game of operation with the colon being the game piece to be removed

Types of Surgeries For Ulcerative Colitis

While no one ever wants to have surgery, I am sure many of you who suffer from ulcerative colitis have heard that surgery could be a potential treatment option down the road. I hope you never need this information and never have to go through it but I do know that being an educated patient is helpful. While many people don’t have the luxury of understanding what exactly surgery for UC may entail, I wanted to write this article with the hope that reading this information may possibly help someone down the line. This information comes from my own experience of surgery for UC.

First and foremost, if you have read any of my other articles or know me at all, you know I am very passionate about the fact that surgery is not a cure for ulcerative colitis. While a person may not be able to have “colitis” anymore if they don’t have a colon, they still have inflammatory bowel disease (IBD). Ulcerative colitis and Crohn’s disease both fall under the umbrella of IBD and are both autoimmune diseases. So while you may be able to remove the diseased organ, you cannot remove a person's immune system.

Having said that, I do believe in the right patient, surgery is a wonderful treatment option. I know firsthand many people who have an amazing quality of life following surgery for their ulcerative colitis.

So let's dive into some of the terms and types of surgeries for UC.

J-pouch surgery for ulcerative colitis

Surgery to create a J-pouch is one of the most common surgical procedures for ulcerative colitis patients. This type of surgery is usually done in two or three steps for the best results. Assuming the patient goes through this in three steps,

  1. The first surgery is to remove the colon/large intestine and give the patient a temporary ileostomy.
  2. The second surgery is to create the J-pouch which is made out of the patient’s small intestine. It is called a “J-pouch” because it is in the shape of a J. With time, this pouch is meant to take the place of the colon and hold stool. At this time, the UC sufferer still has a temporary ileostomy in order to give the body a chance to adjust to the J-pouch.
  3. The third surgery is the one to connect everything together. Meaning, the patient no longer wakes up with an ostomy but instead, that portion of their intestine is connected to the J-pouch.

What is a total colectomy with an ostomy?

Another option for UC patients who need surgery is to have their colons removed and live with an ostomy. With this surgery, in particular, the rectum and anus are left intact but the diseased intestine is removed. Because the creation of a J-pouch can potentially cause more complications, patients who choose this route generally are more comfortable living with an ostomy and don’t want to go through the three-step process to create the Jpouch.

Because ulcerative colitis can affect the rectum as well, there is a chance the disease can return in that area of the body. There can sometimes be discharge from the anus as well which is usually just annoying and not a sign of anything serious. The plus side of leaving the rectum and anus in place is that it allows the patient the chance to change his/her mind down the road if they no longer wish to live with an ostomy. There is still a chance for a J-pouch to be made or even a pull-through (small intestine connects right to the rectum/anus instead of a pouch) to be done.

Total proctocolectomy

This surgical procedure is one that removes the entire large intestine, rectum, and anus. The patient then has what is referred to as a “barbie butt” since everything is completely closed up down there. In this case, the UC sufferer is given a permanent ileostomy with no option for reversal. This is usually done in one surgery and is probably the surgery that has the least amount of complication risk. It also doesn’t allow for any changes down the road so, with this surgery, the patient needs to be a hundred percent sure they are comfortable with the reality.

There are other surgeries for ulcerative colitis that are not as common which include:

  1. Kock pouch (continent ileostomy)
  2. BCIR (continent ileostomy)
  3. T-pouch (similar to J but done in certain patients only)
  4. W- pouch (also similar to Jpouch but used in certain patients only)

The decision to have surgery for ulcerative colitis is not an easy one and something that should always be discussed with your doctor. I hope the information shared in this article helps you to understand some of the procedures a little better. If you have other questions, thoughts or things you’d like to share with your fellow UC sufferers, please do so in the comment section below!

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