Ulcerative Colitis Surgery – To Be Or Not To Be?

It is the question that has to be addressed and answered for more people nowadays who have been diagnosed with colitis. You may have thought that colitis surgery was a last resort for someone whose symptoms are now out of control and can’t be stabilised with stronger medication. Yet that is not always the case.

Some patients have no choice with regards to surgery because their symptoms are so far advanced that they are in danger of experiencing perforation of the bowel and now medication can bring the symptoms under control. In addition to this group, there is another group of people with colitis that endure periods of relapses then recover to an extent but don’t achieve full health. There is always some degree of colitis symptoms that prevail. There are some who just persist with this and can manage their lives satisfactorily. Others feel that the pattern is set and will never be broken and are seeking to achieve a better quality of live if they undertook surgery to have the inflamed colon extracted. They have to understand and appreciate that with an ileostomy or j pouch, life does have to adapt but they are willing to take these challenges on to rid themselves of the discomfort and pain that colitis brings.

What has to be addressed is the risk in undergoing surgery. These operations are not simple. They are lengthy and as with any surgery there is risk. The risk of infection is always there. Plus the greatest unknown risk is how your body will react to the change that it has undergone. This is not so much a factor with an ileostomy than with a j pouch. For some, and thankfully it is a small number, their body never really accepts the creation and function of a pouch and their quality of life suffers to the point where they may face their days having to be planned around trips to the toilet. Minus the pain and discomfort, this is the same scenario as their former life affected with colitis. If that is the case, there is only one option and that is a further operation to replace the pouch with a permanent ileostomy.

For someone who has colitis and suffers the occasional relapse, though who enjoys periods when they return to full health, it is very unusual for them to consider surgery. If they can cope with relapses when they occur and recover sufficiently well to enjoy good health again then few doctors would ever recommend surgery. Who knows, the relapses may become fewer in number perhaps as a result of better understanding by the patient of how to give their body the best chance to reduce the instances of a relapse happening.

Here is another important point to note. There is a lot of misconception amongst the general public about colitis and surgery. It appears that people can think that as soon as you are diagnosed with colitis that it will only be a matter of time before you will be lying on the surgeon’s table about to be cut open. Nothing could be further from the truth. Only a small percentage of those diagnosed with colitis ever end up in the operating theatre. I have seen figures quoted as much as 40% of sufferers go on to have surgery. This is just not true and you should not worry about it. The actual figure is less than 10%.

Ultimately, only you can make the decision to proceed with the surgical process but it is vital that you discuss all the implications not only with you doctor but also the hospital consultant and the surgical team so you fully understand all the issues that require to be addressed before any action is actually taken. Remember, for the vast majority who do undergo surgery, they achieve their goal of a better quality of life, free of the pain and discomfort that colitis brings. It is essential that the sufferer is fully informed and has access to others who have experienced not only the prospect of surgery but who have ultimately undergone the process and bring some control back to their lives. First hand knowledge is now available at The Colitis Experience