R R

What Is Proctocolectomy?

Proctocolectomy is major colorectal surgery that removes the entire colon and rectum. After removal, intestinal waste must leave the body through a new route because the large intestine is no longer present. The small intestine can be brought through the abdominal wall as a permanent end ileostomy or fashioned into an ileal pouch that is connected to the anus. The exact reconstruction depends on the underlying disease, anal-sphincter function, patient factors, and surgical plan.

Link to This Resource Page

Provide a valuable resource to your clients or customers by linking to this resource page. Just place the following link on your website.

To display this...

What Is Proctocolectomy?

Proctocolectomy is major colorectal surgery that removes the entire colon and rectum. After removal, intestinal waste must leave the body through a new route because the large intestine is no longer present. The small intestine can be brought through the abdominal wall as a permanent end ileostomy or fashioned into an ileal pouch that is connected to the anus. The exact reconstruction depends on the underlying disease, anal-sphincter function, patient factors, and surgical plan.

read more about proctocolectomy ...

Copy this HTML:

Copy HTML Copied!

Why Is Proctocolectomy Performed?

The procedure is used for diseases that affect the colon and rectum extensively and cannot be managed adequately with less extensive surgery. Common indications include medically refractory ulcerative colitis, colorectal dysplasia or cancer associated with ulcerative colitis, and familial adenomatous polyposis. It can also be required for selected severe Crohn colitis, although ileal pouch-anal anastomosis is generally avoided when Crohn disease is established because pouch complications are more likely. The goal is to remove the diseased large bowel and prevent or treat complications such as cancer, bleeding, severe inflammation, or toxic colitis.

How Is Proctocolectomy Performed?

The surgeon removes the colon and rectum through an open, laparoscopic, or robotic approach while preserving nearby nerves and organs when possible. One reconstruction option creates a permanent end ileostomy by bringing the end of the ileum through the abdominal wall. Another option, restorative proctocolectomy, forms a pouch from the ileum and connects it to the anus in an ileal pouch-anal anastomosis. Pouch surgery is commonly performed in stages and often includes a temporary diverting ileostomy while the new pouch connection heals.

What Is Recovery Like After Proctocolectomy?

Recovery includes pain control, return of small-bowel function, nutrition, hydration, wound care, and learning to manage an ileostomy when one is present. Patients with an ileal pouch gradually adapt to more frequent and looser bowel movements after intestinal continuity is restored. Fluid and salt intake require attention because the colon no longer absorbs water and electrolytes. Long-term follow-up addresses stoma or pouch function, nutritional issues, disease-related surveillance, and complications such as pouch inflammation.

What Are the Risks and Complications?

Possible complications include bleeding, infection, bowel obstruction, blood clots, urinary problems, sexual dysfunction, and injury to nearby pelvic structures. Ileostomy complications can include dehydration, skin irritation, prolapse, retraction, narrowing, and parastomal hernia. Patients with an ileal pouch can develop anastomotic leakage, pouchitis, pouch stricture, fistula, small-bowel obstruction, or pouch failure. Pelvic surgery can also affect fertility, particularly in patients who undergo restorative proctocolectomy with ileal pouch-anal anastomosis.

Frequently Asked Questions About Proctocolectomy

What organs are removed during proctocolectomy?

The operation removes the colon and rectum. Depending on the reconstruction, the anus can be preserved for an ileal pouch-anal anastomosis or removed when a permanent ileostomy is planned.

What is restorative proctocolectomy?

Restorative proctocolectomy removes the colon and rectum and creates an ileal pouch that is connected to the anus so stool can continue to pass through the natural route.

Is a permanent ileostomy always required after proctocolectomy?

No. Some patients have a permanent end ileostomy, while suitable patients can have an ileal pouch-anal anastomosis with only a temporary diverting ileostomy.

What is pouchitis after proctocolectomy?

Pouchitis is inflammation of an ileal pouch created during restorative proctocolectomy. It can cause increased stool frequency, urgency, abdominal cramping, bleeding, or fever.

References

Biceps Tendon Tear at the Elbow. OrthoInfo, American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org/en/diseases--conditions/biceps-tendon-tear-at-the-elbow/. Date Accessed August 13, 2026.

Distal biceps tendon injuries. PubMed. https://pubmed.ncbi.nlm.nih.gov/20810864/. Date Accessed August 13, 2026.

Complications After Distal Biceps Tendon Repair: A Systematic Review. PubMed. https://pubmed.ncbi.nlm.nih.gov/32091914/. Date Accessed August 13, 2026.

Rehabilitation Following Distal Biceps Repair. PubMed. https://pubmed.ncbi.nlm.nih.gov/30997282/. Date Accessed August 13, 2026.

The Treatment of Distal Biceps Ruptures: An Overview. PubMed. https://pubmed.ncbi.nlm.nih.gov/31879719/. Date Accessed August 13, 2026.