Evaluation of Recent Surgical Updates in the Management of Ulcerative Colitis

Background: Ulcerative colitis (UC) is a chronic inflammatory disease, which affects the mucosa of the colon and rectum. It is manifested by recurrent attacks of intestinal inflammation proceeded by partial healing. This will lead to long-term impairment in bowel function. Unlike Crohn’s disease, UC can be curable by surgery because its manifestations are restricted to the rectum and colon. Objective: To evaluate recent surgical updates in the management of Ulcerative Colitis and discuss the recent literature that tackled this aspect. Method: A comprehensive search was done using biomedical databases; Medline, and PubMed for studies concerned with the recent surgical updates in the management of ulcerative colitis. Keywords used in our search through the databases were “Ulcerative Colitis Pathophysiology”, “Ulcerative Colitis Surgical Management”, and “Ulcerative Colitis Evaluation”. Conclusion: One-fifth of UC patients during the course of the disease will require surgical intervention and around 16% undergo colectomy after a duration of 10 years of the disease. Restorative proctocolectomy with ileal pouch-anal anastomosis (IPAA) is the surgical treatment of choice. Surgical intervention becomes indicated mostly when the disease becomes refractory to medical therapy especially if serious complications started to appear. Emergent surgeries for UC still exists despite the advancement of medical therapy. Nevertheless, the surgical intervention timing should be optimized and determined based on a clear understanding of the outcomes for the patient including quality of life.