Surgical Treatment For Ulcerative Colitis

Although surgery can be the ultimate treatment for long-term ulcerative colitis, this option may not be for everyone. Your doctor will suggest an operation if your ulcerative colitis doesn’t respond to other conventional treatments, including medications and changes in your diet. Surgery can help prevent colon cancer.

When it comes to surgery to treat ulcerative colitis, there are two options that a doctor may consider. We will discuss both of them briefly in this article.


J-Pouch, also known as IPAA (ileal pouch-anal anastomosis), is a procedure aiming at removing the troubling part of your bowel, including your colon and rectum. The surgeon then folds the end of the small bowel to create a pouch of it and connects it to the anal canal. This internal pouch collects stools while the anus allows them to leave the body.

While a j-pouch can make your life easier, it can also have some side effects. For instance, it can become inflamed or irritated. This condition is known as pouchitis. Doctors recommend antibiotics for its treatment.

Since the muscles around your anus are not affected during the creation of a j-pouch, you will eventually be able to pass out stools from your anus the natural way.

Initially, your surgeon will give you an ileostomy to allow the j-pouch to recover. It means that you will have to attach an ostomy pouch over your stoma to take care of your bowel movements. It usually takes 12 weeks for your bowel to recover for you to be fit enough to undergo stoma reversal surgery. During this surgery, the surgeon will reconnect your bowel.

Your doctor will tell you any limitations you have to take care of during the recovery duration.


An ileostomy is a more conservative surgical option to treat ulcerative colitis. During this procedure, the surgeon will disconnect your colon from the small intestine and pull the end of the small intestine through a cut in the belly to create a stoma. After the procedure, you will no longer be able to pass out stools through your anus. Instead, they will leave your body through the stoma. You will have to wear an ostomy bag over the stoma to manage your stool evacuations. You will have to empty or change the bag once it is full.

An ileostomy can be permanent if your surgeon chooses to remove the colon and rectum permanently.

This bowel diversion can also have some side effects, including a heightened risk of infection. You can speak to your doctor or an ostomy care nurse to prevent or get rid of an infection on the stoma or the skin around it.

It will take some time for you to recover from the impact of ileostomy surgery. You can return to your routine activities in 6-8 weeks after surgery. You can eat whatever you want, engage in sports, and go to your workplace. You may, however, need to stay away from heavy lifting unless your doctor approves.

While living with an ileostomy is not hard, you will have to adapt to a careful lifestyle. It doesn’t necessarily mean an extra burden. Eventually, you will get used to this new routine.

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Tips To Care For A Urostomy

You may have several questions regarding how to care for a urostomy. Because the requirements of every person may vary, there is no one right answer. You may, however, find a few suggestions and ideas helpful in this regard.

Emptying and changing the urostomy pouch

During your hospital stay after urostomy surgery, an ostomy care nurse will teach you how to empty and change your ostomy pouch. You will also learn about how to take care of the stoma and the skin around it.

Emptying the pouch

Emptying a urostomy pouch is very easy, thanks to a valve at the bottom of the pouch. With a higher chance of the growth of bacteria in the pouch, you will need to empty it more often. Allowing too much urine to store in the ostomy pouch can result in it gaining weight, which can cause the seal to compromise. You will need to empty the pouch when it is one-third to half full.

You may need to empty the pouch 5-6 times a day, which could mean emptying it every 4 hours. If you drink a lot of fluids, the frequency of emptying the pouch will be even higher.

Changing the pouch

When to change a urostomy pouch depends on the type of pouch you use and the state of your peristomal skin health. The best approach is to change the pouch according to a set schedule to prevent any problems. The best time to change the pouch is the morning before eating or drinking anything. If it is not possible due to any reason, you may want to change the pouch 1 or 2 hours after drinking fluids. You don’t want your stoma to pass out urine while you change the pouch.

You can change your pouch in any position you are comfortable in, such as sitting, standing, or lying. The rule of thumb is to get into the position that allows you to see your stoma when you change the pouch. Most people prefer changing their urostomy pouches while standing because it allows them to prevent any spillage of urine on the floor. You can also sit on the toilet and make sure that urine falls in the toilet bowl without coming in contact with the body and clothes.

The reason you need to set a proper schedule to empty and change the urostomy pouch is that it allows you to keep the pouch clean. A pouch with leftover urine can cause bacteria to travel up into the kidneys through ureters to cause kidney infections. Changing the pouch on a schedule will help prevent such infections.

Protect the skin around the stoma

The skin around your stoma should be just as the skin elsewhere on your abdomen. If any part of the skin comes in contact with urine regularly, it can develop irritation and other problems. It means that you are going to have to ensure a proper seal between the ostomy pouch’s skin barrier and the peristomal skin. For this purpose, you will need to change the ostomy pouch before it seal weakens. You will also need to use the right-sized ostomy pouch and skin barrier opening. For more information in this regard, you may want to meet or contact your ostomy care nurse.

Some Important Facts about Your Stoma

An ostomy surely tends to have an impact on your daily life but not when you are fully prepared for it. So your best shot at living a happy and healthy life even with your stoma is to know about it. This way, you will be able to adjust your routine right according to your requirements.

Important facts about stoma

As mentioned above, an ostomy changes things quite a bit in your life. The best way to control it effectively is to gain some knowledge about it. It is just a matter of accepting that you are going to have to live with something that has the tendency to affect your life. And then you have to be in a right state of mind to gain knowledge about it to manage it so that you could live an active and healthy life.

