Ulcerative colitis (UC) is a disease in the family of inflammatory bowel diseases. The disease causes pain in the abdomen, rectal bleeding, and varying degrees of diarrhea. The treatment options for UC involve medication, IV treatments, and a final option of a colectomy. A colectomy becomes more necessary for the elderly due to the physically threatening aspect of the disease and the increased risk of colon cancer.
Surgical Necessity
It is of the utmost importance than seniors with ulcerative colitis meet regularly and often with the GI doctor. The GI doctor will perform a colonoscopy yearly to evaluate the health of the patient's large intestine. It is after multiple evaluations that your GI doctor may suggest a colectomy if the large intestine starts to look cancerous or if an elderly person is having trouble making it to the bathroom all the time.
Proctocolectomy with Ileostomy Surgery
Two types of surgeries are available for a colectomy. Proctocolectomy with ileostomy is the first and more traditional option. This option is also more common for elderly patients due to the recovery process. Proctocolectomy with ileostomy involves two separate surgeries: the removal of the colon and anus, and then the addition of a colostomy bag attached to the midsection of the body to pass bowel movements through.
Proctocolectomy with Ileostomy Recovery
The recovery process for the elderly is much quicker with proctocolectomy with ileostomy surgery than with the other option. This is because it only requires one set of surgeries and one hospital stay (for approximately one week). For about four to six weeks, you must eat an altered diet (see a nutritionist or your GI doctor) because the body must get used to using the external bag. Once you are recovered, though, you can eat as normal and often as you want, without any of the side effects common with colitis. Know that a colostomy bag must be emptied multiple times a day. For elderly patients, assistance may be needed due the dexterity such a process requires.
Restorative Proctocolectomy Surgery
Restorative proctocolectomy is a newer procedure more commonly used in younger and healthier patients. However, this does not mean this option is not available to elderly patients. Restorative proctocolectomy involves the removal of the large intestine (colon), but allows the body to pass waste naturally. This does so through the development as of a J-pouch n the intestinal tract that "extends" the remaining intestines. This procedure requires three or four separate surgeries, which may be complicated for elderly patients who could struggle with the amount of body stress.
Restorative Proctocolectomy Recovery
The recovery for the elderly is the same as for a young patient. A hospital stay for each procedure is anywhere from four to seven days. The overall recovery period with for all surgeries can last up to six months. This will involve a restricted diet, multiple medications, and an altered lifestyle. This is what proves difficult for the elderly. Many senior patients have special diets, vitamins, and medication they must take on a daily basis. Also, due to fixed incomes, some elderly patients may find it difficult to alter their life for such an extended period.
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