Proctocolectomy and ileostomy for inflammatory bowel disease

	Surgery Overview
	What To Expect After Surgery
	Why It Is Done
	How Well It Works
	Risks
	What To Think About
	References
	Audio articles:
	English
	Español

In proctocolectomy, the large intestine and rectum 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.

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).

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.

This surgery cures ulcerative colitis.

The main complications of ileostomy involve infection and problems with the opening to the abdomen (stoma). The following complications may occur:¹

• 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.
• Between 20% and 25% of people need another surgery to repair the stoma.

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

Bowel disease: Caring for your ostomy

About 1.5 million people in the United States have ostomies. People with ulcerative colitis are more likely to need an ostomy than people with Crohn's disease.

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

Citations

1. 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.