asking my dr . to perform a colectomy to prevent risk of colon cancer later

by darin
(tryon n.c.)

I have ulcerative colitis, many polyps and have had my disease since 2005 I don’t want to get cancer and medication doesn’t help to put my disease into remission any more I’m tired of taking all the steroids and other medications and all the side effects etc and just how its all effecting my wife and our 4 year old daughter and effecting my quality of life in general. Will a colectomy effectively cure me and can I ask my dr. to perform one?

Colectomy In IBD

Colectomy is a treatment option in ulcerative colitis, particularly in longstanding disease, poorly controlled disease or fulminating disease. It is commonly performed laparoscopically or by keyhole surgical approach and is a cure for the inflammatory symptoms that you may get such as tiredness with associated anaemia, abdominal pain, feeling of “unwellness” and general malaise. It will bring more control back into your life and as you say, it will cut your medication needs.

The cons though are several. Firstly its surgery and there is always a risk both from the surgery itself, post-operative complications and the anaesthesia itself. This needs to be discussed with your surgeon who will be able to tell you his/her operative numbers, complications and risks. Colectomy means you will need a stoma bag or at least initially. There are surgical procedures to reconnect your ileum and form a pouch from which you can defecate, but this is usually a 2 tier surgical approach. Even if you have a pouch formation, your stool frequency will usually be a few times a day, but it is much more controlled than in a fully colitic bowel.

Ulcerative colitis is a systemic disease, not just affecting the bowel. You can develop a condition affecting the liver called sclerosing cholangitis, skin rashes such as pyoderma gangrenosum and erythema nodosum, arthropathy or painful joints and eye involvement with a condition called uveitis. Surgery on the bowel will not effect these potential complications although fortunately are relatively unusual in comparison to bowel symptoms.

All the above should be considered when considering colectomy in IBD.




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