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Ulcerative Colitis - What You Need To Know?

MS - General Surgery, DNB - Surgical Gastroenterology, Fellow HPB Surgery & Liver Transplant
Surgical Gastroenterologist, Ernakulam  •  12 years experience
Ulcerative Colitis - What You Need To Know?

Ulcerative Colitis is a chronic inflammatory disease that affects the lining of the intestine and the rectum. It is located just above the anus. Patients suffering from ulcerative colitis tend to have small ulcers in their rectum and the colon. These eventually flare up leading to diarrhea, bloody stools, anemia and abdominal pain. The inflammation starts from the rectum and eventually, spreads to the colon. Ulcerative Colitis tends to flare up and remit in an alternate phase. The remission can last from few weeks to few years.

Methods adopted to diagnose Ulcerative Colitis-
Ulcerative Colitis is very similar to an inflammatory bowel disease known as Crohn’s disease. The only differentiating factor is the fact that, ulcerative colitis affects the colon whereas, Crohn’s disease affects the digestive system and the small intestine. A doctor might prescribe certain tests such as the colonoscopy, blood tests, CT scan, pill camera, stool sample tests etc.

Why is surgery necessary to treat Ulcerative Colitis?
An estimated 40 percent of all Ulcerative Colitis patients need to undergo surgery to recover completely. The reason surgery becomes necessary to treat ulcerative colitis are the following:

  1. Drug therapy and medication become ineffective.
  2. Without undergoing surgery, the condition might increase the risk of developing cancer.
  3. The colon has the risk of getting ruptured if surgery is not performed on time.
  4. There could be excessive bleeding.
  5. Toxic megacolon might set in.

Types of surgery available to treat Ulcerative Colitis
A procedure where the entire colon is removed is known as the colectomy. In case both the colons are removed, the procedure is termed as proctocolectomy. In this procedure, an external pouch needed to be attached to the stoma that collects the stools. There is another method known as pouch surgery.

Pelvic pouch or ileal pouch is also termed as IPAA. This procedure doesn’t involve permanent stoma. In this procedure, both the colon and the rectum are eradicated from the body. The small intestine is then used to form a J-shaped pouch, that serves as the new rectum. The pouch is then connected to the anus. The whole procedure is done via two surgeries.

What are the surgical complications of this procedure?

  1. There could be an excessive bowel movement.
  2. There are instances where an inflammation of the pouch is observed. This condition is known as pouchitis.
  3. There could be a situation of intestinal blockage from adhesion due to surgery.
  4. There could be pouch failure that can happen inside within 5 few years. This is observed in 4 out of 100 patients who are treated. In this case, the patient should go for a permanent ileectomy.

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