Surgery provides a cure for ulcerative colitis by removing the affected area of the colon. But surgery is not for everyone - it comes with risks. For this reason, surgery is usually only recommended for:

  • people with severe ulcerative colitis where other treatment options don't work
  • people who develop colorectal cancer
  • people experiencing severe bleeding related to ulcerative colitis
  • people with toxic megacolon (see How do I know if I have ulcerative colitis for more information)

About 1 in 3 people with ulcerative colitis will have surgery at some point in their lives.

After surgery you may need to wear a bag outside the body to collect solid waste. Instead of wearing a bag, some individuals may choose a procedure that involves the creation of a "pelvic pouch" from existing tissue that is inserted into the pelvis to collect waste inside the body. The involved portion of the intestine is attached to the anus, allowing normal bowel movements to occur. In some types of surgery with internal pouches, the pouch is connected to the outside of the body via a leak-resistant valve, where you eliminate the waste by leaning over a toilet and inserting a small tube through the valve.

Making the decision about surgery

Surgery can be a useful treatment option for people with ulcerative colitis. But it's important to understand the benefits and risks before making the decision to have surgery.

When you talk to your doctor about surgery, you may wish to ask:

  • What type of surgery would you recommend?
  • What parts of the bowel are removed during the surgery?
  • How long would I be in the hospital for the surgery?
  • What are the possible risks (e.g., infection, bleeding) and complications of the surgery?
  • How long does it usually take people to recover and return to their usual activities after surgery?
  • How would I get rid of solid wastes from my body after the surgery? Would I need to wear a pouch or a bag?
  • Are there any alternatives to surgery that would be appropriate for me?

If you have questions about surgery, talk to your doctor.