INFLAMMATORY BOWEL DISEASE
Ulcerative Colitis
A chronic inflammatory bowel disease causing ulceration of the large intestine lining. Dr. Samhitha Reddy provides ulcerative colitis treatment, from medical management to definitive surgical care.
ABOUT THIS CONDITION
What is Ulcerative Colitis?
Ulcerative Colitis (UC) is a chronic inflammatory bowel disease characterised by diffuse mucosal inflammation and ulceration of the colon and rectum, always starting from the rectum and extending proximally. It is marked by periods of active disease (flare-ups) and remission. Symptoms include bloody diarrhoea, abdominal cramping, urgency, and fatigue. Dr. Samhitha Reddy manages ulcerative colitis medically through a gastroenterology-colorectal surgery collaboration, and surgically when medical therapy fails, when complications arise, or when surgical cure (Total Proctocolectomy with J-Pouch) is the optimal long-term strategy for the patient.
SIGNS TO WATCH
Common Symptoms
Symptoms that need attention
WHY IT HAPPENS
Causes & Risk Factors
- Immune dysregulation, the bowel's immune system attacks its own mucosa
- Genetic predisposition, family history increases risk significantly
- Environmental triggers, diet, stress, infections may precipitate flares
- Gut microbiome imbalance, disruption of intestinal bacterial ecology
- Smoking, paradoxically protective in UC; cessation may trigger onset
- NSAIDs and some antibiotics may exacerbate or trigger disease
CLINICAL DETAILS
KeyFacts
Curative surgery, removes colon and rectum, creates ileal pouch-anal anastomosis (IPAA)
Emergency surgery for acute severe colitis unresponsive to IV therapy, life-saving procedure
Total proctocolectomy with permanent ileostomy, when pouch surgery is not appropriate
Colonoscopic surveillance for colorectal cancer in long-standing UC, annually from year 8
Advanced medical therapy (infliximab, vedolizumab) before surgical consideration
Surgical management of UC available at Lux Hospitals, Hyderabad
HOW WE TREAT IT
Treatment Approach
Surgical Management of Ulcerative Colitis, When and How
Surgery for ulcerative colitis is considered in three scenarios: (1) acute severe colitis unresponsive to medical therapy, emergency Subtotal Colectomy; (2) medically refractory chronic disease, elective Total Proctocolectomy with IPAA (J-Pouch); (3) dysplasia or cancer risk. Dr. Samhitha works in close collaboration with gastroenterologists to determine the optimal timing and technique.
- 1
Medical Management First
Aminosalicylates, corticosteroids, immunomodulators (azathioprine), and biologics (infliximab, vedolizumab, ustekinumab) form the medical backbone. Surgery is considered when these fail or complications arise.
- 2
Emergency: Subtotal Colectomy
For acute severe ulcerative colitis not responding to intravenous steroids or biologics, emergency subtotal colectomy is life-saving. The rectal stump is preserved for future pouch surgery when the patient has recovered.
- 3
Elective: Total Proctocolectomy with J-Pouch (IPAA)
The curative surgical option, removes the entire colon and rectum and creates an ileal pouch (J-Pouch) connected to the anus, preserving continence and avoiding a permanent stoma. Performed in 2-3 stages.
- 4
Total Proctocolectomy with End Ileostomy
When J-Pouch surgery is not appropriate (sphincter dysfunction, high cancer risk, patient preference), a permanent ileostomy provides definitive, safe surgical cure.
AVAILABLE TREATMENTS
Treatment Options
Total Proctocolectomy with IPAA (J-Pouch)
Complete removal of colon and rectum with construction of an ileal pouch anastomosed to the anus.
Subtotal Colectomy
A surgical procedure involving the removal of a major portion of the colon, typically performed for severe disease not responding to medical management.
Total Proctocolectomy with End Ileostomy
Complete removal of the colon and rectum. The small intestine is brought out as a permanent ileostomy for stool diversion.
COMMON QUESTIONS
Frequently Asked
Not sure about your condition?
Compassionate, confidential consultations — Book your appointment today.