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Ulcerative colitis is often difficult to treat. There are a variety of drug treatments available, but when those fail or there are serious complications such as severe bleeding, surgery is often the answer. Ulcerative colitis is often cured by surgical removal of the affected colon. Surgery for ulcerative colitis generally involves a full colectomy, or removal of the large intestine. Resection, removal of a portion of tine intestine, is not an option for ulcerative colitis because the condition will simply recur in the remaining bowel.
When ulcerative colitis surgery requires removal of the colon, there are multiple options available to eliminate waste. An ileostomy creates an opening called a stoma in the abdominal wall, and the end of the small intestine is connected to the stoma. Ileostomy patients must use an ostomy bag to collect waste. It is also possible to create a pouch out of the end of the small intestine called a J-pouch (or s- or w- pouch) and then connect it to the rectum so that the patient can eliminate waste through the anus. This may require multiple surgeries, depending on the health of the patient. There are also options for ostomies that do not require ostomy bags. Your doctor will discuss your options and their risks and benefits with you.
If you require surgery for ulcerative colitis, expect to spend up to a week in the hospital and another 6 weeks or so recovering at home. During your hospital stay, you will transition from no food to clear liquid to regular foods as your intestines reset themselves after surgery. If you have an ostomy, you will learn how to manage the waste collection pouch and care for the stoma. It is important to stand up and move around as soon as you are able after surgery, but don't overtire yourself.
At home, expect to spend several weeks recovering. You should plan to have help with household tasks. You will not be able to do any lifting, and for the first couple weeks you may be extremely tired. Plan ahead to have plenty of quiet activities and people to help you with your daily tasks. You may be on a low-fiber or low-residue diet after surgery for ulcerative colitis to allow your intestines time to heal. Your doctor will help you decide when you are ready to return to normal activities.
While colectomy and ileostomy are daunting prospects, many patients with severe ulcerative colitis have a much better quality of life after surgery. Symptoms may be completely eliminated in some cases. Discuss your treatment options with your doctor to determine if surgery is right for you.
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