Ulcerative Surgery - When Is It Required?

What Is Ulcerative Colitis?
Ulcerative colitis is a chronic, inflammatory condition of the colon and the rectum. It affects the mucosal lining of the large intestine (colon) and the rectum. The rectum is present just above the anus.
In this condition, patients have ulcers and abscesses in their colon and rectum.

Symptoms are seen periodically. The symptoms are severe pain in the abdomen, blood in stools and diarrhea. Anemia is seen due to decreased healthy red blood cells as a consequence of bleeding in stools.

When is surgery required?

• The colon has ruptured
• There is extensive bleeding
• The treatment results in severe side effects affecting the patient's health
• Drug therapy fails to provide results
• When it progresses to colon cancer
• Surgery for Ulcerative colitis

There are 2 types of surgeries:

1. Colectomy: Surgery performed to remove the entire colon
2. Proctocolectomy: Surgery is conducted to remove both the colon and rectum. It is considered as the standard treatment for ulcerative colitis.

Procedures for the surgery

1. Ileostomy: The entire colon and rectum are removed and the surgeon creates an opening or stoma in the abdominal wall particularly below the waist. Stoma allows waste from the intestines to exit the body. The tip of the lower small intestine is brought through the stoma. An external bag, or pouch, is attached to the stoma. This is called a permanent ileostomy. Stools pass through this opening and collect in the pouch. The pouch must be worn at all times. Before an ileostomy, the surgeon will perform a proctocolectomy. They will perform the ileostomy in the hospital, and the patient receives general anesthesia.
2. Ileal Pouch Anal Anastomosis (IPAA): This is also called a J-pouch. This is a procedure that does not require a permanent stoma. The patient is still able to eliminate stool through the anus. A pouch is constructed at the end of the ileum and attached to the anus. This is called a J- pouch. As with the ileostomy, the patient will need a proctocolectomy before an IPAA. An IPAA is done in a hospital, and the patient will receive general anesthesia.

Side-effects
Some people experience incontinence after the surgery. Medications may help control the function of the pouch.
Some women may become infertile after the procedure.

Recovery after Surgery
Both sets of the procedure will require a four-to-six-week recovery period.

1. Keep your diet healthy: A healthy diet is essential because good nutrition can help the body heal faster and help avoid post-operation health issues. Absorption of nutrients can be an issue after these surgeries, so eating well will help in maintaining the proper level of nutrients.
2. Keep yourself hydrated: Hydration is important for overall health, especially for digestive health. Drinking six to eight glasses of water per day is recommended.
3. Manage your stress: Anxiety or emotional stress can cause stomach issues, which can aggravate the complaint.