Thanks, Alessandro Armuzzi.
Elective total #colectomy for #ulcerativecolitis is a significant decision for patients, often considered when medical management fails to control symptoms or when there are concerns about long-term complications, such as the risk of colorectal cancer.
From a patient perspective, the best time to consider an elective total colectomy involves several factors:
📌 When UC significantly impairs quality of life despite optimal medical therapy, #surgery may offer a better quality of life. Symptoms such as severe pain, frequent diarrhea, and the inability to maintain a normal lifestyle despite treatment can be indications.
📌 If a patient has tried and failed multiple lines of medical therapy (including biologics and immunosuppressants) or cannot tolerate them due to side effects, surgery may be considered.
📌 The presence of dysplasia or early-stage cancer in the colon or rectum significantly increases the risk of developing colorectal cancer. Elective surgery in this context can be life-saving.
📌 In cases where there's a high risk of complications from UC, such as toxic megacolon, perforation of the colon, or severe bleeding, elective surgery might be considered to prevent these potentially life-threatening conditions.
📌 Decisions around surgery also involve personal life circumstances, including the ability to take time off for surgery and recovery, family planning (as surgery can affect fertility, especially in women), and personal preferences regarding living with a stoma or undergoing procedures for an alternative, such as ileal pouch-anal anastomosis.
📌 For some patients, the prospect of lifelong medication, regular monitoring, and the potential for medication-related side effects may be less appealing than surgery, which offers a chance for a life free from UC symptoms and medications.
📌 Understanding the risks, benefits, and potential outcomes of surgery versus continued medical management is crucial. Decision-making should involve thorough discussions with a multidisciplinary team, including gastroenterologists and colorectal surgeons, and, when possible, input from other patients who have undergone the procedure.
#IBD
It's #ESCPIBDMonth!
What is the best time to indicate elective total colectomy in #UlcerativeColitis? Let us know in the comments below!
Hear Alessandro Armuzzi's point of view below 👇
