Surgery can seem an attractive option to be finally rid of the disease, but the type of surgery most commonly performed doesn't always guarantee a trouble free outcome. Whilst removing the colon and rectum and replacing them with a pelvic pouch fashioned from the small intestine is deemed a cure, it can mean swapping one set of problems for a whole lot of new ones. Most of the problems experienced do resolve over time as the pouch adjusts and the holding capacity increases allowing the person to enjoy near normal bowel function and life without u.colitis. However for some people this is not the case and they continue to have frequent bowel movements and other problems. This is not a fault from the surgery, but rather a situation where the part of the bowel that has been moved and changed to function in a different way doesn't adapt as well as expected. Another problem that can occur is pouchitis, which is a type of inflammation that develops in the pouch with symptoms that can be like having colitis. It requires treatment, but can reoccur with some people experiencing chronic pouchitis.
Another surgical option is an ileostomy (small intestine is brought out through the abdominal wall), which is still carried out in those who choose to have this form of surgery or are not suitable for a pelvic pouch. Appendicectomy (removal of the appendix), which doesn't involve removal of the colon and rectum and is certainly not a standard treatment for u.colitis, has come to the notice of the IBD community in more recent years as a possibility to improving u.colitis in some people. Study reports of this type of surgery and in people with distal colitis who have elected to undergo an appendicectomy have shown some interesting and quite postive results of a settling of the u.colitis.
It's important to first discuss all medical treatment options with your gastroenterologist, but also ask about surgery and for referral to a colorectal surgical colleague if that is the path you wish to follow and explore. The surgeon can then go through all the surgical options with you in detail so that you can make an informed choice about treatment.
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