Ulcerative Colitis: Should I Have Surgery?
Ulcerative Colitis: Should I Have Surgery?Skip to the navigationYou may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Ulcerative Colitis: Should I Have Surgery?Get the factsYour options- Have surgery to remove your colon. This will cure ulcerative
colitis.
- Keep taking medicines to see if your symptoms improve.
Key points to remember- Most people who have mild colitis can control their symptoms
with medicine. Surgery isn't usually done for mild colitis.
- The only cure for
ulcerative colitis is surgery to remove the colon and
the lining of the rectum. After the most common type of surgery, you will still be able to have bowel movements. After the less common type of surgery, you will wear an ostomy bag to remove body waste.
- You are more likely to get colon cancer if you
have had ulcerative colitis for 8 years or longer. But surgery removes the risk
of colon cancer.
- Surgery is usually successful, but it does have
risks. These include blockages in the small intestine and leaking of stool.
- Surgery may be needed if cancer cells are found during a
biopsy.
FAQs Ulcerative colitis is
a common type of inflammatory bowel disease. Parts of the
digestive tract get swollen and have deep sores called
ulcers. Ulcerative colitis affects the
colon and the rectum. Symptoms include: - Belly pain.
- Diarrhea.
- Bleeding or mucus during bowel movements.
You may also start to have symptoms in other parts of your
body, such as your joints, eyes, and skin. In many mild cases, medicines
can reduce swelling and control symptoms, such as diarrhea. But sometimes
medicines don't work. Surgery to remove the colon is the only cure for the
disease.
Ulcerative colitis can lower your quality of life. Frequent diarrhea and belly
pain may force you to limit work or social activities. Having the disease can
be stressful. Some people feel alone and depressed. Over time,
colitis raises your
risk of colon cancer. Most doctors advise getting tested for colon cancer if
you have had ulcerative colitis for 8 years. The risk of colon
cancer is highest when ulcerative colitis affects the entire colon rather than
just part of it. And the longer you have had ulcerative colitis, the greater your risk of colon cancer.footnote 1 Two surgeries
are commonly done. -
Ileoanal anastomosis. This surgery is the most common.
It removes the large intestine and the lining of the rectum, but you can still
have nearly normal bowel movements after the surgery. This surgery is usually successful. About 7 or 8 out of 10 people have no problems after surgery. And most people say their quality of life is better.footnote 2
-
Proctocolectomy and ileostomy. People who can't be
under anesthesia for long periods of time because of illness or age are more
likely to have this surgery. It removes the large intestine and the rectum.
After this surgery, you will wear an
ostomy bag that is attached to an opening in your
belly to collect body waste. This surgery has a lower risk of problems after surgery compared to ileoanal anastomosis.
You
doctor may recommend surgery if: - Medicines and nutritional therapy have failed to
manage severe symptoms.
- Holes develop in the large intestine
(perforation).
- You have colon cancer, a significantly increased
risk of cancer (detected by
biopsies), or a narrowing in the intestine that cannot
be distinguished from cancer, even if you do not have symptoms of active
disease.
- Severe bleeding
requires ongoing blood transfusions.
- Slow growth or other serious
complications occur in a child.
You may choose to have surgery to improve your quality of
life, cure ulcerative colitis, or prevent the possibility of colon
cancer. Compare your options | |
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What is usually involved? |
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What are the benefits? |
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What are the risks and side effects? |
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Have surgery to remove
your colon Have surgery to remove
your colon - Surgery is often done in two
parts, up to 2 weeks apart. After each surgery, you will stay in the hospital
for several days.
- Recovery from surgery takes 1 to 2 weeks at home.
- After surgery, depending on the type, you may wear an
ostomy bag to remove waste.
- Surgery cures ulcerative colitis.
- Surgery prevents colon cancer or can cure it if the cancer has
not spread beyond the colon.
- Problems that can
occur during or after surgery include:
- Blockage of the small
intestine.
- Swelling in the pouch created from the small
intestine.
- Leakage of stool.
- An infection in the pelvis
or belly.
