What Is Total proctocolectomy with ileostomy

Last updated: February 8, 2026Reviewed date: February 8, 2026Reading time: 5 min read
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Total proctocolectomy with ileostomy is surgery to remove all of the colon (large intestine) and rectum. Description You will receive general anesthesia right before your surgery. This will make you be asleep and unable to feel pain. For your proctocolectomy: Your surgeon will make a...

For severe symptoms, danger signs, pregnancy, child illness, or sudden worsening, seek urgent medical care.

বাংলা রোগী নোট এখনো যোগ করা হয়নি। পোস্ট এডিটরে “RX Bangla Patient Mode” বক্স থেকে সহজ বাংলা সারাংশ যোগ করুন।

এই তথ্য শিক্ষা ও সচেতনতার জন্য। এটি ডাক্তারি পরীক্ষা, রোগ নির্ণয় বা প্রেসক্রিপশনের বিকল্প নয়।

Article Summary

Total proctocolectomy with ileostomy is surgery to remove all of the colon (large intestine) and rectum. Description You will receive general anesthesia right before your surgery. This will make you be asleep and unable to feel pain. For your proctocolectomy: Your surgeon will make a surgical cut in your lower belly. Then your surgeon will remove your large intestine and rectum. Your surgeon may also...

Key Takeaways

  • This article explains Description in simple medical language.
  • This article explains Why the Procedure Is Performed in simple medical language.
  • This article explains Risks in simple medical language.
  • This article explains Before the Procedure in simple medical language.
Educational health guideWritten for patient understanding and clinical awareness.
Reviewed content workflowUse writer and reviewer profiles for stronger trust.
Emergency safety firstUrgent warning signs are highlighted below.

Seek urgent medical care if you notice

These warning signs are general safety guidance. Local emergency numbers and clinical judgment should always come first.

  • Severe symptoms, breathing difficulty, fainting, confusion, or rapidly worsening illness.
  • New weakness, severe pain, high fever, or symptoms after a serious injury.
  • Any symptom that feels urgent, unusual, or unsafe for the patient.
1

Emergency now

Use emergency care for severe, sudden, rapidly worsening, or life-threatening symptoms.

2

See a doctor

Book a professional medical evaluation if symptoms persist, worsen, recur often, affect daily activities, or occur in a high-risk patient.

3

Learn safely

Use this article to understand possible causes, tests, treatment options, prevention, and questions to ask your clinician.

Total proctocolectomy with ileostomy is surgery to remove all of the colon (large intestine) and rectum.

Description

You will receive general anesthesia right before your surgery. This will make you be asleep and unable to feel pain.

For your proctocolectomy:

  • Your surgeon will make a surgical cut in your lower belly.
  • Then your surgeon will remove your large intestine and rectum.
  • Your surgeon may also look at your lymph nodes and may remove some of them. This is done if your surgery is being done to remove cancer.

Next your surgeon will create an ileostomy :

  • Your surgeon will make a small surgical cut in your belly. Most often this is made in the lower right part of your belly.
  • The last part of your small intestine (ileum) is pulled through this surgical cut. It is then sewn onto your belly.
  • This opening in your belly formed by your ileum is called the stoma. Stool will come out of this opening and collect in a drainage bag that will be attached to you.

Today, some surgeons perform this operation using a camera. The surgery is done with a few small surgical cuts, and sometimes a larger cut so that the surgeon can assist by hand. The advantages of this surgery, which is called laparoscopy, are a faster recovery, less pain, and only a few small cuts.

Why the Procedure Is Performed

Total proctocolectomy with ileostomy surgery is done when other medical treatment does not help problems with your large intestine.

It is most commonly done in people who have inflammatory bowel disease. This includes ulcerative colitis or Crohn disease .

This surgery may also be done if you have:

  • Colon or rectum cancer
  • Familial polyposis
  • Bleeding in your intestine
  • Birth defects that have damaged your intestines
  • Intestinal damage from an accident or injury

Risks

Total proctocolectomy with ileostomy is most often safe. Your risk will depend on your general overall health. Ask your health care provider about these possible complications.

