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Health Line
5 days ago
- Health
- Health Line
Is Surgery for Ulcerative Colitis (UC) Right for you?
Key takeaways Surgery for ulcerative colitis (UC) is considered when medication and diet changes are ineffective, with about 9.2% of patients eventually undergoing colectomy. Common surgeries include proctocolectomy, ileostomy, and ileal pouch-anal anastomosis (IPAA). After surgery, you may need an ileostomy or an ileoanal pouch to manage waste. Recovery and adaptation to life post-surgery require medical support and patient education. Surgery can significantly improve quality of life and eliminate symptoms for many patients. Long-term follow-up is essential to monitor for potential complications. It's important to discuss all the options fully with your doctor to decide if this option is right for you. Surgery is one of the many treatment options available for people with ulcerative colitis (UC). However, not everyone with this condition will need surgery. You may be able to manage UC through medication and changes to your diet. Over time, the initial treatments your doctor prescribed may no longer work, or they may become less effective. How many people have surgery? In a 2018 study of Swiss people with UC, researchers found that 9.2% of the study participants eventually underwent colectomy (colon removal). They also found that: 5 years after diagnosis, 4.1 percent of people had received a colectomy 10 years after diagnosis, 6.4 percent of people had received a colectomy 15 years after diagnosis, 10.4 percent of people had received a colectomy 20 years after diagnosis, 14.4 percent of people had received a colectomy Most people had their colectomies performed within 10 years of being diagnosed. Surgery rates for people who'd lived with UC for at least 15 years were significantly lower than rates for people who'd been diagnosed more recently. Ileostomy After having UC surgery, your doctor will need to create a way for your body to eliminate waste. A procedure known as an ileostomy can help. In an ileostomy, your ileum (the final section of the small intestine) is connected to your abdominal wall. You'll need a stoma as part of the procedure. A stoma is a surgically created opening that allows waste from your intestines to exit your body. A stoma is typically made in the lower abdomen, just below the waist. Proctocolectomy Proctocolectomy is the most common type of UC surgery. A proctocolectomy is performed in the hospital as an inpatient operation. This means you'll stay in the hospital during the procedure and for part of your recovery. You'll need to receive general anesthesia. After you have a proctocolectomy, you'll also need an ileostomy or an ileal pouch-anal anastomosis (IPAA) to help you eliminate waste. In most cases, your doctor will conduct both procedures on the same day so you don't have to have general anesthesia again. In a total proctocolectomy, the anus is also removed. Ileal pouch-anal anastomosis (IPAA) Ileal pouch-anal anastomosis (IPAA) is sometimes called a J-pouch surgery. In this procedure, the ileum is converted into a pouch shaped like the letter 'J.' The pouch is then connected to your anal canal. IPAA is usually effective, but it hasn't been around as long as ileostomy has. This means it may be more difficult to find a surgeon who can perform the procedure. This procedure is typically performed in two or three stages over the course of 2 or 3 months. You may receive a temporary ileostomy while your pouch heals. What to expect As with the ileostomy, you'll need a proctocolectomy before an IPAA. An IPAA is performed in a hospital, and you'll receive general anesthesia. The IPAA won't function like a normal bowel and rectum at first. You may have bowel leakage for several weeks while you learn to control the internal pouch. Medications may help control the function of the pouch. If you're planning to give birth to children in the future, talk with your doctor about this before the procedure. This procedure may lead to infertility in some people. Continent ileostomy Another type of ileostomy is continent ileostomy or K-pouch surgery. The K-pouch is also known as a Kock pouch, hence its name. During this procedure, the end of your ileum is secured against the inside of your abdomen. Unlike a traditional ileostomy, you don't need to wear an ostomy bag. A K-pouch is also different from a J-pouch in that the ileum isn't connected with the anus. Instead, a continent ileostomy relies on an internal human-made valve that collects waste and prevents the waste from draining out. When the K-pouch gets full, waste is removed via a catheter. You'll need to use a stoma cover and drain the pouch often, at least a few times per day. After your UC surgery, you'll stay in the hospital for 3 to 7 days. This window of time allows your surgeon to monitor you for signs of complications. Both ileostomies and pouch surgeries will require a 4- to 6-week recovery period. During this time, you'll meet regularly with your surgeon, doctor, and possibly an enterostomal therapist. An