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Article Type: Blog

Minimally Invasive Treatment Options for Ulcerative Colitis

Ulcerative colitis, along with Crohn’s disease, is a form of inflammatory bowel disease (IBD) that flares up in the lining of the digestive tract. It can cause unpleasant symptoms like diarrhea and abdominal pain, as well as dangerous ones such as anemia and dehydration. Unlike Crohn’s disease, which can affect any part of the digestive tract, ulcerative colitis is confined to the colon and rectum. In some ways, that can make the condition simple to treat; when patients have the colon and rectum removed, their ulcerative colitis is cured.

Even so, Allen Chudzinski, MD, FACS, FASCRS, colon and rectal surgeon at the AdventHealth Digestive Institute Tampa, says such a drastic measure should not be a patient’s first option.

“Recently, there have been great advances in medical treatments such as biologics for IBD,” Dr. Chudzinski says. Because of biologic agents such as infliximab and adalimumab that keep inflammation at bay, “fewer people with ulcerative colitis are having surgery today than before,” he continues.

Dr. Chudzinski mentions that scientists now know that substances released by the body’s immune system – specifically TNF-alpha and interferon-gamma – cause an autoimmune response that triggers inflammation. By injecting or being infused with biologic medications that block these substances, inflammation can be stopped in its tracks before it starts. Because of this, Dr. Chudzinski says these nonsurgical treatments should be tried first.

Still, these advanced medications do not work for every patient, and they are not without risk. Dr. Chudzinski mentions that ulcerative colitis can cause rectal bleeding and colorectal growths that can turn into cancer. For the nearly 4 in 10 people with IBD for whom medications may not work, surgery may be the best treatment option.

A Better Life After Ulcerative Colitis Surgery: J-Pouch Surgery Can Make It Possible 

“The historic approach to surgically treating ulcerative colitis was to remove the entire colon and rectum,” explains Dr. Chudzinski. This involved creating a permanent ileostomy – a hole between the end of the small intestine and the outside of the abdomen to which an external ostomy bag is attached to collect stool. 

Today, he and his colleague, Hanne Massarotti, MD, FACS, also a board-certified colon and rectal surgeon, can offer patients a procedure in which this ostomy is only temporary. This procedure is often referred to as “J-pouch surgery.” After removing the colon and rectum, the surgeon creates a J-shaped pouch with the end of the small intestine. This pouch is then attached to the anus. The surgeon also makes a temporary ostomy to redirect the stool while the patient recovers from surgery. Once the J-pouch has healed, a second procedure reverses the ostomy and reconnects the digestive tract so the patient can toilet naturally.

Minimally Invasive Surgery Colon & Rectal Surgery in Tampa Gets Patients Back to Normalcy Faster

If having two operations instead of just one sounds less than ideal, patients can take comfort that the Digestive Health Tampa’s colon and rectal surgeons are high-volume experts in offering minimally invasive, closed procedures. With laparoscopic and robotic-assisted surgery, the surgeon only makes a few small incisions – one hidden inside the belly button – instead of a large cut in the abdomen and pelvis. The results are safer procedures that give patients easier and faster recoveries with less pain.

Dr. Chudzinski and Dr. Massarotti strive to offer all of their patients who need surgery a minimally invasive procedure. Usually this takes the form of robotic surgery, associated with better outcomes than traditional, open colon and rectal surgery.

“You can get back to normalcy faster after robotic surgery,” says Dr. Chudzinski. He explains that the small instruments used by the surgical robot cause less trauma, preventing a large inflammatory response by the body. Robotic surgery is also ideal for the surgeon because it gives him or her a magnified, high-definition, 3D view of the surgical site.

Digestive Institute Tampa Provides an Enhanced Recovery After Surgery

Dr. Chudzinski stresses that he and Dr. Massarotti’s patients with ulcerative colitis do very well after surgery. They leave the hospital quickly, and go home being able to eat a regular diet. While much of this is a testament to the skills of the Digestive Institute’s surgeons, it’s also because of the special attention our team gives to ensuring patients are ready for surgery.

“We use enhanced recovery after surgery – ERAS – protocols that start before the procedure,” he says. Patients’ pain receptors are blocked before their operations, and steps are taken to ensure that the pain medications given after surgery do not lead to constipation or abdominal discomfort.

Ulcerative colitis is no walk in the park. However, thanks to advanced treatments offered at the AdventHealth Digestive Institute Tampa, more people can find the relief they need with surgical procedures that are easier on them while completely treating their condition and leaving them with a great quality of life.
 
If you need advanced treatment for ulcerative colitis and want to learn more about your surgical options, speak with a colon and rectal surgeon at the AdventHealth Digestive Institute Tampa. For an appointment, call Call813-615-7557.