Ulcerative colitis is a kind of disease in which there is an inflammation in the colon and rectum along with irritation and sores. In some cases, medicine can be effective but sometimes surgery is required.
According to Crohn’s and Colitis Foundation, 25 to 40 percent of people suffering from ulcerative colitis need surgery.
Nowadays there are two basic methods for this surgery. This method depends on the age and other medical reports of the patient.
Mostly, people lead a very healthy and prosperous life following the surgery. This article is written for you to learn about the basic things related to ulcerative colitis surgery.
What ulcerative colitis surgery?
An ulcerative surgery becomes crucial if the medication has and other treatments are no more effective.
In case of colon cancer and precancerous changes, ulcerative colitis is required.
Having ulcerative colitis for more than 8 years can develop the chances of colon cancer.
In case of any perforation or bleeding in the colon, emergency surgery is required.
Types
Proctocolectomy with ileostomy
There are two main types of ulcerative colitis surgery:
Proctocolectomy with ileostomy involves the following events:
Removal of the large intestine
Placing one end of the ileum to a region in the lower abdomen, mostly on the right side.
Create a surgical hole in the lower abdomen, termed a stoma
Passing an end of the ileum through the stoma and connecting the intestine with the skin. This will create an orifice from the small intestine to the exterior of the body.
Placing an ostomy bag, a bag, or pouch over the stoma. This pouch helps to collect the waste from the small intestine. And then this pouch is emptied into the toilet many times a day.
The feces that move out of the small intestine are not in a solid-state which is why it is hard to notice its movement into the pouch.
It’s not under the control of any patient to control the passing of feces, this is because a stoma has no muscles. Currently, the ostomy bags that are available in markets are very advance. They are flat, odorless, and blend completely with the dress.
After proctocolectomy along with ileostomy, a patient needs to take care of the stoma and should have basic training about the pouch and stomal care.
Some of the bags or pouches are disposable while some can be washed and used again. It depends on a patient’s choice.
Proctocolectomy and ileoanal pouch-anal anastomosis
This is a new process that assists a patient to pass out feces naturally through anal. Most of the time this surgery is termed as J pouch surgery or ileoanal pouch reservoir surgery.
In this procedure, the anus is preserved rather than its removal. Following events occur during this surgery:
Removal of the large intestine (colon and rectum), keeping anus safe.
Making a J pouch or ileoanal reservoir using the small intestine. This internal pouch is used to collect the waste.
Attaching an internally created pouch with the anus.
Feces start to accumulate in the pouch and leave the body through the anus, making bowel movements normal and easier.
A patient can feel feces moving out of the anus and he or she will be able to use the toilet normally if they have strong and good anal muscles.
Though the anus has been preserved but still bowel movements are very loose or watery because the colon has been removed.
Fecal incontinence may be seen in some patients. There is nothing to worry about. It can be cured with medicines. It is necessary to have good anal muscles to avoid any incontinence.
In most cases, IPAA is performed in different stages. In the first step, a pouch is created and attached to the anus. Then this bag is left alone for healing, for many weeks.
A transitory stoma is created until the second surgery occurs.
Following 2-3 months this temporary stoma will be closed and waste will be redirected to the internal pouch and pass out through the anus.
Preparation
Preparation depends on the type of surgery. You will be given a detailed overview before the surgery.
Usually, a patient is advised to keep their bowel empty by practicing “bowel prep”.
Patients may be asked to drink a laxative drink, have antibiotics, and are not allowed to take any solid food item 2 days before surgery.
Always ask your doctor before taking any kind of antibiotics or other drugs before the surgery. It may be allowed to have some medicine with a sip of water but usually, a patient needs to stop taking medicines.
Recovery:
If a surgeon performs the surgery using a long incision, termed as open surgery, then a patient needs to stay in hospital for many weeks.
While in some cases a less invasive surgery, termed laparoscopic surgery is used, then a patient can leave hospital earlier.
Still, it will take several weeks for both types of patients to recover fully.
Right after the surgery, a patient is shifted to recovery. In the recovery room catheter for urine and other drainage tubes are attached with abdomens.
As soon as a patient becomes conscious, the surgeon will tell the details about the removal of drainage tubes and catheters as well. A doctor may advise a patient to sit and have a walk if it is safe for him, this prevents blood clotting.
Complications
The most occurring complication is intestinal obstruction.
Symptoms of obstruction or blockages are:
Worsening abdominal pain
Thin, transparent, and foul-odor fluid in the bag
Vomiting
Liquid reduction in the pouch
Bloating around stoma
If you notice any of the following symptoms, you should immediately contact your doctor.
Patients suffering from IPAA must notice the signs of pouchitis. This term is used for an infection in the internal pouch. It can be treated by taking antibiotics.
Nearly half of the patients have chances to get pouchitis. The main symptoms of pouchitis are:
Diarrhea
Increased bowel movements
Pain in abdomen
Temperature
Pain in joints
Diet:
Without a colon, it is difficult for the body to digest food. That is why a patient needs to be more conscious about the diet.
It is advised to take small meals many times a day instead of having a large quantity at once.
The food items that are prohibited by the doctors are:
Dry fruits such as dates, figs
Raw fruits and veggies
Spicy foods
High sugar foods
Coffee and caffeine food
Foods such as bananas, rice, potatoes can be healthy because they are called binding foods. Drinking a lot of water can help you to avoid dehydration. This will keep your intestines healthy.
Conclusion:
Even though ulcerative colitis is life-changing but it has positive aspects as well. This can help you to get rid of a permanent ostomy.
A doctor can guide you about every detail.
Moreover, therapists and support groups are available for the help of emotionally unstable patients.
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