“When is surgery needed for ulcerative colitis?”
My son was recently diagnosed with ulcerative colitis and he's 7-years-old. He's on a special diet right now and we were discussing the options for medications, but his doctor mentioned surgery as possibility. He doesn't need it right now though. When is surgery a necessity for ulcerative colitis?
7 Answers
Only in the most severe of cases. For example, when the symptoms are severe and medications and diet changes are not helping. Children needing surgery for ulcerative colitis is very rare these days.
Close to 25% children diagnosed with Ulcerative Colitis will eventually need some form of surgery. massive bleeding, chronic debilitating illness, perforation of the colon, or risk of cancer are some of the reasons for surgery.
Typically surgery is reserved for patients who have tried several different treatment options yet continue to have signs of inflammation or symptoms that are concerning and ongoing. It used to be thought that surgery was the last step when medications failed but newer thinking has put surgery on the forefront of treatment for some patients with very severe disease that cannot be cured with medications and/or diet.
The issues of timing and decision-making for surgery in ulcerative colitis are difficult and very personal. The typical general reasons for doing surgery would be persistent bleeding, persistent pain, malnutrition, or failure to thrive (grow) either from nutrition or from the use of medications like steroids, the development of complications from medications, or even just the desire to improve quality of life. Since the surgery for ulcerative colitis is rather major, including substantial risks, needs for anesthesia, long term effects, possible alterations in quality of life, not to mention cost, and hospital stays, everything needs to be discussed and the pros and cons of surgery vs no surgery carefully balanced. So the quick answer is that there is no quick answer. What is serious bleeding to one patient or one doctor may be rather different from another person, or another doctor. Thus it is best to discuss your son’s particular situation with his doctors, and if surgery is believed to be needed, or preferred, then it would be time to meet with a surgeon and to discuss the options further. Good luck to you and to him. BN
Surgery can be done at anytime, however, it is usually reserved for patients that fail medical treatment including biologic therapies.
Surgery is needed in medically recalcitrant ulcerative colitis.
Surgery is usually the last option for ulcerative colitis. It is done when the patients don’t respond to medication and the disease is out of control. In this day and age, we have a lot of medication options, so rarely end up needing surgery during childhood.
Mark R. Corkins, M.D., S.P.R., C.N.S.C., F.A.S.P.E.N., A.G.A.F., F.A.A.P.
Mark R. Corkins, M.D., S.P.R., C.N.S.C., F.A.S.P.E.N., A.G.A.F., F.A.A.P.
