Surgery can become an option for ulcerative colitis in several situations. Your doctor may suggest it if medicines stop working. It may also come up with life-threatening complications. These include severe bleeding or a hole in the large intestine. Another reason is if symptoms only improve with long-term steroids. Long-term steroid use can cause serious side effects. Surgery usually removes the colon and rectum. One type, ileoanal reservoir surgery, builds a pouch from the small intestine. The pouch connects to the anus. Another type, ileostomy, routes stool through a belly opening into an outside pouch. Ask your care team about risks, benefits, and which type fits your situation.