Risks of anesthesia and surgery in general are:

  • Reactions to medicines
  • Breathing problems
  • Bleeding, blood clots
  • Infection

Risks for this surgery are:

  • Damage to nearby organs in the body and to the nerves in the pelvis
  • Infection, including in the lungs, urinary tract , and belly
  • Scar tissue may form in your belly and cause blockage of the small intestine
  • Your wound may break open or heal poorly
  • Poor absorption of nutrients from food
  • Phantom rectum, a feeling that your rectum is still there (similar to people who have amputation of a limb)

Before the Procedure

Always tell your provider what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. Ask which drugs you should still take on the day of your surgery.

Talk with your provider about these things before you have surgery:

  • Intimacy and sexuality
  • Sports
  • Work
  • Pregnancy

During the 2 weeks before your surgery:

  • You may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), clopidogrel (Plavix), Naprosyn (Aleve, Naproxen), and others.
  • If you smoke, try to stop . Ask your provider for help.
  • Always tell your provider if you have a cold, flu, fever, herpes breakout, or other illnesses before your surgery.

The day before your surgery:

  • You may be asked to drink only clear liquids, such as broth, clear juice, and water, after a certain time.
  • Follow the instructions you have been given about when to stop eating and drinking.
  • You may need to use enemas or laxatives to clear out your intestines. Your provider will give you instructions for this.

On the day of your surgery:

  • Take the drugs you have been told to take with a small sip of water.
  • You will be told when to arrive at the hospital.

After the Procedure

You will be in the hospital for 3 to 7 days. You may have to stay longer if you had this surgery because of an emergency.

You may be given ice chips to ease your thirst on the same day as your surgery. By the next day, you will probably be allowed to drink clear liquids. You will slowly be able to add thicker fluids and then soft foods to your diet as your bowels begin to work again. You may be eating a soft diet 2 days after your surgery.

While you are in the hospital, you will learn how to care for your ileostomy.

You will have an ileostomy pouch that is fitted for you. Drainage into your pouch will be constant. You will need to wear the pouch at all times.

Outlook (Prognosis)

Most people who have this surgery are able to do most activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.

You may need ongoing medical treatment if you have a chronic condition, such as:

  • Crohn disease
  • Ulcerative colitis

 

Doctor visit helper

Prepare before seeing a doctor

A simple rural-patient checklist to help you explain symptoms clearly, ask better questions, and avoid unsafe self-treatment.

Safety note: This is not a prescription or diagnosis. For severe symptoms, pregnancy danger signs, children with serious illness, chest pain, breathing difficulty, stroke-like weakness, or major injury, seek urgent care.

Which doctor may help?

Start with a registered doctor or the nearest qualified health center.

What to tell the doctor

  • Write when the problem started and how it changed.
  • Bring old prescriptions, investigation reports, and current medicines.
  • Write allergies, pregnancy status, diabetes, kidney/liver disease, and major past illnesses.
  • Bring one family member if the patient is weak, elderly, confused, or a child.

Questions to ask

  • What is the most likely cause of my symptoms?
  • Which danger signs mean I should go to hospital quickly?
  • Which tests are necessary now, and which can wait?
  • How should I take medicines safely and what side effects should I watch for?
  • When should I come for follow-up?

Tests to discuss

  • Vital signs: temperature, pulse, blood pressure, oxygen saturation
  • Basic physical examination by a clinician
  • CBC, urine test, blood sugar, or imaging only when clinically needed

Avoid these mistakes

  • Do not use antibiotics, steroid tablets/injections, or strong painkillers without proper medical advice.
  • Do not hide pregnancy, kidney disease, ulcer, allergy, or blood thinner use.
  • Do not delay emergency care when danger signs are present.

Medicine safety and first-aid guide

This section is for patient education only. It does not replace a doctor, pharmacist, or emergency care.

Safe first steps

  • Drink safe fluids and monitor temperature.
  • In dengue-prone areas, discuss CBC and platelet count when fever persists or warning signs appear.
  • Use tepid sponging for high fever discomfort; avoid ice-cold bathing.

