Because ulcerative colitis involves only the colon and rectum, complete removal of these with creation of an ileostomy is curative for the disease and is one of the treatment options.
In emergency surgery for UC, the large bowel (colon) is removed, temporarily leaving the rectum and anus, and the end of the small bowel (ileum) is brought out through the abdominal wall to the skin level to create an ileostomy through which the fecal stream is diverted. Depending upon the particular circumstances, this procedure can be performed in a traditional “open” procedure or in a minimally invasive (laparoscopic) fashion.
After the patient recovers, a second procedure can be performed to remove the remaining diseased rectum and create a new rectum (ileal pouch) using the small bowel. The new rectum is connected to the anal opening and a loop ileostomy created to protect the area until it has healed.