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Does Surgery Cure Ulcerative Colitis?

The removal of the colon and rectum has long been said to be a cure for ulcerative colitis but there is much debate by patients and clinicians on whether or not that is true. As time has passed and understanding of IBD has changed the word cure doesn’t seem quite right to most people these days. One notable sign that times are changing is that the Crohn’s and Colitis Foundation of America previously listed surgery as a cure for UC on their website but they have recently changed that

The thought behind surgery as a cure for ulcerative colitis is that UC only affects the colon and the rectum so a total proctocolectomy (removal of the colon and rectum) would essentially cure the disease. 

How We Define Cure

Gif of Severus Snape holding veritiserum and saying that word while looking at it

People differ in the way they think of a cure. I think that for a lot of patients they view a cure as having to take 1 dose of some medication that is invented as a cure and then be done with it. Once they take the cure their body goes back to working exactly like it would had they never had the disease in the first place. Sort of like taking a magic potion. 

People with cancer are told their cancer has been cured after the disease has been in complete remission for 5 years. This doesn’t mean that the cancer can’t come back later and there is no way to truly tell if all cancer cells in the body are gone.

 So the “cure” is actually more like a long, stable remission. Not all oncologists use the word cure because of that. 

A Cure or Trading One Set of Problems for a Different Set of Problems?

The patient with “cured” cancer may live with awful complications of having had cancer because of damage done to the body by chemotherapy and radiation. It’s no longer the cancer causing them problems but because of the cancer they now live with complications of it’s treatment. The cancer is gone but had they never had cancer to begin with they wouldn’t have these complications. In breast cancer a cure may involve surgical removal of one or both breasts. The patient is told their cancer is “cured” but in order to cure it they had to lose a big part of themselves. Would that patient call themselves cured? I think it comes down to personal opinion.

So is Surgery A Cure for Ulcerative Colitis?

After total proctocolecomy there is no way to guarantee a complication-free life with IBD from then on. If a patient has expectations that life will go back to exactly the way it was before they were sick they may be setting themselves up for disappointment. Even in the best of circumstances your body can never be exactly as it was before surgery because you are permanently removing an organ from it. Your body will look and function differently from then on. This isn’t necessarily a negative thing but it is important to have realistic expectations. If your idea of life after surgery is a life that looks like it would if UC had never been part of it then you’re setting yourself up to be let down. 

Types of Surgery for UC

If you have Ulcerative Colitis the two most common options for surgery are:

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