What is the role of surgery in the treatment of ulcerative colitis (UC)?

Updated: Apr 01, 2019
  • Author: E Stanton Adkins, III, MD; Chief Editor: Harsh Grewal, MD, FACS, FAAP  more...
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Answer

Answer

Historically, surgery has been viewed as definitive therapy for ulcerative colitis (UC). Total proctocolectomy is often curative, alleviating symptoms and removing the risk of colonic adenocarcinoma. Before 1980, total proctocolectomy with end ileostomy or continent (or Koch) ileostomy was the mainstay of therapy.

In the late 1970s, however, reports of continence-preserving procedures involving ileal pouch–anal anastomosis (IPAA) began to surface. As experience amassed, the procedure was refined, and IPAA has become the most common operation for patients with UC who wish to maintain anal continence. [1] In patients with Crohn disease and pancolitis, however, total proctocolectomy is palliative.

For more information, see Ulcerative Colitis.


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