Diagnosis: Rule out infectious etiology, Crohn's, other proctoscopy/flexible sigmoidoscopy
Total colonoscopy with biopsies to r/o benign and malignant pathology
Stool for infectious work up

Total/subtotal colectomy with end ileostomy

End

Good operative risk: Total proctocolectomy with ileal pouch anal anastomosis

Poor operative risk or indeterminate colitis: Total abdominal colectomy with ileorectal anastomosis

Good operative risk: Total proctocolectomy with end ileostomy or continent (Kock's pouch) ileostomy

Poor operative risk or indeterminate colitis: Total abdominal colectomy with end ileostomy

Malnourished and high-dose steroids or fulminant colitis/toxic megacolon or bleeding or indeterminate colitis or multiple comorbidities (poor surgical candidate) or first-stage procedure

No anal incontinence

Anal incontinence