How will surgery for UC affect me?
Many patients ask what is life like after colectomy. Will I be able to work, play, socialize, and be active? How will it affect sexual intercourse?
There are two types of surgeries commonly performed for ulcerative colitis.
1) The colectomy with end-ileostomy involves removing the entire colon and bringing the end of the small intestine to the skin where it empties into a bag.
2) The ileal pouch anal anastamosis (IPAA) requires multiple surgeries to remove the colon, then construct a “neo-rectum” out of small intestine before reconnected the intestine to the anal canal internally.
End-ileostomy
After this surgery, patients no longer have bowel movements through the anal canal. In most cases the colon is completely removed and the anal canal is closed. If the rectum is left intact as a closed pouch there may be a small amount of mucous passage every week or so. An ostomy bag is worn over the stoma (small bowel protruding through the abdominal wall looking like a mushroom) just above or below the waist line, usually on the right side of the belly. The stoma and bag are only visible when the patient is naked. Three to four times per day the end of the bag is unclipped and the contents are emptied into the toilet.
The ostomy bag has a round opening with adhesive which attaches to the skin around the stoma. There are several brands, sizes, and colors of ostomy bags. The material excreted from the small intestine into the ostomy bag is not feces since it has not passed through the colon and, as a result, does not have the associated odor. It is often pasty and green.
Next week I will discuss the (very small) limitations on activity with a stoma.