What reasons might an ulcerative colitis patient need surgery?
Unlike Crohn’s disease, the surgical treatment for ulcerative colitis completely eradicates the disease. More than 40% of ulcerative colitis patients may require colectomy-or removal of the colon-in their lives, and the reasons we operate on patients with ulcerative colitis are varied. They can fail medical management or they can have complications, which, again, include toxic megacolon, perforation, stricture, or hemorrhage. The procedure depends very much on the severity of illness. In ulcerative colitis, we remove the entire colon and rectum while trying to restore fecal continence. However, in patients who are acutely ill, we can’t necessarily do that procedure safely. In more severe cases, we may only be able to remove part of the colon—leaving just the rectum—and have to do a temporary ileostomy, which involves creating a way for the patient to pass stool through a hole in the abdomen, bypassing the rectum and colon. When the patient is healthier, they can come back and do the re
