Surgery is likely to be needed for ulcerative colitis for the following reasons.
- Medicines and nutritional therapy have failed to manage severe symptoms.
- Toxic megacolon does not respond to medical treatment within 4 days (or sooner in some cases).
- Holes form in the large intestine. (This is called perforation.)
- You have colon cancer or a significantly increased risk of cancer. (This risk is found by biopsies.) Or you have a narrowing in the intestine that can't be told apart from cancer. You may need surgery even if you don't have symptoms of active disease.
- Severe, disabling complications occur outside the colon. But many complications do not respond to surgery.
- You have severe bleeding that requires ongoing blood transfusions.
- Slow growth or other serious complications occur in children.