Has anyone ever asked if a partial colectomy can be done for left sided UC?

I'm on the lifetime Remicade program and thinking of the future. I don't like the idea of j-pouch, but wondering why the whole colon has
to be removed for partial colon disease?

Yep.. I'm in the same boat as suebear... My colitis is limited to the rectum, but when I do have the surgery, it all has to come out.. I'd rather have that happen than the disease returning later on.... I just wanna be DONE wtih it.. lol...

From my understanding the disease is always continuous starting at the anus. If you have only had problems on the left side I would research a lot more as to whether you can keep part of your colon. Why take out everything when there is a decent chance you cut out just the problem??? I never understood the logic there. If I had only left-sided colitis I would want at least the right side kept; even if it meant there was a 50% chance I may have surgery again. I would press this further and ask to see the data. How many have had partial removal, what percent had it return, what are the consequences of it returning, would any return be more likely because of the surgery,..ask questions I say

So let's say that one day they can grow body parts (they are already doing this with humans, just not colons) does that mean we would be able to cure colitis by having a "new" colon grown? Or does that fact that UC is auto immune mean that our bodies would still attack any new colon? I mean if surgery is done to remove the diseased colon and we are sure that the remaining colon is disease free, why is there a risk for it still spreading? Have they done this surgery before and found they had to do it again? I'd think it would be worth the risk to preserve the healthy colon and body function?

I'm going to disagree with most everyone else here on this thread. I talked to my surgeon and he does partial colon removal. Just because UC can come back in another part of the colon doesn't mean it will. The surgeon I see has done several partial colon removals and has yet to see one case where UC returned in any of his patients.

Every organ has a purpose and a function--I think it is a mistake to say any organ is "not needed." That just means that science has yet to uncover the the full purpose behind the colon, as it has yet to do with the appendix. Taking out an organ should never be considered lightly, and as my surgeon says, if you can get by just removing an organ paritially, that is a much better alternative.

Also, keep in mind that there is no scientific consensus that UC is an auto-immune disease. Many diseases and ailments that have at one time or another been labeled auto-immune only to become identified with viral or bacterial causes later. I think that physicians use the term auto-immune when they cannot diagnose the cause of an ailment, but it doesn't make too much sense to me that the body would attack itself without cause--I expect that many more of these auto-immune diseases will be traced to definite causes within our lifetimes and cures will be found. Doctors don't have all the answers yet and when it comes to UC, they don't have any answers really.

Talk to several physicians and get multiple opinions, but yes, taking out only part of your colon is always an option and is done frequently with Chron's and sometimes with UC.

I personally wouldn't risk it (even though I have pancolitis and it's therefore not an option). There are MANY people living completely normal lives with j-pouches and ostomies. I just wouldn't want to risk it coming back and having to have surgery again.

Yeah i would have never had just a partial one done. i actually did ask about it, because mine wasnt actually very high up. But once my GI explained it to me, it made sense. Because it started just at my rectum and just kept climbing up, so if i had had just my rectum removed 10 years ago, it still would have climbed up.
They have tried transplants but the organ is so big and the body rejects it because of the UC and the patient still has to stay on meds their whole life. I would think that growing a new organ would be the same.
And you really dont need it to live a full life, im just fine without it, and no more scopes or preps or colon cancer worries, so there is an upside. Also they take out your appendix so no appnedicitis either!
But i guess if you could find a dr who would do it, you could have it done, just you would still have to take meds and most likely have more surgery again. Seems kind of silly to me to not just knock it out in one blow.

I'm sure that data is available. I haven't seen the original data, but have seen it referenced in articles I've read in the past.

But everyone has the right to do what they want with their own bodies. Just don't ask me (via Medicare or other public insurance) to pay for two surgeries instead of one, when you're going against the prevailing medical opinion anyway. If people are on their own nickle, they can do what they want.

I don't see the incentive for a surgeon to remove the whole colon if removing part might work, but perhaps someone else does.

I don't think growing a new colon would help. The problem is with our immune systems attacking our colon. The colon hasn't done anything wrong. Its the victim of the immune system.

A quick PubMed search found these two articles, which were written by the same author and seem almost identical. I wish I had a subsciption or a way to access those journals, because the abstracts don't provide much info.

