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Proctocolectomy and Ileostomy for Inflammatory Bowel Disease


Surgery Overview

In proctocolectomy, the large intestine and rectumClick here to see an illustration. are removed, leaving the lower end of the small intestine (the ileum). The doctor sews the anus closed and makes a small opening called a stoma in the skin of the lower abdomen. The surgical procedure to create the stoma (or any other artificial opening) is called an ostomy.

The ileum is connected to the stoma, creating an opening to the outside of the body. The surgery that creates the opening to the intestine is called an ileostomy.

Stool empties into a small plastic pouch called an ostomy bag that is applied to the skin around the stoma. You have to empty the bag several times a day.

What To Expect After Surgery

You may stay in the hospital for several days or as long as 2 weeks after surgery, depending on the severity of the inflammatory bowel disease (IBD).

Why It Is Done

Several situations may require surgery for ulcerative colitis or surgery for Crohn's disease, such as when medicines fail to manage your symptoms or when holes develop in the large intestine.

How Well It Works

This surgery cures ulcerative colitis. About 7 to 8 out of 10 people have long-term success with this surgery.1

Surgery will not cure Crohn's disease. But it may give people some time without symptoms. Crohn's disease usually comes back after surgery.

Risks

The main complications of ileostomy involve infection and problems with the opening to the abdomen (stoma). The following complications may occur:2

  • Up to 30% of people develop infection.
  • Small bowel obstruction occurs in 15% of people.
  • A problem with the stoma develops in up to 30% of people.
  • About 20% to 25% of people need another surgery to repair the stoma.

What To Think About

It is important to learn how to care for and use your ostomy.

Click here to view an Actionset.Bowel Disease: Caring for Your Ostomy

About 1.5 million people in the United States have ostomies.

Complete the surgery information form (PDF)Click here to view a form.(What is a PDF document?) to help you prepare for this surgery.

References

Citations

  1. Cohen JL, et al. (2005). Practice parameters for the surgical treatment of ulcerative colitis. Diseases of the Colon and Rectum, 48(11): 1997–2009. Available online: http://www.fascrs.org/physicians/practice_parameters.

  2. Cima RR, Pemberton JH (2006). Ileostomy, colostomy, and pouches. In M Feldman et al., eds., Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 8th ed., vol. 2, pp. 2549–2561. Philadelphia: Saunders Elsevier.

Credits

ByHealthwise Staff
Primary Medical ReviewerKathleen Romito, MD - Family Medicine
Specialist Medical ReviewerArvydas D. Vanagunas, MD - Gastroenterology
Last RevisedOctober 7, 2010

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