surgery or biological drugs?

That's a hard question to answer. Drugs are going to effect each person differently. Initially I had success with Remicade which gradually began to fail. Entyvio never worked for me. I ran out of medications to try as they all failed, even Prednisone. My quality of life was terrible and that is what ultimately made my decision. In hindsight I wish I had done my surgery sooner. I've had some bumps along the way after my surgery but things have settled down and now I'm enjoying life again, medication free. Yes surgery does rid your body of UC attacking your colon, some have successful surgeries but there are also some that have bad experiences. Look at your quality of life to help make your decision.

If biologics put you into a solid remission then they are better than surgery. A remission is usually the preferred outcome with UC patients when it's possible, otherwise surgery. For me, a remission is 1 bm a day that's fully formed and without urgency or any uc symptoms. After surgery, you get 4-6 bms a day without urgency. Nobody knows how long a remission will last, 2, 4, 6 years and sometimes longer. Everyone with UC eventually flares. With surgery, flares no longer happen and things remain predictable and stable.

We've had members who are on remicade (a biologic) 10 years or more without issue. Some eventually loose response to a biologic, it varies. There are other biologics to switch to if obe doesn't work or you loose response.

The above sums it up. Remember though every outcome is different. With surgery you could go 4-6 times, you could go 10 times. I'm still pretty new (surgery in November) but I some days go about 4 times some days I go like 7. I usually wake up at least once a night now sometimes twice and even though I don't have the "urgency" to have to run to the bathroom a lot of times throughout the day I'll have pressure in my rectum either because I have to go or because of gas. Now, again, I can hold it if I need to but it's uncomfortable and sometimes at night I will be "sleeping", more like dozing off, because of that pressure and not be in a deep sleep until I get up and empty. Also, most people say it takes them about 15 seconds to empty their pouch, for me it can still take a few minutes until I feel like I'm mostly cleared out and even then sometimes it doesn't feel like I am 100%. Again, this may all settle over the year, my surgeon said it usually takes 6 months to a year for your pouch to stretch and settle down, but surgery isn't a full solution always either. I am happier than with UC, and I don't regret surgery but outcomes can differ.

I haven't done too much research on surgery. Are there different types of surgery? Does surgery always mean having to wear a bag outside the body? I'm very curious. Thanks!

hi,Trixy's Got Butt Trouble.i think there are different surgery depending on situation of colon.if small part of colon is infected then they cut it out and reattach the rest of colon to anus.i think it is right information :/

Ipoop i disagree.What if u have a weak immune system to start with like me??? Each of us is so different in our make up. Once your on biologic the short-long term side effects can be dangerous.Tough choice for many. Prob time for me to go surgery route

I think most people try biologics, even if they have a weak immune system. There are probably ways to keep potential immune issues at bay with prophylactic measures. It is really individual though, if someone was really against being on long term drugs, or had a history of colon cancer/polyps, I could definitely understand wanting to opt for surgery.

It's not an easy decision, and the worst part, is that you do not know how your outcome will be. We have a member, Solomon, who didn't want to take drugs, went for surgery before trying the majority of the drugs, and he ended up with a non-functioning j-pouch & has since reverted to an ileo. Nothing is guaranteed with surgery, and once your colon is gone, it's gone. There's no turning back. Situations like his are rare, but as rare as they are, they can happen. Just like getting blood cancer or a life-threatening infection from a biologic. We need to be well informed about the risks of everything.

At a certain age, I would fight to keep my colon simply because I do not know much about surgical outcomes in older people (specifically jpouch, ileo seems to be a good option if you're ok with that). I know we had a member who was in her 60s and she wasn't a candidate for a j-pouch. I am sure a lot more information exists on jpouch.org. I would definitely do research into that if I were considering jpouch surgery later in life. In my situation, I likely would have had to have surgery eventually even if it meant a permanent ileo. I couldn't live how i was forever. It was such a struggle to leave my house.