Proctocolectomy and Ileostomy for Inflammatory Bowel Disease

Surgery Overview

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 belly. The surgery 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. The bag is applied to the skin around the stoma.

What To Expect

You may stay in the hospital for several days or as long as 2 weeks.

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Why It Is Done

The main use of this surgery is for inflammatory bowel disease. It may be used in several situations, such as when medicines don't help ulcerative colitis or Crohn's disease, or when holes form in the large intestine.

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How Well It Works

This surgery cures ulcerative colitis. About 7 to 8 out of 10 people have long-term success with this surgery.footnote 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 stoma, which is the opening to the belly. The following complications may occur:footnote 2

  • Up to 30 out of 100 people get an infection.
  • Small bowel obstruction occurs in 15 out of 100 people.
  • A problem with the stoma develops in up to 30 out of 100 people.
  • About 20 to 25 out of 100 people need another surgery to repair the stoma.

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 (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.

Credits

Current as of: February 10, 2021

Author: Healthwise Staff
Medical Review:
E. Gregory Thompson MD - Internal Medicine
Adam Husney MD - Family Medicine
Kenneth Bark MD - General Surgery, Colon and Rectal Surgery