- Trouble with bladder control (incontinence).
- All surgeries carry risks, such as bleeding,
nerve damage, and anesthesia. Your age and your health can also affect your
risk.
Keep taking medicine
Keep taking medicine
- You take medicines,
including
steroids, for symptoms, to control the disease,
or to keep it in
remission.
- You may need to try different
kinds of medicines to find the right ones that work for you.
- You
will keep seeing your doctor as recommended while your condition is stable and more
often if you're having problems.
- Medicine can relieve
symptoms and help you control the disease.
- You avoid the risks of surgery.
- You may not
be able to control all of your symptoms with medicines, especially if they are
very bad.
- Some medicines for ulcerative colitis can cause side
effects, such as
cataracts or
osteoporosis.
- Medicines do not cure
ulcerative colitis or prevent colon cancer.
I have
suffered from some really bad symptoms from ulcerative colitis. The diarrhea
and pain interrupt my life. I can't go anywhere without checking out where all
the bathrooms are. I don't dare go on long hikes or go skiing, things I used to
do all the time. It makes me depressed. I like the idea of having surgery so I
don't have to deal with this illness anymore. The symptoms
of ulcerative colitis can be painful and embarrassing, but I only get them a
few times a year. My medicines control them really well. I don't think my
condition is bad enough for me to have surgery, and I don't like the thought of
having to use an ostomy bag. I think I will wait and see if my condition gets
worse. I want to have surgery, because I'm scared
of getting colon cancer. I had an uncle who had colon cancer. My risk is
already higher than average because I have ulcerative colitis. Besides, I've
had this disease for 7 years. In another year, I have to start having an annual
colonoscopy to check for cancer. If I have surgery, I won't have to deal with
symptoms or be tested every year and worry about colon cancer.
My medicines are working really well, and
I feel pretty good about my ability to live the life I want. I've had this
condition for 12 years. I get screened every year for colon cancer. So far,
everything is okay. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose surgery Reasons to keep taking medicine I can't control my symptoms with medicine. Medicine controls my symptoms. More important Equally important More important I accept the risks of surgery. I'm worried about the risks of surgery. More important Equally important More important I'll do whatever it takes to get rid of this disease. I don't want to have surgery for any reason. More important Equally important More important I want to remove any risk of getting colon cancer. My risk of cancer is low right now, and I want to wait to have surgery. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery Taking medicine Leaning toward Undecided Leaning toward What else do you need to make your decision?1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure Your SummaryHere's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. Next stepsWhich way you're leaningHow sure you areYour commentsKey concepts that you understoodKey concepts that may need reviewCredits | Author | Healthwise Staff |
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| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
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| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
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| Specialist Medical Reviewer | Peter J. Kahrilas, MD - Gastroenterology |
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References Citations - American Gastroenterological Association (2010). AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology, 138(2): 738-745. Available online: http://www.gastro.org/practice/medical-position-statements.
- Cohen JL, et al. (2005). Practice parameters for the surgical treatment of ulcerative colitis. Diseases of the Colon and Rectum, 48(11): 1997-2009. Available online: http://www.fascrs.org/physicians/practice_parameters.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them. Ulcerative Colitis: Should I Have Surgery?Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. - Get the facts
- Compare your options
- What matters most to you?
- Where are you leaning now?
- What else do you need to make your decision?
1. Get the FactsYour options- Have surgery to remove your colon. This will cure ulcerative
colitis.
- Keep taking medicines to see if your symptoms improve.
Key points to remember- Most people who have mild colitis can control their symptoms
with medicine. Surgery isn't usually done for mild colitis.
- The only cure for
ulcerative colitis is surgery to remove the colon and
the lining of the rectum. After the most common type of surgery, you will still be able to have bowel movements. After the less common type of surgery, you will wear an ostomy bag to remove body waste.
- You are more likely to get colon cancer if you
have had ulcerative colitis for 8 years or longer. But surgery removes the risk
of colon cancer.
- Surgery is usually successful, but it does have
risks. These include blockages in the small intestine and leaking of stool.
