Proctocolectomy and Ileostomy for Inflammatory Bowel Disease
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
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
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
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
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.
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 out of 100 people develop
- Small bowel obstruction occurs in 15 out of
- A problem with the stoma develops in up to 30 out of
- About 20 to 25 out of 100 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.
- Bowel Disease: Caring for Your Ostomy
About 1.5 million people in the United States have
Complete the surgery information form (PDF)(What is a PDF document?) to help you prepare for this surgery.
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.
Cima RR, Pemberton JH (2010). Ileostomy, colostomy, and pouches. In M Feldman et al., eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 9th ed., vol. 2, pp. 2015–2025. Philadelphia: Saunders Elsevier.
|Primary Medical Reviewer||E. Gregory Thompson, MD - Internal Medicine|
|Specialist Medical Reviewer||Peter J. Kahrilas, MD - Gastroenterology|
|Last Revised||October 8, 2012|