surgery

I have had UC for 40 years. It is controlled by medication and not very severe. I have a colonscopy every year for the last 25 years. This is getting old and stressful since I worry about cancer before each test. I am considering surgery to remove my colon to avoid all the issues with UC. I am a 65 year old female in good health and am active. Any input would be appreciated.

UC patients have the best quality of life when they can get their UC into a deep/clinical/quiescent remission (for me, a remission is 1-bm a day without urgency or other UC worries) through medicines or alternative means.

I believe we've all thought: I should just have the surgery and be done with UC altogether, at one point or another. However, the reality is unless your surgery is medically-necessary (i.e., have precancer/dysplasia or your UC is non-responsive to all medicinal treatment) then you're going to have trouble getting health insurance coverage for the procedures (which would be considered elective-surgeries) and have troubles finding a surgeon who will operate on you (worries about getting reimbursed, liability should outcome be less than stellar, among other reasons). Unless you are well off enough to pay hundreds of thousands of dollars out-of-pocket to have those operations then I do not see it happening any time soon (2-3 surgeries to complete j-pouch each with 5-7 day hospital stays, an allowance for complications and the unexpected that could occur).

It's true removing your large intestine would eliminate your colorectal cancer risks but only 3% of UC patients ultimately get a CRC. There are reasons that surgery isn't a 1st line treatment for UC as a whole. You're likely to have more bms than you do now, 4-6 bms a day with a good outcome from j-pouch surgery. There's always risk of complications with any surgery and a colectomy is no different (chronic pain from adhesions/scar tissue, abscesses, chronic-pouchitis, blockages, incontinence/nocturnal-seepage, fertility issues and so on) and additional surgeries down the line. Surgery has it's place, it's a great improvement in quality of life for those who cannot control their UC through traditional means and for them the benefits far outweigh the risks. However, it isn't now or should it be a solution for those of us with well managed symptoms through traditional means, as for you/I the benefits do NOT outweigh the risks of surgery when we're well controlled through medicinal means.

We all have health anxieties and worries about the future (will I be flaring in 6-months, can I book that vacation, might I get hospitalized due to my UC?) due to having a UC. It's part of the whole chronic illness experience that we all share. Unfortunately there is no easy-button. Although a surgery might initially seem like an easy-out of this whole UC mess, it isn't an easy process that we can elect into when it isn't medically necessary.