Is Surgery Really a Cure for Ulcerative Colitis?

Surgery for ulcerative colitis typically involves removing the colon and the rectum and creating a new passage in the body for bowel movements. Because the condition is marked by chronic inflammation in the colon and rectum, removing these two things can effectively eliminate symptoms for many people.

Removing the colon and rectum can be done with one of two procedures: ileal pouch anal anastomosis (J-pouch surgery) or end ileostomy. Talking through the pros and cons of each procedure with your care team can help you understand how each will affect your life, so you can make the right choice for yourself.

End Ileostomy

This surgery removes the colon, rectum, and anus to change the way stool leaves the body. During the procedure, your surgeon will create a quarter-sized opening in your lower abdomen, called a stoma, and connect it to the end of your small intestine. This connection reroutes stool into an external pouch or bag (called an ostomy bag) that’s worn at all times.

For end ileostomies, which are performed under general anesthesia, you’ll spend a few days in the hospital and continue recovering at home for six to eight weeks. During that time, you’ll be on a limited diet (liquids only and then soft foods) and gradually transition back to eating normally.

J-Pouch Surgery

The most common type of ulcerative colitis surgery, J-pouch surgery involves removing the colon and rectum and replacing it with a pouch made from the end of the small intestine. The pouch, which connects to the anus, acts as a new “rectum” that holds stool internally until you’re ready to have a bowel movement. That allows you to poop like you would if you had a colon and a rectum.

J-pouch surgery usually happens in multiple stages. Initially, your surgeon will create the pouch using tissue from your small intestine and give you a temporary ileostomy. You’ll have bowel movements through the ileostomy for 8 to 12 weeks, while the J-pouch heals.

After that, you’ll go into your doctor’s office to make sure the pouch has healed and isn’t leaking. If the J-pouch is working the way it should, you’ll undergo another surgery to reverse the ileostomy. After that, you’ll start having bowel movements from the J-pouch.