enterostomal therapist is a specialized therapist who works directly with people who've had their colon removed. Your care team will likely cover the following points with you to help improve your recovery: Eat well: Good nutrition can help your body heal and help you avoid post-operation health issues. Nutrition absorption can be an issue after these surgeries, so eating well will help you maintain healthy levels of nutrients. Hydrate: Hydration is important for your overall health but especially for your digestive health. Drink six to eight glasses per day at a minimum. Stay active: Work with a rehab therapist or a physical therapist to slowly recover your physical capabilities, and exercise when you can. Staying active is a great way to care for your overall health as you recover, but too much activity too soon could complicate your recovery. Manage stress: Anxiety or emotional stress can cause stomach issues, which can increase your risk of an accident. Surgery risks Surgery is usually a last-resort option for UC, partly due to the fact that any surgery can pose risks and complications. Some of the risks of UC surgery include: bleeding infection scarring itching or irritation of the stoma organ damage blocked intestines from scar tissue buildup diarrhea excessive gas rectal discharge nutritional deficiencies, especially vitamin B12 electrolyte imbalances Bowel surgery may also increase your risk of developing phantom rectum. A phantom rectum refers to the feeling of having to pass a bowel movement even though you no longer have a rectum. This can occur for several years postsurgery. Meditation, antidepressants, and over-the-counter (OTC) pain relievers may help with phantom rectum.
ABC News
6 days ago
- Health
- ABC News
Country dialysis patient faces choice of moving to Adelaide or stopping treatment
Move to Adelaide or stop accessing life-saving medical support. These are the options Chris Thomas, a 68-year-old Crystal Brooke resident in the mid-north of South Australia, faces. The retired farmer has been receiving treatment in the Lyell McEwin Hospital in Adelaide since May after he had two major cardiac arrests while undergoing rehabilitation following the amputation of a leg. This is in addition to him needing regular dialysis, treatment he had been receiving in Port Pirie for the past four years. Given his complex medical conditions, Mr Thomas was told he was not medically fit to be discharged from hospital or for transfer to Port Pirie. So now he and his family are facing the tough choice: move to Adelaide or effectively give up medical support. His daughter Alex Thomas was disappointed more effort hadn't been made to find alternative options for her father given he had lived in the country his whole life and didn't want to move to the city. "And that when you're vulnerable and when you reach your 11th hour of life that you're going to be able to stay within your home no matter what your postcode is." Ms Thomas has made an impassioned plea to SA Health to investigate options that would allow her father to return home and keep receiving treatment. "I want them to honour his desire to go home," she said. "I want them to cease discriminating against him because he lives in a regional area." SA Health Minister Chris Picton said his office had reached out to Mr Thomas's family, and there would be a senior medical review of his case to "see what options could be available". "We provide dialysis services right across the state, but there are obviously some levels of medical conditions that people have where they do need to be in a tertiary hospital setting," Mr Picton said. "Ultimately, in a state like South Australia, we can't provide the quaternary level of hospital care and the sub-speciality level of hospital care in each locality of everywhere across regional South Australia. Satellite dialysis units and home dialysis services are available across a number of the state's metropolitan and regional health services, but are designed to care for less complex and lower-risk patients. In a statement, SA Health extended its "sincerest sympathies to Mr Thomas and his family, who are navigating an incredibly difficult time". "Due to Mr Thomas's ongoing, high-risk medical issues, he is not medically fit for discharge from Lyell McEwin Hospital, or for transfer to Port Pirie," the statement said. "The health and wellbeing of our patients is always our priority. Ms Thomas however said that it was important to her dad, who had worked as a farmer and pastoralist as well as at Roxby Downs, that he spend the rest of his days living and receiving treatment in the bush. "It's his choice, no-one is more acutely aware of his mortality than he is," Ms Thomas said. "If he moves to Adelaide he is going to be grossly isolated from everything he has ever known. SA Health staff said at no stage had Mr Thomas or his family been advised that he should withdraw from medical care. The Port Pirie Satellite Dialysis Unit offers expert care in renal dialysis; like other satellite dialysis units, Port Pirie offers care for stable, lower-complexity patients.
