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. This allows for fairly normal bowel movements.
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 from the ileum and then 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
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
About 25 to 30 out of 100 people who have this surgery have one or
more of the following complications:2
- Inflammation of the ileal pouch
- Blockage of the small intestine (small bowel
- Pelvic infection (sepsis)
- Abdominal sepsis
leakage of stool (incontinence)
Less than 10 out of 100 people have sexual problems.2
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.
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.
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.
Primary Medical Reviewer
||E. Gregory Thompson, MD - Internal Medicine
Specialist Medical Reviewer
||Peter J. Kahrilas, MD - Gastroenterology
Current as of
||October 8, 2012