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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

Most people stay in the hospital for a few days to a week.

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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. Most 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.


Examples of complications are dehydration, infection, blockage of the small intestine, not absorbing medicines so they don't work as they should, and problems with the stoma. Some people need one or more surgeries to treat complications.



  1. Holubar SD, et al. (2021). American Society of Colon and Rectal Surgeons clinical practice guidelines for the surgical management of ulcerative colitis. Diseases of the Colon and Rectum, 64(7): 783–804. DOI: 10.1097/DCR.0000000000002037. Accessed 7/2023.


Current as of: October 19, 2023

Author: Healthwise Staff
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All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.