Proctocolectomy and Colectomies

You may wonder what a colectomy or a proctocolectomy are, and here, we’ll go over what each of these are, the differences, and why someone may possibly get one or the other. A proctocolectomy is a removal of the rectum and colon, with a colectomy being a removal of your colon. While they may alleviate the Crohn’s disease symptoms, it does permanently alter the gastrointestinal system in the body. 

Colectomy 

This is usually done if there is a disease within the colon, and it needs to be removed, but your rectum is left unaffected by say Crohn’s disease and the like. The surgeon usually joins the ileum to the rectum, and you’ll be able to pass stool still via your anus without an external pouch. 

Proctocolectomy 

This is something that’s recommended if the large intestine is too diseased and has to be taken out. There are variations, but usually you get this with the end ileostomy that’s there. In the end ileostomy, the end of your small intestine is then inverted through a hole made by your abdominal wall, diverting waste to the ostomy appliance that’s there. Those that have ulcerative colitis may get an ileal pouch and anal anastomosis, which create a j pouch internally using your small intestine end, and usually eliminates an ostomy bag. However, for those who have Crohn’s disease, it isn’t recommended since the disease does recur in that pouch. With a proctocolectomy, the anus, colon, and the rectum are removed and usually you get an ileostomy that creates a stoma to drain out the waste. 

The stoma is about a quarter in size and protrudes a bit from the abdomen area. Usually, it’s pink, and looks shiny and moist. The ostomy pouch attaches to this and is worn all the time to et waste. Usually, the site for ileostomies is your lower abdomen near the right side of the navel, just underneath the belt line. After this, you may feel like you have bowel movements, and it does cause phantom rectum feelings. This is very normal, but it doesn’t need treatment or anything else attached to this. Oftentimes these feelings do usually subside as time goes on too. 

Living with The Ileostomy 

You can actually live a life that’s long, productive, and active, and in a lot of cases, patients can do the same things they did before, including activities outside, various sports, swimming and other water activities, even travel and work outside the home. It is common to feel a little bit self-conscious after this, and you might feel your body image change as well. The bag, however, does lay flat underneath your clothing, and it isn’t visible to other people. Nobody needs to find out that you have an ostomy bag, unless of course you choose to let them know about this. 

It is important however, to keep your mental and emotional health together too, just like with your physical health. If you’re experiencing feelings that you feel would be better discussed with a doctor, remember there is no shame in getting help for this as well. It’s a big change after all. You may struggle at first with the ostomy bag, since you do need to empty it a bit.  There are also different pouch systems as well. Usually, there aren’t any real dietary restrictions to worry about, but you should always make sure to have lots of fluids, so you don’t suffer from electrolyte loss or dehydration as a result of this. Foods high in pectin such as bananas and applesauce also will help you as well.