Ulcerative colitis is a chronic inflammatory bowel disease that primarily affects the lining of the colon and rectum, causing ulcers, inflammation, and uncomfortable symptoms. Dr. Albert Chung, a double board-certified colorectal surgeon in Santa Margarita, CA, offers comprehensive evaluation and personalized treatments for ulcerative colitis, helping you achieve lasting relief and improved quality of life. Schedule your consultation today by calling (714) 988-8690.
Ulcerative colitis (UC) is a chronic inflammatory bowel disease that causes ongoing inflammation and ulcers along the inner lining of the colon and rectum. Symptoms tend to develop gradually and can intensify over time without proper treatment. The condition typically follows a pattern of flares (periods of active inflammation and symptoms) followed by remission. The exact cause isn't fully understood, but genetic predisposition, immune system dysfunction, and environmental factors like stress and diet all play a role.
UC and Crohn's disease are both inflammatory bowel diseases (IBD), and they share many symptoms. The key differences: UC affects only the colon and rectum, with continuous inflammation along the lining. Crohn's can affect any part of the digestive tract, with patches of inflammation that can extend deeper into the bowel wall. Distinguishing between them is important because treatment approaches differ.
UC is sometimes named by where it affects the colon: ulcerative proctitis (rectum only), proctosigmoiditis (rectum and lower colon), left-sided colitis, or pancolitis (entire colon). The extent influences treatment choices and follow-up.
Symptoms vary depending on the severity and location of inflammation, but typically include:
UC can also cause symptoms outside the digestive tract, including joint pain, eye inflammation, and skin problems. These can be the first signs of a flare for some patients.
During your initial visit, Dr. Chung will carefully review your medical history and symptoms. From there, several diagnostic tests can help confirm UC and distinguish it from other conditions like Crohn's disease, infection, or IBS.
UC currently has no cure other than surgery, but multiple treatments effectively manage symptoms, reduce flare frequency, and help maintain remission. Most patients work through these approaches in steps.
When surgery is the right answer, there are two main approaches. Dr. Chung will discuss which fits your situation, anatomy, and goals.
For patients on medical management, the goal is to achieve and maintain remission with the lowest effective dose of medication. Regular follow-ups, symptom tracking, and adjustments based on how you're doing are part of the long game.
For surgical patients, recovery timelines vary by approach and individual factors. Dr. Chung provides detailed aftercare instructions and ongoing monitoring. Most patients return to regular activities and experience lasting symptom relief.
Ulcerative colitis is managed day to day by a gastroenterologist, and most patients never need a surgeon. The ones who do are best served when the surgeon is involved early rather than at the point of crisis. Dr. Chung sees UC patients from across Orange County for surgical consultation when medications are failing, when steroid dependence has become a problem, when dysplasia is found on surveillance colonoscopy, and for second opinions before committing to colectomy. He coordinates directly with your gastroenterologist so that the decision to operate, and its timing, are made together.
Restorative proctocolectomy with an ileal pouch (J-pouch) is the operation most younger UC patients choose, because it removes the disease and preserves the ability to pass stool normally. It is usually done in two or three stages over several months, with a temporary ileostomy while the pouch heals. Once the ileostomy is closed, patients typically have four to eight soft bowel movements a day, with good daytime control that improves through the first year. Pouchitis, an inflammation of the pouch that responds to a short antibiotic course, affects up to half of patients at some point. Long-term satisfaction rates are high, and most patients return to unrestricted work, exercise, and travel. Dr. Chung performs these operations minimally invasively and follows pouch patients long term.
| Ongoing medical therapy | Colectomy with J-pouch | Colectomy with permanent ileostomy | |
|---|---|---|---|
| Disease status | Controlled, with risk of flares | Cured (colon removed) | Cured (colon removed) |
| Medications | Lifelong, often biologics | Usually none for UC | None for UC |
| Bowel function | Variable; urgency during flares | 4 to 8 soft stools a day, good control | Managed by pouch appliance, no urgency |
| Cancer surveillance | Colonoscopy every 1 to 3 years after 8 years of disease | Pouch and cuff check every 1 to 3 years | Not needed for the colon |
| Operations | None | Two or three stages over 3 to 6 months | One operation |
| Best suited to | Patients responding well to treatment | Younger, otherwise healthy patients with good sphincter function | Patients with poor sphincter function, other illness, or who prefer a single operation |
UC patients across Orange County see Dr. Chung for a surgical opinion at the point where the question changes from which medication to try next to whether removing the colon would give a better life. That conversation is worth having early, with the surgeon who would do the operation, and long before an emergency forces it.
Dr. Chung sees patients at 30212 Tomas, Suite 365, Rancho Santa Margarita, CA 92688, off the 241 toll road in South Orange County. Patients come from Mission Viejo, Lake Forest, Irvine, Laguna Hills, Laguna Niguel, Aliso Viejo, San Juan Capistrano, Ladera Ranch, Trabuco Canyon, Santa Ana, and across Orange County. Most new patients are seen within days, and a first visit usually includes the exam, a plain-language explanation, and a treatment plan the same day.
Not ready for an in-person visit? Dr. Chung also offers online video consultations. Read what patients say on the reviews page.
No. Both are inflammatory bowel diseases, but UC affects only the colon and rectum with continuous inflammation of the inner lining, while Crohn's can affect any part of the digestive tract in patches and through the full thickness of the bowel wall. The distinction matters because surgery cures UC but not Crohn's.
Medications control UC but do not cure it. Because the disease is confined to the colon and rectum, removing them (proctocolectomy) does cure it. Most patients are managed medically for years and only a minority ultimately need surgery.
They help with symptoms but do not treat the underlying inflammation. During flares, limiting high-fiber foods, dairy, caffeine, and alcohol often reduces cramping and urgency. Between flares, a balanced diet supports healing. Medication remains the foundation of treatment.
When medications, including biologics, have failed to control the disease; when a patient cannot come off steroids; for complications such as toxic megacolon, perforation, or uncontrolled bleeding; and when precancerous changes (dysplasia) or cancer are found on surveillance colonoscopy. Some patients also choose surgery to end years of medication and flares.
Both begin with removal of the colon and rectum. A J-pouch reconstructs a reservoir from small intestine and connects it to the anus so stool passes normally. An end ileostomy brings the small intestine to the abdominal wall, where stool collects in an external pouch. The J-pouch avoids a permanent appliance; the ileostomy is a simpler, single operation with no risk of pouch complications.
Surveillance colonoscopy for cancer begins about eight years after diagnosis for patients with disease beyond the rectum, and is repeated every one to three years depending on extent, severity, and other risk factors. Dr. Chung performs these examinations and can proceed directly to surgical planning if dysplasia is found.
Whether you're newly diagnosed, struggling through a flare, or considering surgery, Dr. Chung can help you build a plan that fits your life and your disease.
Book a consultation Call (714) 988-8690Although similar, ulcerative colitis affects only the colon's lining, whereas Crohn’s disease can impact any part of the digestive tract.
Currently, there is no medical cure, but surgery can effectively eliminate symptoms and improve quality of life significantly.
Dietary adjustments greatly help reduce symptoms and prevent flare-ups. Dr. Chung provides personalized dietary guidance tailored to your needs.
Prompt diagnosis and treatment greatly improve colorectal cancer outcomes. Call Dr. Albert Chung’s colorectal clinic in Orange County.
