Your child might need surgery if:
- They have serious inflammation that doesn’t get better with medicines and nutritional support
- They have a serious complication, such as severe bleeding
Most people with ulcerative colitis need surgery at some point to remove the colon and reduce the risk for colon cancer.
There are 2 main types of surgery for ulcerative colitis. Both are surgeries to remove the colon. The most common surgery goes by many names:
- J-pouch surgery
- Ileoanal anastomosis (pronounced ill-ee-oh-AIN-ull an-as-toe-MOE-sis)
- Pull-through operation
- Restorative proctocolectomy (pronounced prahk-toe-coal-EKT-uh-mee)
In this operation, surgeons remove the entire colon and the lining of the rectum. Then they create a pouch inside the body from the end of the small intestine (ileum) to the anus.
To give the pouch a chance to heal and function as the new “bowel” for the child, surgeons usually do this operation in two steps:
- Remove the colon and lining of the rectum, create the pouch and attach it to the anus.
- Connect the small intestine to an outside opening made in the skin of the belly so waste can pass to a bag attached on the outside. This is called ileostomy (pronounced ill-ee-OSS-tuh-mee).
Ileostomy is temporary. It allows the rectum to heal without stool passing through. In about 2 months, after the inside pouch heals, surgeons remove the outside bag and close the ileostomy. This allows waste to pass out through the anus.
Colectomy (or proctocolectomy)
The second type of surgery for ulcerative colitis is called proctocolectomy (or sometimes just colectomy). This operation is rarely, if ever, needed. Surgeons remove the entire colon. If the rectum is too unhealthy to work well, surgeons take it out along with the colon. Then they create a permanent ileostomy.
Care for your child before and after surgery
Before either surgery, your child’s surgical team will explain the details, including:
- What will happen before, during and after your child’s operation
- How long it’s likely to take
- How long your child may need to stay in the hospital afterward
- What kind of care your child will need at home after surgery
Some children who have pouch surgery have complications afterward. The IBD Center team provides care and support for these conditions, which include urgent need to use the bathroom, bleeding, inflammation of the pouch and problems emptying stool from the pouch. Treatment options offered through the IBD Center include dietary therapies, antibiotics, probiotics, medicines that reduce inflammation, treatments done with an endoscope and surgery.