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IBD Treatment - Colectomy

Having a colectomy - a surgical procedure to remove all or part of your colon - can save your life, but it also requires changes to the way your body works. We understand that this procedure may make you nervous. It may help you to know that you are not alone. Each year thousands of people in the United States people of all ages - even newborn babies -  have this surgery. Most are enjoying full, healthy, active lives years after their surgery.

At Penn State IBD Center, we are able to offer you the most advanced and least invasive options for managing your disease, and for many of our patients, a permanent colostomy or ileostomy is not necessary. Learn more about ileal pouch procedures and laparoscopy.

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What is a Colectomy?

A colectomy is a surgical procedure to remove all or part of your colon. Your colon, also called your large intestine, is a long tube-like organ at the end of your digestive system. A colectomy may be necessary to treat or prevent diseases and conditions that affect your colon, like ulcerative colitis.

If you need a colectomy, it is likely you have serious IBD symptoms and possibly disease at your anus. You may be in severe pain, and medications are not helping. You and your doctor may decide that removing a part of your colon is the best next step in your treatment. Most often a colectomy removes part of the colon, and then the two ends of the remaining colon are connected together to allow the continued normal passage of bowel movements.

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What is a Colostomy?

Sometimes a colectomy may require the creation of a colostomy or ileostomy - an opening in the abdominal wall that is made during surgery. Many patients who get a colostomy or ileostomy get significant relief of disease symptoms, especially around the anus.

  • A surgeon may create a colostomy when you undergo surgery to remove part of your colon. It is an opening in the belly that is used to bring out the end of your colon
  • The end of your colon is brought through this opening to form a stoma or colostomy. The size and placement of the stoma is different for everyone, and its placement is usually decided before your surgery with stoma nurse specialists, so that it does not interfere with skin folds or belt lines.
  • After a colostomy has been created, the intestines will work just like they did before, except that your stools will now exit through the stoma into a bag that your wear under your clothes.
  • A colostomy bag or pouch (not to be confused with an ileal pouch, which is internal), is worn externally, will capture your stools.

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Will My Colostomy Be Permanent?

A colostomy will be permanent if your anal sphincters must be removed, or if they are not reliable. Anal sphincters will be removed if the disease is invading or very close to anal tissue.

For many of our patients, the colostomy is temporary, if the area of disease or injury of the bowel does not involve the anal sphincter. If the surgeon can safely remove the diseased tissue and preserve the function of the anal sphincters, it may be possible to rejoin the bowel. Sometimes, your doctors will decide to perform a temporary colostomy to help the rejoined area heal. When complete healing is determined, the temporary colostomy can be closed.

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Surgical Advancements at Penn State Hershey's IBD Center

To perform your colectomy, our skilled surgeons may make a large cut in your abdomen or, if appropriate, use an advanced surgical technique called laparoscopy, which involves only small incisions and the insertion of a small camera and surgical tools. Our surgeons can even perform some surgeries with only one small incision. This is called single-site laparoscopy.

Most of our patients will not need a colostomy. Our surgical techniques and instruments have decreased the number of operations that require a colostomy.

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What Will My Life Be Like With a Colostomy?

Wearing a stoma bag is one of the biggest changes you will face after colostomy surgery. It takes getting used to, but it is not as difficult as you might imagine. The basic piece of equipment is a bag (made of odor-resistant plastic or vinyl) that collects the stool.

  • The pouches attach to your body with adhesive skin barriers that are custom-fitted by you and your stoma nurse and do not irritate your skin.
  • A closure at the bottom of the pouch allows you to empty it without removing it from your body.
  • Nobody will notice the pouch. It is small and stays flat, so you do not have to wear baggy clothes.

You will be able to resume physical activity gradually after surgery. Talk to your doctor about when you can return to sports and other activities.

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Ongoing Care and Support After a Colostomy

Your stomal therapist at Penn State IBD Center will help you adjust to living with either a permanent or temporary colostomy. They will counsel you before and after your operation, show you how to care for your colostomy and colostomy bag, and follow up with you on a regular basis.   Prior to your operation you will go to a stoma class where they will educate you and have you practice managing the bag on a model that you can take home to practice with. Their goal is to help you live well with your stoma and enjoy your life again.

In addition to medical care and a preoperative stoma class, we offer bi-monthly support group meetings for patients living with IBD and a stoma. Support from your peers can be comforting for people living with a colostomy. Crohn's and colitis support group meetings are often intimate gatherings where patients and their loved ones can share their stories, seek emotional support, find answers to their questions, and connect with a community who share their challenges.  Learn more about Crohn's and colitis support groups at Penn State IBD Center.

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