Ulcerative Colitis Specialist

What is ulcerative colitis?

Ulcerative colitis, or UC, is an inflammatory condition affecting the colon and rectum that make up your large intestine. Ulcerative colitis causes symptoms such as:

• Bleeding from the rectum
• Diarrhea
• Abdominal cramps
• Weight loss
• Fever

Patients who have extensive ulcerative colitis that lasts more than eight years are at an increased risk of developing colorectal cancer.

How is ulcerative colitis diagnosed and treated?

Ulcerative colitis may be diagnosed by review of your clinical history and diagnostic testing, like colonoscopy, and other imaging tests.

Many cases of ulcerative colitis respond to nonsurgical treatments, including medicine to manage your symptoms. These may include anti-inflammatory medications or a short course of corticosteroids such as prednisone. 

In moderate to severe cases, immune-modulating drugs or biologics, such as infliximab, adalimumab, or vedolizumab may be recommended by your gastroenterologist. 

However, up to one-third of ulcerative colitis cases eventually need surgery. For patients with ulcerative colitis, surgery can provide long-term relief and allow patients to come off of all ulcerative colitis medications.

When would I need surgery for ulcerative colitis?

If conservative approaches aren’t successful, Dr. Zaghiyan may recommend surgery to treat your ulcerative colitis. 

In patients with long-standing ulcerative colitis, the risk of colorectal cancer and dysplasia (pre-cancer) rises. In patients with ulcerative colitis and symptoms lasting greater than eight years, frequent colonoscopies are needed to screen for cancer or dysplasia.  

Another reason why surgery may be recommended is dysplasia or cancer found at the time of a colonoscopy.

What does ulcerative colitis surgery involve?

The most common surgical procedure Dr. Zaghiyan uses for patients who have ulcerative colitis is J-pouch surgery, also known as ileal pouch-anal anastomosis (IPAA). J-pouch surgery involves removing your entire colon and rectum but preserving the anal canal. 

Dr. Zaghiyan uses part of your small intestine to create a J-pouch, which as the name suggests, is a pouch-shaped like a letter J.

The J-pouch connects to your anus, enabling you to pass stools. However, you’ll need to have a temporary ileostomy for the first few months after your surgery to allow time for the J-pouch to heal.

Whenever possible, Dr. Zaghiyan performs J-pouch surgery through a minimally invasive approach using laparoscopic and transanal techniques called transanal ileal pouch-anal anastomosis (taIPAA), allowing minimal skin incisions with the majority of the surgery performed through the anus using endoscopic techniques. 

Dr. Zaghiyan is one of the leading experts in this approach to J-pouch surgery with one of the largest experiences with this procedure in the world. 

Depending on your overall health and the condition of your tissues, Dr. Zaghiyan can carry out the J-pouch surgery in either two or three stages. 

If you’re well and have healthy tissues, she can remove your colon and bowel in the first operation, and reverse the ileostomy in a second procedure.

Some patients need to have their colon removed and then recover their strength before undergoing a second operation to remove the rectum, followed by a third procedure to reverse the ileostomy. Dr. Zaghiyan advises you at your consultation which approach would be most appropriate.

A J-pouch surgery is a major abdominal procedure, but it does offer relief to most patients. After the surgery, your ulcerative colitis symptoms improve and you should feel better quite quickly.

If you have symptoms of ulcerative colitis, call Karen Zaghiyan MD or book an appointment online today.