Normally they will do a total colectomy, your entire colon and all of your rectum except for 1/2 inch. They leave a rim of tissue so that the nerve endings can help you with continence, knowing the difference between a toot and a poop. The Jpouch is made from your ileum, which should be disease free. It's very important that your doctor determines if you have UC or Crohns. There is a blood test and the PillCam that looks for inflammation or scar tissue in your small intestine. If you truly have UC, then your ileum will not be a target of your immune system, and you will have a high percentage of success with this surgery and will be able to go off all your drugs. It's a long, hard process. They do it in either a 2 or 3 surgery sequence and you will usually need 6+ weeks off work for each. I would check with your state laws and company rules for how long you can take off work, as well as research your health insurance plan, what it covers, and most importantly, your maximum out of pocket cost. At 5 years out, you have a low risk of cancer, but as time goes on, like decades, it starts to become an issue. I had my surgery for cancer prevention after a colonoscopy showing pre-cancerous changes.