The Crohn’s and Colitis Center works in close collaboration with the Department of Surgery and a group of very talented colorectal surgeons.
Surgery for Ulcerative Colitis
Ulcerative colitis affects only the rectum and colon. It is a disease of the lining of the large intestine and does not affect deeper layers of the bowel or the small intestine. Most of the time, ulcerative colitis can be successfully treated with medical therapies. When these medical therapies are not enough, surgery can be offered. The surgery for ulcerative colitis can involve removing the entire colon and rectum. Doing this is often termed “curative” because the diseased area has been removed. This can be done as an open surgery or often as a laparoscopic surgery.
Ileoanal J-pouch for ulcerative colitis
Patients with ulcerative colitis who have not responded sufficiently to medical therapy can have this procedure done in two or three stages. In the first stage, the colon or the colon and rectum are completely removed. A new rectum called a "J-pouch" is then created and then "anastomosed", or hooked up, to the muscles of continence (anal sphincters). Usually a temporary, diverting ileostomy, or bag, is created upstream from this complicated surgery so that it can heal without infection. Between 6-12 weeks of this initial procedure, the temporary ileostomy, or bag, is taken away with a smaller operation and the patient can return to evacuating in a normal fashion.
Surgery for Crohn's Disease
Surgery for Crohn's disease also is performed when medical therapies are not enough. Sometimes patients with Crohn's disease will get a narrowing of their intestines called a "stricture". When this occurs, and it is unable to be treated with medications, surgery is then used to either remove or, in some cases, widen the bowel. Particularly with Crohn's disease of the small intestine, bowel preserving surgery is emphasized. Other areas of the gastrointestinal tract that are involved with Crohn's disease include the colon, rectum and anus.
Along with antibiotics, anorectal problems are often treated surgically to drain infection. Once the infection is cleared, more aggressive medical treatments can then be started. In particular with Crohn's disease, we work in close conjunction with our surgical colleagues since a combination of surgical and medical procedures are often needed in order to maximize a patient's therapy.
More information about surgical procedures for Crohn's disease and ulcerative colitis.
