University of California San Francisco

Varma Bio Headshot
Madhulika Varma, MD

Professor of Surgery
Division of Surgical Oncology
Chief, Section of Colorectal Surgery 
Director, UCSF Center for Pelvic Physiology 

 

Address

1825 4th Street, #L4C11
San Francisco, CA 94107
United States

Email: [email protected]
Phone: 415-885-3606
Fax: 415-885-3886

Biography

Dr. Madhulika Varma, Chief of Colorectal Surgery, specializes in the surgical treatment of diseases of the colon, rectum, and anus. Her areas of expertise include colon and rectal cancer, inflammatory bowel diseases such as ulcerative colitis, Crohn’s disease, and pelvic floor disorders. She is also a specialist in advanced laparoscopic and robotic colorectal surgery, using minimally invasive techniques to treat many of these diseases. Dr. Varma is the director of the UCSF Center for Pelvic Physiology, which evaluates patients with fecal incontinence, constipation, pelvic floor prolapse, rectal cancer, and anal fistulas. She is a member of the clinical team of the UCSF Women’s Continence Center and the UCSF Center for Colitis and Crohn’s Disease. Dr. Varma earned her medical degree at Brown University School of Medicine in Providence, R.I. She completed her residency in general surgery at UCSF and spent a year at the University of Minnesota to obtain specialized training in colon and rectal surgery. She returned to the faculty at UCSF in 2000, where she completed a fellowship in Clinical Outcomes Research and Epidemiology. Her research interests include the assessment of clinical outcomes and quality of life for patients with colorectal cancer, inflammatory bowel diseases, and defecation disorders.

Videos

Education

Institution Degree Dept or School End Date
University of California Diversity, Equity, and Inclusion Champion Training 2018
Brown University M.D. School of Medicine 1991

Research Narrative

  • A Randomized, Subject and Evaluator Blinded, Sham Controlled, Multicenter Study to Evaluate Efficacy and Safety of NASHA/Dx for the Treatment of Fecal Incontinence
  • The Comprehensive Validation of the CSI (Constipation Severity Instrument) and CRQOL (Constipation-Related Quality of Life) and the Comprehensive Validation of the RCM (Rome III Constipation Module)
  • A Phase II Trial of Neoadjuvant Chemoradiation and Local Excision for uT2uN0 Rectal Cancer
  • Timing of Rectal Cancer Response to Chemoradiation
  • The Effect of Rectal Resection on Bowel, Bladder, and Sexual Functioning in Patients with Inflammatory Bowel Disease
  • A Randomized Control Trial to Examine the Efficacy of Anorectal Biofeedback
  • Prevalence of Sexual Dysfunction in Ulcerative Colitis Patients
  • Outcomes of Patients Presenting to the UCSF Center for Pelvic Physiology with Pelvic Floor Disorders

Clinical Trials

  1. Biofeedback Treatment for Functional Constipation (NCT00502957)
    Related Conditions: Constipation, Functional Constipation| Start Date: | End Date:

