What are the Pros and Cons of Ulcerative Colitis Surgery?

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  • Written By: Amy Hunter
  • Edited By: Andrew Jones
  • Last Modified Date: 19 September 2018
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Ulcerative colitis surgery is used as a treatment for a form of irritable bowel syndrome, ulcerative colitis, that causes the inner lining of the large intestine to become inflamed and ulcerated, leading to severe pain, fever, and diarrhea. Surgery for ulcerative colitis nearly always eliminates the symptoms of the disease, but requires lifestyle modifications that may be cumbersome and embarrassing. Between 20 and 40 percent of people with ulcerative colitis eventually undergo surgery as a treatment for the condition.

In ulcerative colitis surgery, the physician removes the colon and rectum. Because the inflamed area is removed, symptoms of the disease disappear. When performing the surgery, the physician has two choices, perform an ileostomy, which requires the patient to wear a bag over a small opening in the abdominal wall to collect stool, or a newer procedure that allows the doctor to attach the small intestines to the anus, so the patient can expel stool normally. With no large intestines, however, the patient will experience more frequent bowel movements, as well as watery stool.


After ulcerative colitis surgery, the patient often experiences severe flatulence after eating. It is possible for the patient to adjust his or her schedule to allow for privacy after eating to minimize embarrassment. People undergoing ulcerative colitis surgery will also need to modify their diet. Consumption of foods high in insoluble fiber, such as vegetable skins and popcorn, will need to be reduced or stopped altogether. Foods that are difficult to digest can create blockages, particularly in patients who undergo an ileostomy.

Patients who undergo ulcerative colitis surgery must also be diligent about drinking enough fluids to maintain proper potassium and sodium levels. These patients may also experience trouble taking certain medications. Pills that are time-released, large or coated may not dissolve in the digestive tract properly.

Complications from ulcerative colitis surgery include the need to convert to an ileostomy later, which occurs in between 5 and 10 percent of patients, as well as bowel obstructions from scar tissue following surgery, pouchitis, and infertility. Pouchitis occurs when the internal pouch created from the small intestines to collect stool becomes irritated. Symptoms of pouchitis are similar to ulcerative colitis, such as diarrhea, fever, and abdominal pain. Symptoms of a bowel obstruction include a feeling of fullness or pain in the lower abdomen, diarrhea or the inability to pass any stool, and bloating. Approximately half of women who have ulcerative colitis surgery experience infertility, possibly due to scar tissue buildup around the fallopian tubes.



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