OTC medicine safety

  • For fever, common fever medicine may be discussed with a clinician or pharmacist.
  • Avoid aspirin/ibuprofen-like medicines in suspected dengue unless a doctor says it is safe.

Avoid these mistakes

  • Do not start antibiotics without a proper medical decision.
  • Do not use steroid tablets or injections casually for quick relief.
  • Do not delay emergency care because of home remedies.

Get urgent help if

  • Fever with breathing difficulty, confusion, repeated vomiting, bleeding, severe weakness, stiff neck, or dehydration needs urgent care.
Medicine names, dose, and timing must be decided by a qualified clinician or pharmacist after checking age, pregnancy, allergy, other diseases, and current medicines.

For rural patients and family caregivers

Patient health record and symptom diary

Write your symptoms, medicines already taken, test results, and questions before visiting a doctor. This note stays on your device unless you print or copy it.

Doctor to discuss: Medicine doctor / pediatrician for children / qualified clinician
Tests to discuss with doctor
  • Temperature chart and hydration assessment
  • CBC with platelet count if fever persists or dengue/other infection is possible
  • Urine test, malaria/dengue tests, chest evaluation, or blood culture only when clinically indicated
Questions to ask
  • What is the most likely cause of my symptoms?
  • Which warning signs mean I should go to emergency care?
  • Which tests are really needed now?
  • Which medicines are safe for my age, pregnancy status, allergy, kidney/liver/stomach condition, and current medicines?
  • Do I need antibiotics, or is this more likely viral?

Emergency warning signs such as chest pain, severe breathing difficulty, sudden weakness, confusion, severe dehydration, major injury, or loss of bladder/bowel control need urgent medical care. Do not wait for online information.

Safe pathway to proper treatment

Care roadmap for: What Is Total proctocolectomy with ileostomy

Use this simple roadmap to understand the next safe steps. It is educational and does not replace examination by a doctor.

Go to emergency care if you notice:
  • Severe or rapidly worsening symptoms
  • Breathing difficulty, chest pain, fainting, confusion, severe weakness, major injury, or severe dehydration
Doctor / service to discuss: Qualified healthcare provider; specialist depends on symptoms and examination.
  1. Step 1

    Check danger signs first

    If danger signs are present, seek emergency care and do not wait for online information.

  2. Step 2

    Record the symptom story

    Write when symptoms started, severity, medicines already taken, allergies, pregnancy status, and test results.

  3. Step 3

    Visit a qualified clinician

    A doctor, nurse, or qualified healthcare provider can examine you and decide which tests or treatment are needed.

  4. Step 4

    Do only useful tests

    Do tests after clinical assessment. Avoid unnecessary tests, random antibiotics, or repeated medicines without diagnosis.

  5. Step 5

    Follow up and return early if worse

    If symptoms worsen, new warning signs appear, or treatment is not helping, return for review quickly.

Rural patient practical tips
  • Take a written symptom diary and all previous prescriptions/test reports.
  • Do not hide medicines already taken, even herbal or over-the-counter medicines.
  • Ask which warning signs mean urgent referral to hospital.

This roadmap is for education. A real diagnosis and treatment plan requires history, examination, and clinical judgment.

RX Patient Help

Ask a health question safely

Write your symptom story. A health professional or site editor can review it before any answer is prepared. This box is not for emergency care.

Emergency first: Severe chest pain, breathing trouble, unconsciousness, stroke signs, severe injury, heavy bleeding, or rapidly worsening symptoms need urgent local medical care now.

Frequently Asked Questions

Is this article a replacement for a doctor?

No. It is educational content only. Patients should consult a qualified clinician for diagnosis and treatment.

When should I seek urgent care?

Seek urgent care for severe symptoms, rapidly worsening condition, breathing difficulty, severe pain, neurological changes, or any emergency warning sign.

References

Add references, clinical guidelines, textbooks, journal articles, or trusted medical sources here. You can edit this area from the RX Article Professional Blocks panel.

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