Ulcerative colitis is inflammation of the inner lining of rectum and colon. Symptoms include rectal bleeding, diarrhea, abdominal cramps, weight loss, and fevers. Patients have an increased risk for colorectal cancer. The cause is unknown.

Treatment: Initial treatment is medical.

When is surgery necessary? Patients who have life-threatening complications such as massive bleeding, perforation, or infection. Also, in those whose medical therapy fails. In patients with long standing ulcerative colitis large bowel cancer risk is increased. Repeated colonoscopy and biopsies are performed and surgery is recommended if precancerous lesions are discovered.

Type of operation: The standart operation is the removal of entire colon and rectum (Restorative proctocolectomy). This could be done in one or multiple steps. The rectum is replaced with small bowel pouch. Usually a temporary ileostomy is created that is closed 2-3 months later. Most patients experience 5-10 defecations per day. In some patients the pouch may be inflamed and when medical treatment fails it may have to be removed.

(Simplified from Patient Eduction Brochures of The American Society of Colon and Rectal Surgeons)