Digestive System Disorders. Surgical Options For Ulcerative Colitis

Surgical Options For Ulcerative Colitis

Are you, or someone you know, facing surgery for ulcerative colitis? Surgery can be a life altering experience for many people and it is often a positive one because they no longer will have to deal with the debilitating symptoms of their disease. Today, there are three different options for people facing surgery for ulcerative colitis. However, sufferers of the disease should consult their physician and do their research to decide which option is the best for them. The surgical options available are a Proctocolectomy with Ileostomy, a Restorative Proctocolectomy and a Koch Pouch procedure.

The most known of the procedures that is still widely used today is the Proctocolectomy with Ileostomy procedure. In this operation, the entire colon, rectum and the anus are removed, and the end of the small intestine is brought out through a hole in the abdomen. This hole (called a Stoma) is usually on the right side just below the belt line. Through this hole, the waste is drained out of the body and into a specially made, lightweight bag that is discreet under clothing (unless the bag gets too full). The bag is attached to the body with a special adhesive and paste. These bags are emptied several times a day and changed by the patient every 3-5 days. Only one surgery is required for this procedure and the recovery time for the patient is basically quicker. This surgery is also used as a as a back up procedure when complications with the other two procedures develop as well as emergency situations. Possible complications of having an ileostomy may include peristomal hernia, parastomal fistulization, skin irritation, a prolapsed stoma, high stoma output (ileostomy flux) and ileostomy retraction.

Another popular choice among people facing surgery for ulcerative colitis is a procedure known as a Restorative Proctocolectomy aka. Ileoanal Pouch Anal Anastomosis (IPAA). This newer operation allows the patient to eliminate waste through the anus; making the use of a bag for waste disposal unnecessary. The Restorative Proctocolectomy operation is carried out in two stages. This first stage consists of the removal of the colon and rectum while the sphincter muscles of the anus are preserved. The ileum (the end of the small intestine) is made into a pouch and pulled down and connected to the preserved anus. To allow this new pouch time to heal, a temporary ileostomy is also performed. After the first stage of the procedure, the patient waits on average of about ten to twelve weeks before the second stage is performed. After the waiting period, another surgery is scheduled to close the temporary ileostomy and to make the new pouch operational. After the operation, the new pouch serves as a reservoir for the waste. Possible complications for people who have this procedure done might include Pouchitis (inflammation of the pouch), pouch malfunction and bowel obstruction due to adhesions or scar tissue from the surgery. Removal of the pouch and the construction of a permanent ileostomy may be required when these complications do arise.

The third and the least known of the surgical options for ulcerative colitis is called a continent ileostomy aka a Koch Pouch. This procedure includes constructing a pouch out the small intestine to store the waste; much like the Restorative Proctocolectomy. However the difference between the Koch Pouch and the Restorative Proctocolectomy is the means of the waste disposal itself. Unlike the Restorative Proctocolectomy, the Koch Pouch is emptied by the patient using a thin tube inserted into stoma to drain the contents a few times a day. In order to stop the waste from coming out, a one-way nipple valve sitting flush with the skin is put into place. To protect the stoma, the patient wears a Band Aid, gauze or a stoma cap. Nipple valve slippage, which makes it difficult to irrigate or stop the stool coming out at odd times, is a complication of the Koch pouch procedure. To remedy this complication, either the removal of the pouch and a permanent ileostomy or revision surgery with re-fixation of the nipple valve may be required.

Surgery for ulcerative colitis is a health restoring and life changing event for many people with the disease. After the removal of the diseased colon, they can go on to live healthy, productive and happy lives. It is also a body altering experience as well and the psychological implications of the change in body image might be a challenge to some. However, online and offline support groups are available so the patient can meet others who have gone through the same operations.

Digestive System Disorders

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Surgical Options For Ulcerative Colitis