Ulcerative colitis (UC) is a disorder of the large intestine resulting in inflammation, ulceration and bleeding. Symptoms can include diarrhea, increased stool frequency and urgency, abdominal and pelvic pain/cramping, and weight loss. It most commonly occurs in young adults or later in life and has a tendency to run in families. The exact cause of UC is unknown. There is a broad spectrum of the disease from mild to severe rapidly progressive forms. The initial treatment is medications to reduce the inflammation and symptoms. Although this is often successful, some patients have chronic or refractory disease and may need to be considered for surgical referral. Chronic UC also increases the risk of colon cancer and close surveillance of the colon is indicated.
Complex Surgical Management - (in coordination with Gastroenterologists' medical management)
For patients with UC who do not respond to medical therapy or who have chronic symptoms despite maximal medical treatment, surgery may need to be considered. This usually requires complete removal of the colon and rectum. Traditionally this resulted in a permanent ostomy, but newer techniques of reconstruction are now available to preserve the anus and continence. The surgical management of UC is complex and requires specialized training and experience that a colorectal surgeon provides.
Many patients with ulcerative colitis who require surgery are excellent candidates for sphincter preserving procedures. The ileoanal Jpouch procedure preserves the anus and a reservoir is created from the small intestine to improve function and lifestyle. This is a highly specialized procedure and requires careful patient selection. It is best performed by an experienced colorectal surgeon.