Having Bowel Surgery: Proctocolectomy with Permanent Ileostomy

This surgery is done to treat diseases of the digestive tract. It removes all of your large intestine. When healed, waste passes from your small intestine through an opening (stoma) in your belly (abdominal) wall and into a pouch outside of your body. There are 2 ways the surgery may be done:

  • Open surgery. This is a traditional surgery. It is done through a large cut (incision).

  • Laparoscopic surgery. This is a minimally invasive surgery. It is done through small incisions.

Your healthcare provider can discuss which option will be best for you.

Entire colon and rectum are removed.

Stoma is formed to pass waste.

Getting ready for surgery

Follow any instructions about getting ready from your healthcare provider. Preparation may begin a few weeks before surgery and can include the following:

  • If you smoke, try to quit.

  • Tell your provider about any medicines you are taking. You may need to stop taking all or some of these before your surgery. This includes:

    • Prescription medicines

    • Aspirin and over-the-counter pain and fever medicines (NSAIDS or nonsteroidal anti-inflammatory drugs)

    • Blood-thinning medicines (anticoagulants)

    • Street drugs

    • Herbs, vitamins, and other supplements

  • If you will have a stoma, a specially trained healthcare provider will meet with you. This provider will be called an enterostomal therapy (ET) nurse or a wound, ostomy, and continence (WOC) nurse. Together you will decide on the stoma’s placement. An ileostomy is usually placed in the right lower part of the belly. After the surgery, this nurse will see you and answer any questions you have. He or she will also teach you (and your family if you wish) about caring for the ostomy.

  • Follow any directions you are given for taking medicines and for not eating or drinking before surgery. This includes any instructions for bowel prep.

The procedure

  • The entire colon and rectum are removed. The anus is also removed.

  • The provider then forms a stoma. The small intestine is sewn to an opening in the belly wall to let waste leave the body.

Risks and complications

Bowel surgery has certain risks and possible complications. Your health care provider can discuss them with you. They may include:

  • Infection

  • Injury to nearby organs

  • Blood clots

  • Risks related to anesthesia

  • Complications at the stoma area such as bleeding, blockage, or a hernia