Surgery to remove the colon and rectum is called a proctocolectomy. This is the standard surgical procedure for patients with ulcerative colitis where medical therapy has failed or serious life-threatening complications have ensued.
Symptoms of Proctocolectomy are:
- Frequent, possibly painful, sensations of needing to pass a stool, although none is produced
- Diarrhoea that is urgent, frequent and usually bloody
- Continual tiredness
- Nausea and vomiting
- Pain or cramps in the abdomen
- Fever – when there is severe inflammation
As the rectum has been removed, another procedure called an ileostomy is then needed to divert waste matter to the outside of the body. An ileostomy is similar to a colostomy in that an opening (stoma) is made in the skin of the lower abdominal wall. In this case, the small intestine is connected to the abdominal wall so that waste material passes to the outside of the body.
The procedure will include the removal of the colon and rectum, formation of a temporary ileostomy, and formation of an ileoanal pouch. First, a midline incision, approximately eight inches in length, is made. Then, the colon and rectum are removed.
The free end of the small intestine is made into a pouch. The pouch is connected to the anus, thereby reestablishing the continuity of the digestive tract.
To create the ileostomy, a loop of the small intestine is brought out through an opening in the abdominal wall. The small intestine is then attached to the abdominal wall to create an exit for waste.
There can be complications following this type of surgery, including blockage of the stoma and retraction of the intestine, which may need another operation to put right. Your surgeon will discuss the possible complications that could happen during and after the surgery.