Publications

MOST RECENT PUBLICATIONS FROM A TOTAL OF 72
  1. Multi-Disciplinary Management in Rectal Cancer Survivorship: A Clinical Practice Review.
    Chan H, Savoie MB, Munir A, Moslehi J, Anwar M, Laffan A, Rowen T, Salmon R, Varma M, Van Loon K| | View in PubMed
  2. Association between adherence to the American Cancer Society Nutrition and Physical Activity Guidelines and stool frequency among colon cancer survivors: a cohort study.
    Greenberg AL, Tolstykh IV, Van Loon K, Laffan A, Stanfield D, Steiding P, Kenfield SA, Chan JM, Atreya CE, Piawah S, Kidder W, Venook AP, Van Blarigan EL, Varma MG| | View in PubMed
  3. Robotic transanal excision of rectal lesions: expert perspective and literature review.
    Watanaskul S, Schwab ME, Chern H, Varma M, Sarin A| | View in PubMed
  4. Robotic repair of perineal hernias: a video vignette and review of the literature.
    Watanaskul S, Schwab ME, Colley A, Chern H, Varma MG, Hoffman WY, Sarin A| | View in PubMed
  5. Proof-of-concept for intervention to prevent post-operative ileus in patients undergoing ileostomy formation.
    Greenberg AL, Kelly YM, Sarin A, Varma MG| | View in PubMed
  6. Organ Preservation in Patients With Rectal Adenocarcinoma Treated With Total Neoadjuvant Therapy.
    Garcia-Aguilar J, Patil S, Gollub MJ, Kim JK, Yuval JB, Thompson HM, Verheij FS, Omer DM, Lee M, Dunne RF, Marcet J, Cataldo P, Polite B, Herzig DO, Liska D, Oommen S, Friel CM, Ternent C, Coveler AL, Hunt S, Gregory A, Varma MG, Bello BL, Carmichael JC, Krauss J, Gleisner A, Paty PB, Weiser MR, Nash GM, Pappou E, Guillem JG, Temple L, Wei IH, Widmar M, Lin S, Segal NH, Cercek A, Yaeger R, Smith JJ, Goodman KA, Wu AJ, Saltz LB| | View in PubMed
  7. Comparison of advanced techniques for local excision of rectal lesions: a case series.
    Schwab ME, Hernandez S, Watanaskul S, Chern H, Varma M, Sarin A| | View in PubMed
  8. Risk factors and outcomes associated with postoperative ileus following ileostomy formation: a retrospective study.
    Greenberg AL, Kelly YM, McKay RE, Varma MG, Sarin A| | View in PubMed
  9. Survival impact of bowel resection at the time of interval cytoreductive surgery for advanced ovarian cancer.
    McNamara B, Guerra R, Qin J, Craig AD, Chen LM, Varma MG, Chapman JS| | View in PubMed
  10. Perfusion Assessment in Left-Sided/Low Anterior Resection (PILLAR III): A Randomized, Controlled, Parallel, Multicenter Study Assessing Perfusion Outcomes With PINPOINT Near-Infrared Fluorescence Imaging in Low Anterior Resection.
    Jafari MD, Pigazzi A, McLemore EC, Mutch MG, Haas E, Rasheid SH, Wait AD, Paquette IM, Bardakcioglu O, Safar B, Landmann RG, Varma MG, Maron DJ, Martz J, Bauer JJ, George VV, Fleshman JW, Steele SR, Stamos MJ| | View in PubMed
  11. Vitamin D Levels in Patients with Colorectal Cancer Before and After Treatment Initiation.
    Savoie MB, Paciorek A, Zhang L, Van Blarigan EL, Sommovilla N, Abrams D, Atreya CE, Bergsland EK, Chern H, Kelley RK, Ko A, Laffan A, Sarin A, Varma MG, Venook AP, Van Loon K| | View in PubMed
  12. Consolidation mFOLFOX6 Chemotherapy After Chemoradiotherapy Improves Survival in Patients With Locally Advanced Rectal Cancer: Final Results of a Multicenter Phase II Trial.
    Marco MR, Zhou L, Patil S, Marcet JE, Varma MG, Oommen S, Cataldo PA, Hunt SR, Kumar A, Herzig DO, Fichera A, Polite BN, Hyman NH, Ternent CA, Stamos MJ, Pigazzi A, Dietz D, Yakunina Y, Pelossof R, Garcia-Aguilar J, Timing of Rectal Cancer Response to Chemoradiation Consortium| | View in PubMed
  13. Does Extended PET Acquisition in PET/MRI Rectal Cancer Staging Improve Results?
    Bailey JJ, Jordan EJ, Burke C, Ohliger MA, Wang ZJ, Van Loon K, Varma MG, Hope TA| | View in PubMed
  14. Consensus Statement of Definitions for Anorectal Physiology Testing and Pelvic Floor Terminology (Revised).
    Bordeianou LG, Carmichael JC, Paquette IM, Wexner S, Hull TL, Bernstein M, Keller DS, Zutshi M, Varma MG, Gurland BH, Steele SR| | View in PubMed
