Ileoanal Anastomosis for Ulcerative Colitis
This surgery is done to treat
ulcerative colitis. The doctor removes all of the
large intestine 
(colon) and the diseased lining of the rectum. This surgery is also called an ileal pouch-anal anastomosis (IPAA).
In an ileoanal procedure, the lining of the rectum is removed, and the
lower end of the
small intestine (the ileum) is attached to the opening of the anus. The
surgeon makes a pouch from the ileum to hold fecal material (stool). The lower
end of the pouch is attached to the anus. The muscles around the rectum are
left in place, allowing fairly normal bowel movements.
Going to College With Ulcerative Colitis
Making the transition to college with ulcerative colitis can feel overwhelming at times. You're dealing with new demands of schoolwork and social life. On top of that, you're adjusting to a new living environment while managing a chronic illness. If you’re living on campus, you may be sharing a dorm room and bathroom. And you’ll want to be careful about eating cafeteria food that triggers ulcerative colitis symptoms. Just because you have UC doesn't mean you can’t thrive in every facet of college...
Read the Going to College With Ulcerative Colitis article > >
The ileoanal procedure cures ulcerative colitis by removing all the tissue that the disease could return to.
What To Expect After Surgery
This surgery is sometimes done in two stages. In the first surgery, the doctor removes the large intestine, makes an opening in the abdomen, and attaches the ileum to the opening. This is called an ileostomy. In a second surgery, the pouch is formed and attached to the opening of the anus. Recovery from each surgery takes 1 to 2 weeks. The two steps may be done in the same operation if you are not ill at the time of surgery.
Why It Is Done
This surgery can be done for most patients who have ulcerative colitis. Several circumstances may require surgery for ulcerative colitis.
This surgery is not done:
- For people whose rectal muscles do not work normally.
- For some people who have colon or rectal cancer.
How Well It Works
Ths surgery is usually successful. About 7 or 8 out of 10 people have no problems after surgery. And most people say their quality of life is better after surgery.1
Risks
About 25% to 30% of people who have this surgery have one or more of the following complications:2
- Inflammation of the ileal pouch (pouchitis)
- Blockage of the small intestine (small bowel obstruction)
- Pelvic infection (sepsis)
- Abdominal sepsis
- Major leakage of stool (incontinence)
- Sexual difficulties
Women may have a harder time getting pregnant (infertility) after ileoanal anastomosis.3
What To Think About
The ileoanal procedure has become the preferred surgery because it cures ulcerative colitis and doesn't require the person to have an ostomy in order to have bowel movements.
After ileoanal surgery, children and young adults usually become used to having bowel movements more often than usual.
Complete the surgery information form (PDF)
(What is a PDF document?) to help you prepare for this surgery.
Citations
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 (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.
Waljee A, et al. (2006). Threefold increased risk of infertility: A meta-analysis of infertility after ileal pouch anal anastomosis in ulcerative colitis. Gut, 55(11): 1575-1580.
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