- Surgery may be needed if cancer cells are found during a
biopsy.
FAQs What is ulcerative colitis?Ulcerative colitis is
a common type of inflammatory bowel disease. Parts of the
digestive tract get swollen and have deep sores called
ulcers. Ulcerative colitis affects the
colon and the rectum. Symptoms include: - Belly pain.
- Diarrhea.
- Bleeding or mucus during bowel movements.
You may also start to have symptoms in other parts of your
body, such as your joints, eyes, and skin. How is it treated?In many mild cases, medicines
can reduce swelling and control symptoms, such as diarrhea. But sometimes
medicines don't work. Surgery to remove the colon is the only cure for the
disease. What are the long-term risks of the disease?
Ulcerative colitis can lower your quality of life. Frequent diarrhea and belly
pain may force you to limit work or social activities. Having the disease can
be stressful. Some people feel alone and depressed. Over time,
colitis raises your
risk of colon cancer. Most doctors advise getting tested for colon cancer if
you have had ulcerative colitis for 8 years. The risk of colon
cancer is highest when ulcerative colitis affects the entire colon rather than
just part of it. And the longer you have had ulcerative colitis, the greater your risk of colon cancer.1 What kinds of surgeries are done?Two surgeries
are commonly done. -
Ileoanal anastomosis. This surgery is the most common.
It removes the large intestine and the lining of the rectum, but you can still
have nearly normal bowel movements after the surgery. This surgery is usually successful. About 7 or 8 out of 10 people have no problems after surgery. And most people say their quality of life is better.2
-
Proctocolectomy and ileostomy. People who can't be
under anesthesia for long periods of time because of illness or age are more
likely to have this surgery. It removes the large intestine and the rectum.
After this surgery, you will wear an
ostomy bag that is attached to an opening in your
belly to collect body waste. This surgery has a lower risk of problems after surgery compared to ileoanal anastomosis.
Why might your doctor recommend surgery?You
doctor may recommend surgery if: - Medicines and nutritional therapy have failed to
manage severe symptoms.
- Holes develop in the large intestine
(perforation).
- You have colon cancer, a significantly increased
risk of cancer (detected by
biopsies), or a narrowing in the intestine that cannot
be distinguished from cancer, even if you do not have symptoms of active
disease.
- Severe bleeding
requires ongoing blood transfusions.
- Slow growth or other serious
complications occur in a child.
You may choose to have surgery to improve your quality of
life, cure ulcerative colitis, or prevent the possibility of colon
cancer. 2. Compare your options| | Have surgery to remove
your colon | Keep taking medicine
|
|---|
| What is usually involved? | - Surgery is often done in two
parts, up to 2 weeks apart. After each surgery, you will stay in the hospital
for several days.
- Recovery from surgery takes 1 to 2 weeks at home.
- After surgery, depending on the type, you may wear an
ostomy bag to remove waste.
| - You take medicines,
including
steroids, for symptoms, to control the disease,
or to keep it in
remission.
- You may need to try different
kinds of medicines to find the right ones that work for you.
- You
will keep seeing your doctor as recommended while your condition is stable and more
often if you're having problems.
|
|---|
| What are the benefits? | - Surgery cures ulcerative colitis.
- Surgery prevents colon cancer or can cure it if the cancer has
not spread beyond the colon.
| - Medicine can relieve
symptoms and help you control the disease.
- You avoid the risks of surgery.
|
|---|
| What are the risks and side effects? | - Problems that can
occur during or after surgery include:
- Blockage of the small
intestine.
- Swelling in the pouch created from the small
intestine.
- Leakage of stool.
- An infection in the pelvis
or belly.
- Trouble with bladder control (incontinence).
- All surgeries carry risks, such as bleeding,
nerve damage, and anesthesia. Your age and your health can also affect your
risk.
| - You may not
be able to control all of your symptoms with medicines, especially if they are
very bad.
- Some medicines for ulcerative colitis can cause side
effects, such as
cataracts or
osteoporosis.
