What is a Proctocolectomy?

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  • Written By: Malcolm Tatum
  • Edited By: Bronwyn Harris
  • Last Modified Date: 01 October 2019
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Sometimes referred to as a total colectomy, a proctocolectomy is a form of surgery used to treat a number of different bowel diseases, including ulcerative colitis. This type of surgical procedure is usually reserved for situations where other forms of treatment, such as medication and diet, have not resulted in the ability to manage the health issue. Once the surgery is complete, the patient will wear a proctocolectomy pouch for the remainder of his or her life.

As part of the surgery, the colon and the rectal lining are removed completely. Once the large intestine and rectum are removed, the small intestine is surgically attached to the anus. As the final step in the proctocolectomy, a small opening known as the end-ileostomy or stoma is created, usually in the abdomen. The stoma makes it possible for the body to eliminate waste efficiently.

After the completion of the proctocolectomy, the patient must wear what is usually referred to as a proctocolectomy bag or pouch. The purpose of the pouch is to catch the waste as it escapes through the stoma. Depending on the rate of production of waste, the bag is usually emptied or changed two or more times each day.


There are several benefits to undergoing a proctocolectomy. The most immediate is a cessation of the pain and suffering that is common during an outbreak of ulcerative colitis. After the surgery, the patient will not longer endure extreme cramping or live with a constant sense of urgency to void the system. For many patients, this total colectomy means that it is possible to no longer be housebound or unable to participate in various types of social events, since there is no longer a fear of experiencing a loss of control in a public setting.

Along with the benefits afforded by the surgery, there are also potential risks present. The threat of infection is a constant concern, making it necessary to pay close attention to the condition of the stoma. In the event that the small opening should become swollen or inflamed, medical attention should be sought immediately.

Patients who undergo a proctocolectomy often benefit from counseling. As part of the therapy, patients have the opportunity to come to terms with the need to wear the proctocolectomy bag, as well as learn how to change the bag efficiently. In some cases, family members and caregivers are also invited to participate in the therapy, making it possible for them to learn how to offer compassionate support.


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