Colectomy subtypes, follow-up surgical procedures, postsurgical complications, and medical charges among ulcerative colitis patients with private health insurance in the United States.
Loftus EV Jr, Friedman HS, Delgado DJ, Sandborn WJ.
Inflamm Bowel Dis. 2009 Apr;15(4):566-75.
BACKGROUND: We describe colectomy subtypes, follow-up surgical and diagnostic procedures, complications, and direct medical charges occurring within 180 days of colectomy among privately insured patients with ulcerative colitis (UC). METHODS: This was a retrospective analysis of an insurance claims database for 2001-2005. We identified patients with a diagnosis of UC and no concurrent diagnosis of Crohn's disease who underwent colectomy. Colectomy types were classified as: 1) total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), 2) subtotal colectomy (SC) with ileostomy and Hartmann pouch or ileorectal anastomosis, 3) TPC with ileostomy, and 4) partial colectomy (PC). Follow-up surgical and diagnostic procedures and complications were collected. We developed estimates for UC-related charges for hospitalizations, outpatient visits, and medications for the time period 180 days before and after colectomy. RESULTS: A total of 55,934 UC patients were identified, of whom 540 had a colectomy and at least 180 days of pre- and postcolectomy follow-up. The colectomy distribution was: TPC-IPAA, 44%; SC-ileostomy, 22%; TPC-ileostomy, 17%; and PC, 17%. Within 180 days after colectomy, 54% of patients had a second colectomy-related surgery, and 27% had a follow-up diagnostic procedure. Complications following colectomy for UC included: abscesses (11.5% early / 14.6% late), sepsis/pneumonia/bacteremia (9.3% early / 10.0% late), and fistulas (3.9% early / 8.3% late). The mean UC-related direct medical charge for the 180 days following and including initial colectomy was $90,445. CONCLUSIONS: In this retrospective study of privately insured UC patients, we observed frequent follow-up surgical/diagnostic procedures, identified several complications postcolectomy, and estimated substantial charges 6 months pre- and postcolectomy.


Colectomy and the incidence of postsurgical complications among ulcerative colitis patients with private health insurance in the United States.
Loftus EV Jr, Delgado DJ, Friedman HS, Sandborn WJ.
Am J Gastroenterol. 2008 Jul;103(7):1737-45. Epub 2008 Jun 28.
PURPOSE: We sought to describe the types of colectomy, follow-up surgical/diagnostic procedures, and complications occurring within 180 days of colectomy in a population of privately insured individuals with ulcerative colitis (UC). METHODS: This was a retrospective analysis of claims data of privately insured patients (MarketScan) for the years 2001-2004. We identified a cohort of patients with UC who underwent colectomy. Colectomies were classified into four categories based on the surgery occurring on the first colectomy date: (a) total proctocolectomy (TPC) with ileal pouch-anal anastomosis (IPAA), (b) subtotal colectomy (SC) with ileostomy and Hartmann pouch or ileorectal anastomosis, (c) TPC with ileostomy, and (d) partial colectomy (PC). Follow-up surgical/diagnostic procedures and complications were compared across colectomy categories. RESULTS: A total of 25,586 UC patients were identified, of whom 215 patients had a colectomy and at least 180 days of pre- and postcolectomy follow-up. The colectomy distribution was: TPC-IPAA (52%), SC-ileostomy (22%), TPC-ileostomy (14%), and PC (13%). Within 180 days postcolectomy, 54% of patients had a second colectomy-related surgery (including unplanned surgeries in 15.3%), and 27% had a follow-up diagnostic procedure. Postcolectomy complications included abscesses (11.6% in the first 30 days postcolectomy, 16.3% in the day 31-180 postcolectomy period), fistulas (4.2% early, 6.0% late), and sepsis/pneumonia/bacteremia (7.9% early, 9.3% late). CONCLUSION: Postcolectomy surgical procedures and complications occur frequently after colectomy in privately insured patients with UC.

hello everyone. i am 26 years old and was first diagnosed with uc at 18. i am currently a left side victim and due to neglect on my part, sulfasalazine pills no longer do the job. I have been upgraded to enema type meds for about a year now and am currently experiencing a major flare. does anyone with left sided uc have a recomendation for the best med type? i haven't had to take steroids yet and am hoping to keep it that way.

(Sulfasalazine is a 5-ASA, the oldest oral one.) RE partial surgery for left-sided UC: folly!!!!!!!! You can delude yourself, but there's no way you're going to have normal function w/o a rectum. Plus the remaining sections will be subject to flares-- enough convincing data on this has been collected over decades. The stats Fruitgirl cites comes from IBD gastros at the Mayo Clinic HQ. Not a pretty picture; however, UCers suffering a couple dozen bloody bms daily are usually ready to part with the entire organ rather than continue a living hell, or to risk its recurrence. / Old Hat (30 yrs with left-sided UC ... [etc.])

I think that in j pouch surgery the lining of the rectum is removed, which would mean UC woudln't be an issue in the rectum anymore, I believe.

I was hoping someone would come along who has full access to one of those journals. I'm sure in the full text it breaks down the chance of additional surgeries for each type of first surgery.