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Historically, the standard operation for ulcerative colitis has been removal of the entire colon, rectum, and anus.
This operation is called a proctocolectomy (Illustration A) and may be performed in one or more stages.
However, this operation requires creation of a Brooke ileostomy (bringing the end of the remaining bowel through the abdomen wall, Illustration B) and chronic use of an appliance on the abdominal wall to collect waste from the bowel.
The continent ileostomy ( Illustration C) is similar to a Brooke ileostomy, but an internal reservoir is created.
In addition, patients who have long-standing ulcerative colitis and show cancer signs may be candidates for removal of the colon, because of the increased risk of developing cancer.
More often, these patients are followed carefully with repeated colonoscopy and biopsy, and only if precancerous signs are identified is surgery recommended.
Hospitalization may be necessary to put the bowel to rest.Surgery is indicated for patients who have life-threatening complications of inflammatory bowel diseases, such as massive bleeding, perforation, or infection.