HealthSheets™


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 cuts.

Your healthcare provider can talk with you about the option that is best for you.

Getting ready for surgery

Follow any instructions about getting ready from your healthcare provider. You may need to start getting ready a few weeks before surgery. You may have to do 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:

    • Prescription medicines

    • Over-the-counter medicines for pain and fever, such as aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs)

    • Blood-thinning medicines (anticoagulants)

    • Street drugs

    • Herbs, vitamins, and other supplements

  • If you drink alcohol, tell your provider how much. This is very important if you are a heavy drinker. Alcohol withdrawal can be life threatening. So be honest with your provider.

  • If you will have a stoma, you'll meet with 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 often 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. You may also be given instructions for bowel prep.

The procedure

  • The whole colon and rectum are taken out. The anus is also taken out.

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

Risks and possible complications

Bowel surgery has some possible risks and complications. Your healthcare provider can talk with you about them. They may include:

  • Infection

  • Injury to nearby organs

  • Blood clots

  • Risks linked to anesthesia

  • Problems near the stoma, such as bleeding, blockage, or a hernia

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