Various drug treatments are given depending on the severity of the disease. Patients should be under close monitoring during treatment. During the course of the disease, conditions such as toxic megacolon or perforation may occur and emergency surgery may be required. It should also be kept in mind that ulcerative colitis patients may develop colon cancer over years.
Indications for surgery:
- Resistance to drug therapy
- Presence of dysplasia (pre-cancerous cellular changes)
- Presence of cancer
- Drug-related side effects
- Steroid (cortisone) dependent disease
- Growth and development delay in children
- Emergency surgery
When deciding on surgery, a multidisciplinary evaluation including departments such as surgery, gastroenterology, pathology and radiology is required.
Ulcerative Colitis Surgery
Surgery for ulcerative colitis is often done in stages. The most common application is 3-stage surgery:
Stage 1: Total colectomyComplete removal of the large intestine up to the rectum (leaving the rectum inside)
Stage 2: Proctectomy + ileal pouch (IPAA) – anal anastomosis + loop ileostomy
At this stage, the rectum left in the first surgery is removed. A pouch is made from the small intestine and this pouch is connected to the anus. In addition, a loop ileostomy is created.
Stage 3: Ileostomy closure
Changes can be made in this approach depending on the patient's condition, but the most commonly applied approach is 3-stage surgery.
Since ulcerative colitis is a disease that only affects the colon and rectum, the disease can be eliminated with successful surgical treatment.
Some complications may occur after ulcerative colitis surgery. The patient should be informed in detail before the surgery in terms of possible postoperative complications and expectations regarding quality of life.
