Inflammatory bowel disease (IBD) is a chronic inflammatory disorder that can affect the small bowel, large bowel or both. Ulcerative colitis (UC) and Crohn’s disease are IBDs typically treated with medications; however, sometimes surgery is necessary when medications no longer work or there are complications from the disease that requires it. Patients struggle with deciding on surgery, especially if they may need a temporary or permanent stoma.
The fear of patients
There is a time and place for surgery, although every effort maximizes medical treatment and tries to avoid it. However, patients may physically need surgery, but they won’t move forward because they aren’t emotionally ready. Reasons for not wanting surgery vary, but there are common themes patients express. Some are fearful of surgery or its finality.
By avoiding surgery, some let their disease control their lives as their health declines. Each patient comes to an emotional acceptance in their own time, hopefully with support from doctors, family and friends.
Having surgery
A patient suffering from UC for years felt weak and couldn’t do what he wanted. His wife encouraged him to consider surgery, but he wasn’t ready. His turning point came when he couldn’t bring his son to school for fear of needing a bathroom. It was time to take his life back, as letting UC rule his life was not what he wanted.
He underwent surgery, and when asked if he regretted having it, he said, “No, I wish I had done it sooner. My opinion on having an ileostomy is that it is life giving. I was reluctant to look at surgical options because of my pride, fear of what would happen and what I “couldn’t” do. There is absolutely nothing I can’t do now.”
When medications cannot help, sometimes surgery can be the answer.
Roberta Muldoon, M.D., Assistant Professor of Surgery, Colon and Rectal Surgery, Division of General Surgery at Vanderbilt University Medical Center, [email protected]