Scar tissue may form in your belly and causes blockage of your intestines.
Your wound may break open.
Poor healing of your wound in your perineum (where the rectum was removed)
Poor absorption of nutrients from food because of your ileostomy
Phantom rectum, a sensation that your rectum is still there (similar to people who have amputation of a limb)
Before the Procedure
Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription. Ask your doctor which drugs you should still take on the day of your surgery.
Talk with your doctor or nurse about these things before you have surgery:
Intimacy and sexuality
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.
Always let your doctor know about any cold, flu, fever, herpes breakout, or other illnesses that may occur before your surgery.
Eat high fiber foods and drink 6 to 8 glasses of water every day.
The day before your surgery:
Eat a light breakfast and lunch.
You may be asked to drink only clear liquids, such as broth, clear juice, and water, after noontime.
Do NOT drink anything after midnight, including water. Sometimes you will not be able to drink anything for up to 12 hours before surgery.
Your doctor or nurse may ask you to use enemas or laxatives to clear out your intestines. They will give you instructions for this.
On the day of your surgery:
Take your drugs your doctor told you to take with a small sip of water.
Your doctor or nurse will tell you 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. Your doctor or nurse will slowly add thicker fluids and then soft foods 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, your nurse and doctor will teach you 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.
Most people who have total proctocolectomy with ileostomy 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.
If you have a chronic condition, such as Crohn's disease or ulcerative colitis, you may need ongoing medical treatment.
Cunningham D, Atkin W, Lenz HJ, et al. Colorectal cancer. Lancet. 2010 Mar 20;375(9719):1030-47.
Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 50.
Khatri VP, Asensio JA, eds. Subtotal colectomy/panproctocolectomy and j-pouch reconstruction. Operative Surgery Manual. 1st Ed. Philadelphia, Pa: Saunders; 2003:chap 35.
Scriver G, Hyman N. Ileostomy construction. Operative Techniques in General Surgery. 2007;9(1): 43-49.
David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc., and George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California.