Having Bowel Surgery: Ileoanal Pouch

This surgery is done to treat diseases of the digestive tract. It removes all of the large intestine. When healed, bowel movements still occur through the anus.

Preparing for surgery

Preparation may begin a few weeks before surgery and can include the following:

  • If you smoke, try to quit.

  • Tell your doctor about any medications (including aspirin, NSAIDs, and blood thinners), herbs, or supplements you take. Ask whether you should stop any of them before surgery.

  • If you will have a stoma, a specially trained healthcare provider called an enterostomal therapy (ET) nurse will meet with you. The ET nurse will help you determine the optimal location for the stoma on the abdominal wall.

  • If instructed, stop eating solid food a day or two before surgery. Switch to a diet of clear liquids such as broth.

  • You may receive instructions for bowel prep, which helps ensure that your digestive tract is ready for surgery.

  • Don’t eat or drink anything after midnight the night before surgery. This includes water, gum, and breath mints.

  • If your doctor tells you to take medication the morning of surgery, swallow it with only small sips of water.

Image of the intestines with the colon and rectum highlighted to show the section to be removed.

Image showing the intestinal pouch for collecting waste

The procedure

  • The colon and rectum are removed.

  • The anus and surrounding muscles are left in place.

  • Part of the small intestine is reshaped to form a pouch within the body. The pouch works like a rectum. It stores waste until a bowel movement occurs.

  • A temporary ileostomy may be needed as the intestine heals. This is a procedure that lets waste pass into a pouch outside the body.

Risks and complications

Bowel surgery has certain risks and possible complications. Your healthcare provider can discuss them with you. They may include:

  • Infection

  • Injury to nearby organs

  • An anastomosis that leaks

  • Blood clots

  • Risks related to anesthesia