- Medicines do not cure
ulcerative colitis or prevent colon cancer.
|
|---|
Personal storiesPersonal stories about surgery to cure ulcerative colitis
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I have suffered from some really bad symptoms from ulcerative colitis. The diarrhea and pain interrupt my life. I can't go anywhere without checking out where all the bathrooms are. I don't dare go on long hikes or go skiing, things I used to do all the time. It makes me depressed. I like the idea of having surgery so I don't have to deal with this illness anymore." "The symptoms of ulcerative colitis can be painful and embarrassing, but I only get them a few times a year. My medicines control them really well. I don't think my condition is bad enough for me to have surgery, and I don't like the thought of having to use an ostomy bag. I think I will wait and see if my condition gets worse." "I want to have surgery, because I'm scared of getting colon cancer. I had an uncle who had colon cancer. My risk is already higher than average because I have ulcerative colitis. Besides, I've had this disease for 7 years. In another year, I have to start having an annual colonoscopy to check for cancer. If I have surgery, I won't have to deal with symptoms or be tested every year and worry about colon cancer." "My medicines are working really well, and I feel pretty good about my ability to live the life I want. I've had this condition for 12 years. I get screened every year for colon cancer. So far, everything is okay." 3. What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to choose surgery Reasons to keep taking medicine I can't control my symptoms with medicine. Medicine controls my symptoms. More important Equally important More important I accept the risks of surgery. I'm worried about the risks of surgery. More important Equally important More important I'll do whatever it takes to get rid of this disease. I don't want to have surgery for any reason. More important Equally important More important I want to remove any risk of getting colon cancer. My risk of cancer is low right now, and I want to wait to have surgery. More important Equally important More important My other important reasons: My other important reasons: More important Equally important More important 4. Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery Taking medicine Leaning toward Undecided Leaning toward 5. What else do you need to make your decision?
Check the facts
1.
Can mild forms of ulcerative colitis be controlled with medicine? You're right. Most people who have mild colitis can control their symptoms with medicine. 2.
Is there a cure for ulcerative colitis? You're right. There is a cure for ulcerative colitis. It's surgery to remove the colon and the lining of the rectum. 3.
Does surgery remove the risk of colon cancer? You're right. Surgery removes the risk of colon cancer. 4.
Does everyone who has surgery need to wear an ostomy bag? You're right. You will need to wear an ostomy bag after one kind of surgery. But with the more common type of surgery, you will be able to have nearly normal bowel movements. Decide what's next1.
Do you understand the options available to you? 2.
Are you clear about which benefits and side effects matter most to you? 3.
Do you have enough support and advice from others to make a choice? Certainty1.
How sure do you feel right now about your decision? Not sure at all Somewhat sure Very sure 2.
Check what you need to do before you make this decision. Credits | By | Healthwise Staff |
|---|
| Primary Medical Reviewer | E. Gregory Thompson, MD - Internal Medicine |
|---|
| Primary Medical Reviewer | Adam Husney, MD - Family Medicine |
|---|
| Specialist Medical Reviewer | Peter J. Kahrilas, MD - Gastroenterology |
|---|
References Citations - American Gastroenterological Association (2010). AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology, 138(2): 738-745. Available online: http://www.gastro.org/practice/medical-position-statements.
- Cohen JL, et al. (2005). Practice parameters for the surgical treatment of ulcerative colitis. Diseases of the Colon and Rectum, 48(11): 1997-2009. Available online: http://www.fascrs.org/physicians/practice_parameters.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.Current as of:
May 5, 2017 American Gastroenterological Association (2010). AGA medical position statement on the diagnosis and management of colorectal neoplasia in inflammatory bowel disease. Gastroenterology, 138(2): 738-745. Available online: http://www.gastro.org/practice/medical-position-statements. Cohen JL, et al. (2005). Practice parameters for the surgical treatment of ulcerative colitis. Diseases of the Colon and Rectum, 48(11): 1997-2009. Available online: http://www.fascrs.org/physicians/practice_parameters. Last modified on: 8 September 2017
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