A chronic inflammatory bowel disease impacting the colon and rectum, ulcerative colitis can get uncomfortable fast. Although it can usually be managed with medication and lifestyle changes, sometimes these options simply aren’t enough.
Sometimes, due to medication failure, severe problems, and low quality of life, surgery is the only option.
Let’s break down the five primary surgeries for UC—colectomy, ileostomy, J-pouch surgery, ileoanal reservoir surgery, and proctocolectomy—and what they mean for you.
1. Colectomy
A colectomy is basically the surgical removal of your color – a portion or the whole thing. In other words, a partial colectomy or a total colectomy.
This procedure is used to eliminate the part of the colon that is giving you issues. If performed successfully, it can greatly reduce or cure problems like bleeding, diarrhea, and pain.
2. Ileostomy
This surgery is where the small intestine (ileum) is redirected through your abdominal wall to form a stoma. When you have a bowel movement, waste goes through this stoma into an external pouch.
In other words, an Ileostomy bypasses your colon completely. It is a useful procedure for relieving symptoms and providing relief to a colon that is inflamed or diseased. Basically, the main plumbing of your colon is too damaged, so a new exit ramp is created to keep from having backups.
3. J-Pouch Surgery
The ileal pouch-anal anastomosis (IPAA) surgery gets a little extensive. Overall, it removes the colon and rectum and makes a pouch composed of part of the small intestine. This is then attached to the anus.
You May Also Like
While this may sound unsettling, what it accomplishes is pretty straightforward. It allows for regular bowel movements and allows you to ‘go’ without an external pouch. This surgery replicates the function of your colon and rectum that were removed.
RELATED: How To Manage Ulcerative Colitis
4. Ileoanal Reservoir Surgery
This is similar to a J-pouch surgery in that it forms an internal pouch or reservoir from your small intestine and is attached to the anus. As a result, you can pass stool as you normally would. Again, no external pouch, and no irregular or abnormal bowel movements.
5. Proctocolectomy
This surgery removes both the colon and rectum, and is sometimes used in conjunction with ileostomy or J-pouch procedures. It all depends on personal preference, symptom severity, and the state of your internal ‘plumbing.’
What this achieves is the removal of diseased tissue. All parts of your digestive system affected by ulcerative colitis are effectively removed.
Which One Is Right For You?
When it comes to UC surgeries, the choices can be difficult. After all, this can be a life-changing procedure that, in some cases, alters the way you function forever. This is why you should undergo serious consultation with your healthcare team. Your overall health and lifestyle are two very important factors to consider. You will also factor in your particular case of UC.
While Black patients are not necessarily at lower or higher risk of UC, they do potentially face challenges when it comes to proper diagnosis, treatment, and healthcare access. Because UC has long been associated with people of European descent, it may go under-recognized in Black populations.
This is why you should always be straight with your doctor about any concerns or questions you may have. Seek second opinions whenever your gut instinct tells you to! And don’t forget support groups. There are groups that can help you make tough decisions, such as the Facebook Crohn’s & Colitis Foundation Black / African American Community Group.
It’s understandable that the idea of surgery can be daunting, but know that you have many people in your corner. Many people have made these decisions before you, and many are willing to help you on the way. With a solid crew around you, good doctors, and consistent support, you can choose the surgery right for you, and get back to living a better life!
