When Surgery Makes Sense for Your Ulcerative Colitis

If you’re reading this, we don’t need to tell you that living with ulcerative colitis is challenging — and that's an understatement. For the up to 900,000 Americans who have ulcerative colitis, it can feel like every aspect of their lives is controlled by this inflammatory bowel disease.

While we make every effort to relieve your symptoms without surgery, this route may need to come into play depending on the course of your disease. In fact, about 10% of people with ulcerative colitis undergo surgery within 10 years of diagnosis.

Should this surgical need arise for your ulcerative colitis, you’re in exceptionally good hands here at Fairfax Colon & Rectal Surgery. Our team has considerable experience with the different types of colorectal surgeries that are called upon for inflammatory bowel conditions like ulcerative colitis. 

In the following, we explore when surgery for ulcerative colitis might make good sense.

When medications no longer control your ulcerative colitis

As we mentioned, we make every effort to control your ulcerative colitis symptoms through nonsurgical means, starting with medications.

Ulcerative colitis is an autoimmune disease in which your body mistakenly attacks your bowel and rectum, creating inflammation, pain, and issues with your bowel movements.

Our frontline treatments for ulcerative colitis include anti-inflammatory drugs, immunosuppressants, and biologics, and these drugs can work very well for many, but not all, people.

If your ulcerative colitis isn’t responding to medications, it may be time to consider surgery.

Complications from ulcerative colitis

There are times when the decision to undergo surgery for your ulcerative colitis is out of our hands if an emergency arises, such as:

• A perforation in your colon
• Developing fulminant ulcerative colitis, which leads to severe symptoms
• Severe rectal bleeding
• Toxic megacolon — your colon stops working because of inflammation

Each of these situations can be a life-threatening emergency that requires immediate surgery to prevent widespread infection.

Surgery for ulcerative colitis

Until now, we’ve just been referring to surgery in generic terms, but let’s dive into exactly what we accomplish during an ulcerative colitis procedure.

In general, there are two ways in which we go about treating ulcerative colitis surgically:

1. Ileal pouch-anal anastomosis (IPAA)

During this two- or three-part procedure, we remove your colon and rectum and create a J-shaped pouch at the end of your small intestine to collect waste. This is why the procedure is often referred to simply as a J-pouch.

After the J-pouch has healed, we go back in and attach it to your anus to preserve your ability to have bowel movements naturally. You use an external pouch called an ostomy bag to collect your waste between your first and second procedures.

2. Proctocolectomy with ileostomy

In this procedure, we remove your colon, your rectum, and your anus. We then take the lower end of your small intestine and attach it to an opening in your lower abdomen called a stoma. This opening is where we attach the ostomy bag, which will collect your waste from now on.

Each of these surgeries aims to relieve your ulcerative colitis symptoms, once and for all.

If you’d like to figure out whether surgery is a good idea for managing your ulcerative colitis, you can get the ball rolling by contacting one of our offices in Fairfax, Fair Oaks, Alexandria, Gainesville, Woodbridge, or Lansdowne, Virginia, to schedule an appointment.