Signs of a healthy stoma

Right after the surgery, the stoma will be swollen. Its process of shrinking back to its permanent size may take a number of weeks or months. In this scenario, it is very important to know what a healthy stoma looks like. The signs of healthy stoma include:

  • Pink or red in color
  • Slightly moist
  • Not painful
  • Quick to bleed when rubbed or washed, but the bleeding should subside in a short amount of time

Other important facts

  • Stoma drainage: The stomal output should be emptied into the pouch. And you have to make sure that that it is not leaking under the skin barrier. In case you have a urostomy and the urine coming out of your stoma has blood in it, you need to contact your stoma care nurse.
  • Temporary stomas: Temporary stoma is a loop or double-barrel. This ostomy has a supporting device which is called rod or bridge. This stoma is removed after two weeks.
  • Peristomal skin: Peristomal skin is the skin around stoma. Remember, this skin should not have any rash, irritation or redness, and it should be a normal skin just like anywhere else on your body. This skin can be protected from irritation, which is caused by drainage, with the help of a properly fitting barrier. To keep this skin healthy, you are going to have to develop a habit of cleaning it while changing barrier. Be cautious about the redness, swelling, rash, or irritation on this part of the skin.
  • Types of pouching system: Remember, the type of pouch you need to use depends upon the type of surgery you had. There are different types of pouches from different manufacturers available for each kind of stoma.

Things to Consider About Colostomy Irrigation

If you have a sigmoid or descending colostomy, you can train your color to empty it at a regular time every day. This process is referred to as irrigating. Your doctor is the person to tell you if you are a good candidate for this process.

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What are the benefits of colostomy irrigation?

It’s mainly the matter of whether the colostomy irrigation is right for you. If it is, it is going to offer you several advantages.

  • You can wear a small stoma cap or a low profile small pouch.
  • You are not going to have to do frequent pouch changes.
  • You will have a sense of freedom.

How does the colostomy irrigation work?

The process of colostomy irrigation is done with the help of a tool which is pretty similar to enema. It is placed in the stoma. The first irrigation will be done by the healthcare team. Then you will be taught about how to do it at home. Now let’s talk about the process of colostomy irrigation.

  • You will have to allow one hour for the process of colostomy irrigation.
  • The special irrigation equipment will be used to place water into your stoma.
  • The equipment which is used during this process includes an irrigation bag, a sleeve, and a stoma cone.
  • After the irrigation is done, you can either use a stoma cap or attach a one or two-piece closed pouch to protect the stoma.

You will be able to determine the exact timing of stoma irrigation with the help of your ostomy care nurse. You may have to do this irrigation process on daily basis but it should be a problem once the process becomes a part of your daily routine.

Is colostomy irrigation right for you?

Yes, you are going to have to be eligible for colostomy irrigation because it is not appropriate for everyone. You will certainly not get a recommendation for this procedure if you have a urostomy or ileostomy. Even if you have a colostomy, you are going to have to talk to your health physician to discuss about whether or not you can do this procedure on daily basis. A few things that need to be considered in this regard are as under.

  • Remember, irrigation is a time commitment. It takes at least an hour.
  • You need to have irrigation equipment. And there is a fixed time slot that you have to get in order to perform this irrigation.
  • You are going to have to be persistent. It will take at least 8 weeks for your bowels to become properly regulated.
  • Last but not the least; you will have to be physically capable of doing this procedure without any help.

Again, you need to ask your doctor or nurse whether or not you are a good candidate for colostomy irrigation.

Researching for your Stoma

This day in age makes researching for things super easy.  We all have smartphones and the fastest internet available in the county and can learn about anything almost instantly.  It is a beautiful thing and it can really help your sanity when you hear bad news.  You can research quickly what you don’t know and in a way be relieved.  When you find out you are going into surgery you most likely got really nervous.  I know I sure did. All surgeries kinda scare me and bring out the worst in me. It is a normal feeling and most of us have it.  The thoughts of never being able to feel hot, or pretty also creep into your mind.  You think that sensual times will never be that way again.  These are the thoughts and feelings that happen when you are waiting on an ostomy surgery.  Learning about what you can and cannot do is easy now and for most people, they are relieved when they see their lives won’t truly change much, but these are the feelings and emotions that haunt your dreams when you get out of the surgery.  So who do you talk to to get over those feelings and fears? I want to go over my journey and who helped me. Because who you listen to and read from is important.

So take a breath and calm down because I am nothing special and the first thing I did was really simple. I talked with my doctor and nurse. My ostomy team was really nice, helpful, and encouraging.  It is simply stupid not to learn in person from people who do know what they are talking about.  This is the greatest wealth of knowledge for actual medical issues.  Use it and love it!  Ask all the questions you can and the hard ones too. I would have to say that I learned about all the sensual things from them and it was not awkward at all.  I think my nurse actually brought it up first.  It is part of life and really depending on where you are and who you are truly necessary.

But we all have a phone.  Another great area of information was simply from online sources.  There are a lot of major companies in the ostomy industry that is really worth checking out. These guys have a whole lot of starter information and lots of gear information.  I ended up calling up a few of these companies to get in-depth information, because well I didn’t know jack to start with.  They were really helpful and I spent an hour on the phone the frist call and ended up with some samples mailed to my home.  It was a great experience and they were focused on me and my lifestyle.  It was a reason I started to be more vocal about my ostomy and started to ask questions and talk to other areas as well. 

Now go local.  The next path was pharmacists and this was a tip from my online store friends.  They suggested I talk with local pharmacists who deal with this and buy gear specifically for what people like to buy.  That was a good idea and they helped me walk through the history of products.  They went through popular items and what people use for different reasons. Also, it was great to find a local place to buy from in case I needed an emergency item quickly! So take heart and ask questions always.