WHAT ARE THE SURGICAL OPTIONS?
1: Removal of the entire colon, rectum, and anus. A permanent ileostomy (connecting the small intestines to the skin).
This removes all of the risk of cancer with Ulcerative Colitis.
2: Same as option 1 with an continent ileostomy (Kock pouch).
This option removes the risk as well. The Kock pouch has better life style benefits, but many complications.
3: Removal of the colon and most of the rectum. Connecting the small intestine (with a pouch) to the end of the rectum.
This removes almost all of the cancer risk. The pouch allows good bowel control, but inflammation of the pouch (pouchitis) is painful and symptomatic.
4: Removal of the colon and connecting the small intestines to the rectum.
This option removes the cancer risk to the colon, but not the rectum. The ability to control bowel movements is almost normal.
WHICH ALTERNATIVE IS PREFERRED?
Each alternative has advantages and disadvantages. Lifestyle, age, bowel control, other medical problems all enter into the decision for the highest quality of life.