Table of ContentsView AllTable of ContentsIndicationsHow to PrepareHow Is It DoneRecoveryComplications
Table of ContentsView All
View All
Table of Contents
Indications
How to Prepare
How Is It Done
Recovery
Complications
Many types of surgery are used to treatinflammatory bowel disease (IBD). A type often used is aproctectomy, which involves the removal of the rectum and possibly the anus.This is the same procedure sometimes used to treatrectal cancer.
When a proctectomy is performed, another procedure called anileostomymay be needed to redirect stool out of your body.This involves connecting the last part of yoursmall intestineto a hole created in the wall of your abdomen (called astoma). Depending on how much of yourcolonis removed, an ileostomy may be temporary or permanent.
This article explains when a proctectomy is needed, how to prepare for the procedure, and how the surgery is performed. It also describes what to expect after surgery along with the possible risks and complications.
Dorling Kindersley / Getty Images
When is a Proctectomy Needed?
Inflammatory bowel disease, either in the form ofCrohn’s diseaseorulcerative colitis (UC), is a disease of the colon and small intestine that causes abdominal pain, diarrhea, rectal bleeding, severe cramping, and weight loss.
When symptoms of Crohn’s disease or UC become difficult to manage, a proctectomy may be recommended. If the rectum and entire colon need removal, it is referred to as aproctocolectomy.
As aggressive as the surgery is, it may be medically necessary when IBD leads to potentially serious complications likeabscesses(pockets of pus),strictures(narrowing of the intestine), orfistulas(abnormal passages in tissues).
Although the prospect of a proctectomy and ileostomy may seem daunting, the procedures (when medically indicated) can improve your quality of life if you’ve been suffering severe symptoms and all other treatment options have failed.
While there is currently no cure for Crohn’s disease or UC, seven out of 10 people who undergo proctocolectomy with ileostomy experience long-lasting, disease-freeremission.
Research suggests that between 10% and 20% of people with Crohn’s disease will eventually need a proctectomy.
How to Prepare for a Proctectomy
If a proctectomy has been scheduled, your surgeon will meet with you and walk you through the preparations needed for surgery.
These include:
Proctectomy Surgery for Inflammatory Bowel Disease
What Happens During Proctectomy?
Although the surgical techniques can vary, they involve the same general steps:
Once completed, the surgeon closes the incision with stitches or staples. After you recover from the anesthesia, you are wheeled to your hospital room where you can expect to be for several days.
What Happens After a Proctectomy?
Once discharged from the hospital, most people will go home with an ileostomy. The specialist nurse called an ostomy nurse will show you how to care for your stoma, change the collection bag (ostomy bag), and eat to help normalize stools.
The recovery timeline can vary but usually takes several months.
You can consider going back to work when you are able to remain active around the house for eight hours without pain. Even then, consider working half days with light duty at first.
Potential Complications of a Proctectomy
As with any surgery, complications are possible after a proctectomy and ileostomy. Because of the complexity of some of these surgeries, roughly one in every four people will experience some sort of postoperative complication, some mild and others severe.
Some of the more serious complications include:
When to Seek Immediate CareDo not hesitate to call your care team or healthcare provider if you experience any of the following after undergoing a proctectomy:Fever with chillsOpening of the surgical woundFoul-smelling discharge from the woundIncreasing pain, redness, swelling, or heat from the woundNo bowel movement four days after leaving the hospitalBloody, black, or tarry stoolsAn abnormally swollen bellyBelly pain that is getting worseUnusual leakage from the rectumPersistent nausea or vomitingSwollen legs and anklesShortness of breathChest pain
When to Seek Immediate Care
Do not hesitate to call your care team or healthcare provider if you experience any of the following after undergoing a proctectomy:Fever with chillsOpening of the surgical woundFoul-smelling discharge from the woundIncreasing pain, redness, swelling, or heat from the woundNo bowel movement four days after leaving the hospitalBloody, black, or tarry stoolsAn abnormally swollen bellyBelly pain that is getting worseUnusual leakage from the rectumPersistent nausea or vomitingSwollen legs and anklesShortness of breathChest pain
Do not hesitate to call your care team or healthcare provider if you experience any of the following after undergoing a proctectomy:
Summary
Proctectomy surgery is a difficult prospect for many people with IBD to face. Having this surgery means a permanent ostomy, and even though most patients feel better and enjoy life more after ostomy surgery, it’s natural to have concerns.
Talking about the surgery with a colorectal surgeon and a gastroenterologist often helps in putting many risk factors in perspective. The good news is that the majority of people with IBD who have proctectomy surgery heal up well and go on to feel better and enjoy their lives more.
9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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