Ulcerative Colitis: A Challenge to Surgeons

Ulcerative colitis is a chronic disease that specifically affects themucosa of the rectum and colon. although the etiology of thisrecurring inflammatory disorder remains essentially unknown,there have been significant advances in identifying the likely geneticand environmental factors that contribute to its pathogenesis. theclinical course of the disease typically manifests with remissionsand exacerbations characterized by rectal bleeding and diarrhea.since ulcerative colitis most commonly affects patients in theiryouth or early middle age, the disease can have serious long?termlocal and systemic consequences. there is no specific medicaltherapy that is curative. although medical therapy can amelioratethe inflammatory process and control most symptomatic flares, itprovides no definitive treatment for the disease. proctocolectomyor total removal of the colon and rectum provides the onlycomplete cure; however, innovative surgical alternatives haveeliminated the need for a permanent ileostomy. the aim of thisreview is to provide a detailed account of the surgical managementof ulcerative colitis.