  15. Expert Commentary on Rectal Prolapse.
    Varma MG| | View in PubMed
  16. SNMMI Comment on the 2016 Society of Surgical Oncology "Choosing Wisely" Recommendation on the Use of PET/CT in Colorectal Cancer.
    Zukotynski K, Jadvar H, Hope T, Subramaniam RM, Van Loon K, Varma M, Niederkohr RD, PET Center of Excellence| | View in PubMed
  17. Characteristics Associated With Successful Fitting of a Vaginal Bowel Control System for Fecal Incontinence.
    Matthews CA, Varma MG, Takase-Sanchez MM, Hale DS, Van Drie D, Muir T, Wells E, Jannelli M, Richter HE| | View in PubMed
  18. Successful implementation of an Enhanced Recovery After Surgery program shortens length of stay and improves postoperative pain, and bowel and bladder function after colorectal surgery.
    Sarin A, Litonius ES, Naidu R, Yost CS, Varma MG, Chen LL| | View in PubMed
  19. A Novel Decision Aid for Surgical Patients with Ulcerative Colitis: Results of a Pilot Study.
    Cohan JN, Ozanne EM, Sewell JL, Hofer RK, Mahadevan U, Varma MG, Finlayson E| | View in PubMed
  20. The American Society of Colon and Rectal Surgeons' Clinical Practice Guideline for the Evaluation and Management of Constipation.
    Paquette IM, Varma M, Ternent C, Melton-Meaux G, Rafferty JF, Feingold D, Steele SR| | View in PubMed
  21. Impact of a Novel Vaginal Bowel Control System on Bowel Function.
    Varma MG, Matthews CA, Muir T, Takase-Sanchez MM, Hale DS, Van Drie D, Richter HE| | View in PubMed
  22. Impact of Surgery on Relationship Quality in Patients With Ulcerative Colitis and Their Partners.
    Cohan JN, Rhee JY, Finlayson E, Varma MG| | View in PubMed
  23. Differences in Symptom Severity and Quality of Life in Patients With Obstructive Defecation and Colonic Inertia.
    Chou AB, Cohan JN, Varma MG| | View in PubMed
  24. Faecal incontinence in men referred for specialty care: a cross-sectional study.
    Cohan JN, Chou AB, Varma MG| | View in PubMed
  25. Impact of Patient Age on Procedure Type for Ulcerative Colitis: A National Study.
    Cohan JN, Bacchetti P, Varma MG, Finlayson E| | View in PubMed
  26. Outcomes Analysis of Biologic Mesh Use for Abdominal Wall Reconstruction in Clean-Contaminated and Contaminated Ventral Hernia Repair.
    Sbitany H, Kwon E, Chern H, Finlayson E, Varma MG, Hansen SL| | View in PubMed
  27. Effect of adding mFOLFOX6 after neoadjuvant chemoradiation in locally advanced rectal cancer: a multicentre, phase 2 trial.
    Garcia-Aguilar J, Chow OS, Smith DD, Marcet JE, Cataldo PA, Varma MG, Kumar AS, Oommen S, Coutsoftides T, Hunt SR, Stamos MJ, Ternent CA, Herzig DO, Fichera A, Polite BN, Dietz DW, Patil S, Avila K, Timing of Rectal Cancer Response to Chemoradiation Consortium| | View in PubMed
  28. The American Society of Colon and Rectal Surgeons' Clinical Practice Guideline for the Treatment of Fecal Incontinence.
    Paquette IM, Varma MG, Kaiser AM, Steele SR, Rafferty JF| | View in PubMed
  29. Outcomes after ileoanal pouch surgery in frail and older adults.
    Cohan JN, Bacchetti P, Varma MG, Finlayson E| | View in PubMed
  30. A vaginal bowel-control system for the treatment of fecal incontinence.
    Richter HE, Matthews CA, Muir T, Takase-Sanchez MM, Hale DS, Van Drie D, Varma MG| | View in PubMed
  31. The evolution of evaluation and management of urinary or fecal incontinence and pelvic organ prolapse.
    Steele SR, Varma MG, Prichard D, Bharucha AE, Vogler SA, Erdogan A, Rao SS, Lowry AC, Lange EO, Hall GM, Bleier JI, Senagore AJ, Maykel J, Chan SY, Paquette IM, Audett MC, Bastawrous A, Umamaheswaran P, Fleshman JW, Caton G, O'Brien BS, Nelson JM, Steiner A, Garely A, Noor N, Desrosiers L, Kelley R, Jacobson NS| | View in PubMed
  32. The evolution of evaluation and management of urinary or fecal incontinence and pelvic organ prolapse.
    Steele SR, Varma MG, Prichard D, Bharucha AE, Vogler SA, Erdogan A, Rao SS, Lowry AC, Lange EO, Hall GM, Bleier JI, Senagore AJ, Maykel J, Chan SY, Paquette IM, Audett MC, Bastawrous A, Umamaheswaran P, Fleshman JW, Caton G, O'Brien BS, Nelson JM, Steiner A, Garely A, Noor N, Desrosiers L, Kelley R, Jacobson NS| | View in PubMed
