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Standard treatment for ulcerative colitis depends on the extent of involvement and disease severity. The goal is to induce remission initially with medications, followed by the administration of maintenance medications to prevent a relapse. The concept of induction of remission and maintenance of remission is very important. The medications used to induce and maintain a remission somewhat overlap, but the treatments are different. Even if the era for biological therapy for inflammation bowel disease (ibd) has arrived, restorative proctocolectomy with ileal pouch-anal anastomosis (ipaa) is still the surgical treatment of choice for the majority of patients with ulcerative colitis (uc) who fail medical therapy or develop dysplasia or neoplasia as well as for patients with familial adenomatous polyposis (fap). This means the immune system, the bodys defence against infection, goes wrong and attacks healthy tissue. The most popular theory is that the immune system mistakes harmless bacteria inside the colon for a threat and attacks the tissues of the colon, causing it to become inflamed. In appropriately selected patients, ileal pouch-anal anastomosis (ipaa) has become the surgical procedure of choice in the treatment of ulcerative colitis. 1 ipaa removes the diseased large bowel, eliminates the need for a permanent stoma, and provides a good functional outcome and quality of life. 1, 2, 3 since it was first described in 1978, 4 the technique of ipaa has evolved so it can be. Ulcerative colitis affects your colon, which is part of your digestive system. A lot of things can cause trouble in that general area, so how do you know what it feels like to have ulcerative. This is a more common symptom of crohns disease, which typically affects the end of the small intestine (ileum) and colon, and ulcerative colitis, the other main form of ibd which affects the colon. 4 among people with ibd, rectal bleeding is more typical of ulcerative colitis than crohns disease. 1 bleeding related to inflammation in the colon often occurs along with diarrhea.