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Reasons for creating a colostomy 

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Ulcerative colitis

Ulcerative colitis, like Crohn’s disease, is an inflammatory bowel disease that affects the wall of the large intestine. Ulcerative Colitis occurs in 0.1 percent of the population, and in people of all ages.

An infection-like condition in the wall of the colon, ulcerative colitis causes the mucosa to swell, thicken and redden, with cuts and sores on the inner side. The mucosal surface becomes flat and the mucosal folds are lost – and as a result, the intestinal wall can’t absorb as much fluid as normal. This provokes peristaltic movements, which lead to diarrhea containing blood and remnants of damaged mucous membranes. In severe cases, the patient can lose a substantial amount of blood and the illness can be relatively debilitating.

Treatment
Ulcerative colitis is a chronic condition for which there is no known pharmacological cure, although therapies are available that may dramatically reduce the signs and symptoms. For around 80 percent of patients, the illness is only active for short periods, with long symptom-free periods.

Beginning in the rectum, ulcerative colitis can spread to the left side of the colon – and sometimes to the entire colon. An ileostomy is usually only considered if pharmacological treatment does not provide a satisfactory result. If the entire colon is not surgically removed, the illness is likely to flare up in the remaining part of the colon, leaving the patient at risk of having to undergo further surgery. For this reason, patients suffering from ulcerative colitis rarely undergo colostomy surgery. Instead, they will have a pouch procedure or ileoanal anastomosis as an alternative to a permanent ileostomy.

As ulcerative colitis affects only the large intestine, the condition can also be cured surgically by removing the large intestine and the rectum or the mucous membrane of the rectum.

Find out more
In a comprehensive booklet about basic stoma care called Colostomy – Background and Consequences.

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