  33. Perineal flap reconstruction following oncologic anorectal extirpation: an outcomes assessment.
    Wang ED, Conkling N, Xu X, Chern H, Finlayson E, Varma MG, Hansen SL, Foster RD, Hoffman WY, Sbitany H| | View in PubMed
  34. Treatment of fecal incontinence: state of the science summary for the National Institute of Diabetes and Digestive and Kidney Diseases workshop.
    Whitehead WE, Rao SS, Lowry A, Nagle D, Varma M, Bitar KN, Bharucha AE, Hamilton FA| | View in PubMed
  35. Simple interventions for complex complications: moving surgery forward.
    Cohan JN, Varma MG| | View in PubMed
  36. Impact of depression and anxiety on the quality of life of constipated patients.
    Albiani JJ, Hart SL, Katz L, Berian J, Del Rosario A, Lee J, Varma M| | View in PubMed
  37. Exacerbation of symptom severity of pelvic floor disorders in women who report a history of sexual abuse.
    Imhoff LR, Liwanag L, Varma M| | View in PubMed
  38. Outcomes after rectal cancer surgery in elderly nursing home residents.
    Finlayson E, Zhao S, Varma MG| | View in PubMed
  39. Fecal incontinence decreases sexual quality of life, but does not prevent sexual activity in women.
    Imhoff LR, Brown JS, Creasman JM, Subak LL, Van den Eeden SK, Thom DH, Varma MG, Huang AJ| | View in PubMed
  40. Practice parameters for anal squamous neoplasms.
    Steele SR, Varma MG, Melton GB, Ross HM, Rafferty JF, Buie WD, Standards Practice Task Force of the American Society of Colon and Rectal Surgeons| | View in PubMed
  41. A randomized controlled trial of anorectal biofeedback for constipation.
    Hart SL, Lee JW, Berian J, Patterson TR, Del Rosario A, Varma MG| | View in PubMed
  42. Development and assessment of the constipation-related disability scale.
    Hart SL, Albiani JJ, Crangle CJ, Torbit LA, Varma MG| | View in PubMed
  43. Practice parameters for the management of rectal prolapse.
    Varma M, Rafferty J, Buie WD, Standards Practice Task Force of American Society of Colon and Rectal Surgeons| | View in PubMed
  44. Chromosomal copy number alterations are associated with tumor response to chemoradiation in locally advanced rectal cancer.
    Chen Z, Liu Z, Li W, Qu K, Deng X, Varma MG, Fichera A, Pigazzi A, Garcia-Aguilar J| | View in PubMed
  45. Gender-specific differences in pelvic organ function after proctectomy for inflammatory bowel disease.
    Wang JY, Hart SL, Wilkowski KS, Lee JW, Delmotte EC, del Rosario KM, del Rosario AS, Varma MG| | View in PubMed
  46. Sew or staple: does it make a difference?
    Varma MG| | View in PubMed
  47. Age differences in patients evaluated for constipation: constipation characteristics, symptoms, and bowel and dietary habits.
    McCrea GL, Miaskowski C, Stotts NA, Macera L, Paul SM, Varma MG| | View in PubMed
  48. Validation of the risk index category as a predictor of surgical site infection in elective colorectal surgery.
    Pastor C, Baek JH, Varma MG, Kim E, Indorf LA, Garcia-Aguilar J| | View in PubMed
  49. An increase in compliance with the Surgical Care Improvement Project measures does not prevent surgical site infection in colorectal surgery.
    Pastor C, Artinyan A, Varma MG, Kim E, Gibbs L, Garcia-Aguilar J| | View in PubMed
  50. Pelvic floor disorders and quality of life in women with self-reported irritable bowel syndrome.
    Wang J, Varma MG, Creasman JM, Subak LL, Brown JS, Thom DH, van den Eeden SK| | View in PubMed
  51. A valid and reliable measure of constipation-related quality of life.
    Wang JY, Hart SL, Lee J, Berian JR, McCrea GL, Varma MG| | View in PubMed
  52. Gender differences in self-reported constipation characteristics, symptoms, and bowel and dietary habits among patients attending a specialty clinic for constipation.
    McCrea GL, Miaskowski C, Stotts NA, Macera L, Paul SM, Varma MG| | View in PubMed
