A new clinical trial suggests that people with ulcerative colitis do better with a one-stage operation.
In ulcerative colitis, the whole of the colon may become severely inflamed and the patient may become incapacitated by pain and frequent attacks of diarrhoea, maybe even passing blood. If the condition is not controlled by drugs, an operation may be necessary.

Till now, surgeons have tended to favour a two-stage procedure, which involves creating a diverting ileostomy - an artificial opening in place of the rectum - while the diseased area is cut out later on. But the evidence that this is better than doing the operation all in one go - a procedure called one-stage protocolectomy - has been shaky.

Now researchers at the University of Heidelberg, Germany, have done a new trial, comparing 57 patients undergoing the one-stage operation with 114 having the two-stage procedure. They found a clear benefit in terms of reduced post-operative complications for the one-stage procedure. What's more, the one-stage operation works out cheaper.