Colectomy as a precaution

I recently had a chromocolonoscopy done because a routine colonoscopy showed an SSA earlier this year. After having the chromo the doctor’s report recommended doing a colectomy due to the amount/size of polyps and I believe finding more SSA’s (although I don’t have complete results until I go in for my follow up). All biopsies in the past have come back normal (they did a lot in my last colonoscopy earlier this year) so based on prior history I’m assuming my recent biopsies will also. Assuming no cancer yet and with UC in remission, I am having a really hard time accepting this recommendation. My PSC is progressing. They have said that is another reason they recommend taking the colon. They believe my PSC will ultimately add to my getting colon cancer. Just wondering what others have experienced. Are there other therapies that may help put off a colectomy? My thoughts are I do not have cancer and am not experiencing any UC symptoms so I would like to put it off as long as I can. I know cancer can and will pop up but like I said I am having a very hard time accepting this. This was not on my radar until a few days ago.

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I would certainly consult with your hepatologist if you haven’t done so yet. If you have, perhaps a second opinion from another hepatologist would confirm or give other options.

Mark

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I have an appointment with my hepatologist in a few weeks and will definitely be asking her and will go from there. Thanks!

I just went through colectomy surgery a week ago (Oct 1). There were a number of factors which went into the decision to do it (long time UC, SSA, a patch which appeared normal visually but showed indefinite for dysplasia, etc). When you say they recommended colectomy because of the amount of SSA, that sounds like maybe they saw a lot. My GI was very definite, that it is far worse to deal with colon cancer than to deal with a colectomy.
One factor to consider is whether the surgeon thinks he can do a j-pouch, or whether he/she thinks you would need a permanent ileostomy. I think that depends on various factors that would be particular to your case.
Another: 4 years ago I had a partial colectomy, because the disease was centered in my ascending and transverse colon, the surgeon decided he could leave part of my descending colon. You might ask whether that is possible for you. It meant that for those 4 years I had less of a life adjustment than going directly to the full colectomy. It bought me some time, but then the precancerous changes came back – indefinite dysplasia and SSA.
It is not a pleasant prospect, to have your colon taken out. After you get the full report and talk it over with your GI, if you still have doubts about the course of action, then maybe get a second opinion.

Hi Bob - I hope you are healing well. I met with my GI doctor and they did say I would not need to have a full colectomy. They recommend leaving the rectum and attaching my small intestine to it. I then met with a surgeon who recommended the j-pouch because according to her there were some polyps in my rectum and she thought it best to not chance leaving the rectum with known polyps. She was going to discuss with my GI doctor so waiting to hear back. I do have a consultation set up with another surgeon for a second opinion so am curious to get her take on it. I was very happy to hear I had other options. How is your healing/recovery going?