Which surgery is considered curative for ulcerative colitis (UC)?

The procedure recognized as curative for ulcerative colitis (UC) is proctocolectomy with ileal pouch-anal anastomosis (IPAA). This surgical intervention involves the complete removal of the colon and rectum, followed by the creation of a pouch from the ileum (the last section of the small intestine) and its connection to the anal canal. By removing the colon and rectum, which are the primary sites of inflammation and ulceration in UC, this surgery effectively eliminates the disease and its associated symptoms.

The construction of the ileal pouch allows for improved bowel function post-surgery, enabling patients to have relatively normal bowel movements. This procedure is often the preferred surgical option for patients with severe UC who do not respond to medical management and have moderate to severe disease. While other surgeries, like partial colectomy or ileostomy creation, can manage symptoms or improve quality of life, they do not fully address or eliminate the underlying disease as proctocolectomy with IPAA does.

In summary, proctocolectomy with IPAA provides a comprehensive solution for ulcerative colitis, offering both disease resolution and functional outcomes that align closely with the physiological needs of patients following the procedure.