Ulcerative colitis is a common inflammatory bowel disease that’s often first diagnosed between ages 15 and 30. M. Jonathan Worsey, MD, FRCS, FACS, FASCRS, and Keith Beiermeister, MD, FACS, FASCRS, at San Diego Colon and Rectal Surgeons in La Jolla, California, offer comprehensive care for ulcerative colitis. Dr. Worsey and Dr. Beiermeister have done more than a thousand restorative proctocolectomy surgeries, producing superior functional results. They also have extensive experience maintaining continence by creating a J-pouch or a Kock pouch.

If you need relief from pain and other symptoms, call or schedule an appointment online.

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What is ulcerative colitis?

Ulcerative colitis is a bowel disease that develops in your rectum’s and large intestine’s inner lining, causing inflammation and sores (ulcers). While the exact cause is unknown, medical experts have identified several possible contributing factors, including an abnormal immune response, bacteria, food sensitivities, medications, and genetics.

What symptoms develop if I have ulcerative colitis?

Ulcerative colitis is commonly marked by bouts of flare-up followed by periods of remission. The most common symptoms include:

  • Diarrhea
  • Abdominal pain
  • Blood in stools
  • Urgent need to have a bowel movement
  • Bowel movements during the night
  • Loss of bowel control
  • Rectal pain
  • Fatigue
  • Fever

An estimated 10-30% of all patients develop symptoms outside their gastrointestinal tract. For example, you might have joint pain, skin rashes, and eye inflammation.

How is ulcerative colitis treated?

Ulcerative colitis is initially treated with medication, most often managed by a gastroenterologist, that reduce inflammation, lessens your symptoms, suppresses your immune system, and keeps your ulcerative colitis in remission.

When medication fails to improve your symptoms, surgery to remove the colon and rectum can cure ulcerative colitis. The surgical management of ulcerative colitis has improved dramatically from previously only having an ileostomy as an option.

An ileostomy is surgically created by creating a connection between the small intestine and an opening in your abdomen. This allows waste to continuously drain out to an external pouch.

But now you have other surgical options that preserve continence, including:

Restorative proctocolectomy
A restorative proctocolectomy is available to those whose anal sphincter muscle is still intact. After removing your colon and most of the rectum, your surgeon creates an internal pouch, called a J-pouch, from the small intestine.

Then they connect the pouch to the anal muscles. The internal pouch collects waste until you release it by going to the bathroom.

This procedure generally occurs in either two or three stages. If you need a two-stage procedure, the colon and rectum are removed, the pouch is created and connected to the sphincter, and a temporary ileostomy is done during the first surgery. In some patients who are very sick from their colitis, only the colon will be removed in the first surgery. After they recover, the rectum is then removed in the second surgery, along with the creation of the pouch and temporary ileostomy.

The ileostomy drains waste, giving the surgery time to heal. Then during your final surgery, Dr. Worsey and Dr. Beiermeister close the ileostomy.

Kock pouch

The Kock pouch or K-pouch is also an internal pouch created at the end of the small intestine. In this procedure, the pouch is connected to an abdominal opening. However, the opening has a valve that keeps the waste inside the pouch. To empty the pouch, you insert a tube and let the waste drain into the toilet. You do this 2-4 times each day.

You can get relief from ulcerative colitis. Call San Diego Colon and Rectal Surgeons today or schedule an appointment online.