen by a process known as Ileostomy.
  • Proctocolectomy involves the removal of both the rectum and colon to avoid further aggravation.
  • Following the proctocolectomy, the surgeon may carry out Ileoanal Anastomosis (Ileal Pouch-Anal Anastomosis). In this procedure, a pouch is created using a small part of the small intestine. This pouch is then connected to the anus to help in the elimination of the wastes.

General precautionary measures to control Ulcerative Colitis
Making healthy lifestyle and dietary modifications can go a long way to control ulcerative colitis and the associated symptoms.

  • Spicy foods can worsen the incidence of ulcerative colitis. Enrich your diet with lots of fruits, vegetables (squash, avocados, fish (especially salmon and tuna), meat, dairy products, olive oil, walnuts, flaxseed oil, almonds.
  • Make sure the diet is a low-fiber diet.
  • Avoid alcoholic and caffeinated drinks and beverages, foods high in sulfur content, refined sugar.
  • Research suggests stress and lack of physical activities can aggravate the ulcerative colitis. Mediation and daily exercise can produce fruitful results.
  • Make sure your sleep is not compromised (6-8 hours daily).

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