When is Surgery Needed for Ulcerative Colitis?

Surgery is indicated in UC when:

• Medical therapy (steroids, biologics, immunosuppressants) fails or causes unacceptable side effects
• Acute severe colitis unresponsive to IV steroids (toxic megacolon, perforation, haemorrhage)
• Dysplasia (pre-cancer) or colon cancer develops in long-standing UC
• Growth failure in children despite medical therapy

Restorative Proctocolectomy with IPAA (Pouch Surgery)

Dr. Ashok Kumar specialises in Ileal Pouch-Anal Anastomosis (IPAA) — the gold standard operation for UC. The entire colon and rectum is removed, and a reservoir (J-pouch or S-pouch) is fashioned from the last 30–40 cm of the small intestine. This pouch is joined to the anal canal, restoring natural bowel evacuation without a permanent stoma.

Dr. Ashok Kumar's special expertise in pouch surgery was developed during his tenure at SGPGI. He performs the procedure in staged fashion (2 or 3 stages) depending on the patient's condition and nutritional status.

Outcomes of Pouch Surgery

• Most patients have 4–8 bowel movements per day — a dramatic improvement from severe colitis
• 90%+ patient satisfaction with quality of life
• Pouch failure rate: ~5–10% over 10 years
• Return to near-normal diet and activities within 3 months