Why would a person with ulcerative colitis need a colectomy?

Colectomy tends to be reserved for severe ulcerative colitis that is not responding well to medical treatment, or if the person is unable to tolerate medical treatment.  More urgent colectomies may need to be performed if the person has a flare that makes him or her particularly ill. For example, colectomy would be necessary if there is high blood loss from rectal bleeding, or if the colon perforates.

There are anywhere from 7,000 to 46,000 new diagnoses of ulcerative colitis annually, and unfortunately, up to 30 to 40 percent of people with ulcerative colitis will ultimately require a colectomy (removal of the colon). There are three main reasons for needing a colectomy for ulcerative colitis.

First, you could develop colon cancer or risk factors or features that increase your risk for colon cancer due to prolonged periods of time with ulcerative colitis.

Second, you have what's called medically refractory ulcerative colitis, which means you've gone through all the available medications and are still very symptomatic. At that point, doctors will have no other option except to remove your colon.

Finally, the third reason to require a colectomy is if you have massive dilation of your colon, called toxic megacolon, if you have uncontrollable bleeding or if you have severe symptoms that require admission to a hospital and an emergent colectomy. That's the least common indication for a colectomy. The more common reasons are medically refractory disease as well as colon cancer or precancerous lesions.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.