I had severe ulcerative colitis.And had a couple of c diff recurrences while failing Humira, Entyvio and Stelara. Finally Rinvoq worked for me causing me to go from severe to mild with no recurrences (due in part to no need for antibiotics, which are a major trigger).

But then when they removed an area of high dysplasia in my colon, pathology showed a small area had converted to cancer. They thought they probably got it all, but I didn't want to take a chance.

A couple of years before I was thinking of doing a j-pouch, but elected a full procto-colectomy with end ileostomy instead. One consideration was that pouchitis is common, and that is treated with antibiotics. The probability of c diff after removal of the large colon is remote, but not 0.

They removed the colon together with the surrounding fat layer where lymph nodes are located. Testing over 70 lymph nodes + the colon was totally clear, So I have no regrets (other than I wish I could have found something like Rinvoq that worked for me years earlier).