  53. Treatment of transsphincteric anal fistulas: are fistula plugs an acceptable alternative?
    Wang JY, Garcia-Aguilar J, Sternberg JA, Abel ME, Varma MG| | View in PubMed
  54. Hospitalized ulcerative colitis patients have an elevated risk of thromboembolic events.
    Wang JY, Terdiman JP, Vittinghoff E, Minichiello T, Varma MG| | View in PubMed
  55. Factors that increase risk of colon polyps.
    Grahn SW, Varma MG| | View in PubMed
  56. A review of the literature on gender and age differences in the prevalence and characteristics of constipation in North America.
    McCrea GL, Miaskowski C, Stotts NA, Macera L, Varma MG| | View in PubMed
  57. Pathophysiology of constipation in the older adult.
    McCrea GL, Miaskowski C, Stotts NA, Macera L, Varma MG| | View in PubMed
  58. Surgery for inflammatory bowel disease.
    Hwang JM, Varma MG| | View in PubMed
  59. Implementation of quality measures to reduce surgical site infection in colorectal patients.
    Wick EC, Gibbs L, Indorf LA, Varma MG, Garcia-Aguilar J| | View in PubMed
  60. Obstructive defecation in middle-aged women.
    Varma MG, Hart SL, Brown JS, Creasman JM, Van Den Eeden SK, Thom DH| | View in PubMed
  61. Fecal incontinence: does age matter? Characteristics of older vs. younger women presenting for treatment of fecal incontinence.
    Wang JY, Patterson TR, Hart SL, Varma MG| | View in PubMed
  62. Review article: self-report measures to evaluate constipation.
    McCrea GL, Miaskowski C, Stotts NA, Macera L, Hart SA, Varma MG| | View in PubMed
  63. The constipation severity instrument: a validated measure.
    Varma MG, Wang JY, Berian JR, Patterson TR, McCrea GL, Hart SL| | View in PubMed
  64. Dartos muscle interposition flap for the treatment of rectourethral fistulas.
    Varma MG, Wang JY, Garcia-Aguilar J, Shelton AA, McAninch JW, Goldberg SM| | View in PubMed
  65. Small bowel bezoar in a patient with Noonan syndrome: report of a case.
    Bitton A, Keagle JN, Varma MG| | View in PubMed
  66. Fecal incontinence in females older than aged 40 years: who is at risk?
    Varma MG, Brown JS, Creasman JM, Thom DH, Van Den Eeden SK, Beattie MS, Subak LL, Reproductive Risks for Incontinence Study at Kaiser (RRISK) Research Group| | View in PubMed
  67. Faecal incontinence in adults.
    Madoff RD, Parker SC, Varma MG, Lowry AC| | View in PubMed
  68. Gross versus microscopic pancolitis and the occurrence of neoplasia in ulcerative colitis.
    Mathy C, Schneider K, Chen YY, Varma M, Terdiman JP, Mahadevan U| | View in PubMed
  69. Conserved motifs in somatostatin, D2-dopamine, and alpha 2B-adrenergic receptors for inhibiting the Na-H exchanger, NHE1.
    Lin CY, Varma MG, Joubel A, Madabushi S, Lichtarge O, Barber DL| | View in PubMed
  70. Local therapy for rectal cancer.
    Visser BC, Varma MG, Welton ML| | View in PubMed
  71. Local excision of rectal carcinoma.
    Varma MG, Rogers SJ, Schrock TR, Welton ML| | View in PubMed
  72. Evaluation of plasma insulin-like growth factor-binding protein-3 as a potential predictor of preeclampsia.
    Varma M, de Groot CJ, Lanyi S, Taylor RN| | View in PubMed

In the News

Research

  • A Randomized, Subject and Evaluator Blinded, Sham Controlled, Multicenter Study to Evaluate Efficacy and Safety of NASHA/Dx for the Treatment of Fecal Incontinence
  • The Comprehensive Validation of the CSI (Constipation Severity Instrument) and CRQOL (Constipation-Related Quality of Life) and the Comprehensive Validation of the RCM (Rome III Constipation Module)
  • A Phase II Trial of Neoadjuvant Chemoradiation and Local Excision for uT2uN0 Rectal Cancer
  • Timing of Rectal Cancer Response to Chemoradiation
  • The Effect of Rectal Resection on Bowel, Bladder, and Sexual Functioning in Patients with Inflammatory Bowel Disease
  • A Randomized Control Trial to Examine the Efficacy of Anorectal Biofeedback
  • Prevalence of Sexual Dysfunction in Ulcerative Colitis Patients
  • Outcomes of Patients Presenting to the UCSF Center for Pelvic Physiology with Pelvic Floor Disorders