Although she received “permission” from his gastroenterologist to travel, her condition landed her in an emergency room in Curitiba, Brazil. Severe UC flares are standard in a gastroenterology practice, and surgery is not always the only solution. In these cases, therapy is usually initiated with intravenous corticosteroids for three days. If this fails, infliximab or cyclosporine is used. Colectomy is recommended if C-reactive protein (CRP) levels are still elevated after two days and bleeding and diarrhoea occur.
Controlling surgery and inflammation with colectomy is important to avoid serious complications. It is usually a three-step surgical procedure: 1. colectomy with end ileostomy; 2. J-pouch formation (IPAA) and duck ileostomy; 3. closure of the duck ileostomy.
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