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If you have diverticulitis, colon cancer, or inflammatory bowel disease, your healthcare provider may recommend removing all or part of your colon. This potentially lifesaving procedure is called a colectomy.
Overview
What Is a Colectomy?
A colectomy is a procedure in which all or part of the colon is removed.
The large intestine, which consists of the colon and rectum, is a long, tunnel-like organ at the end of the digestive system. Here, waste products form into feces before passing through the rectum and anus.
If disease or a physical blockage affects the colon, a colectomy may be needed to help the rest of the gastrointestinal (GI) tract function properly.
The amount and location of colon removal will depend on a patient’s health condition and reason for the procedure. In some cases, the entire colon may need to be removed. Other times, only part of the colon may need resection.
Total Colectomy
During a total colectomy (proctocolectomy), the surgeon removes the entire colon and rectum.
This can result in an ileostomy. During this procedure, the small intestine is connected to an opening in the abdominal wall, or stoma. The stoma attaches to a pouch outside of the body called an ostomy bag, which collects waste.
Alternatively, the small intestine may be attached directly to the anus through an ileal pouch, which holds waste inside the body without the need for an ostomy bag.
Not everyone may be suitable for an ileal pouch. Your doctor will discuss which option is best for you based on your health condition.
Subtotal or Partial Colectomy
A subtotal colectomy involves removing the entire colon but leaving the rectum intact.
During a partial colectomy, only the colon is removed, and the rectum is left intact. The remaining parts of the colon may be reattached. This is called an anastomosis.
If an anastomosis isn’t possible, the colon may need to be connected to a hole in the abdominal wall, which would attach to an ostomy bag.
Sigmoid Colectomy
A sigmoid colectomy removes the end of the colon, also called the sigmoid colon.
Hemicolectomy
In a hemicolectomy, the right side or left side of the bowel is removed.
Why Is a Colectomy Procedure Done?
A colectomy can help treat or prevent many different diseases, conditions, and injuries that affect the GI tract. These include:
- Scar tissue blocking the lower GI tract
- Colon cancer
- Diverticulitis, which refers to inflamed sacs (diverticula) lining the inside of the colon
- Inflammatory bowel disease, including ulcerative colitis and Crohn’s disease
A colectomy can also treat other conditions, including a twisted bowel (volvulus) or intussusception, which occurs when one part of the gut folds into a nearby section.
A colectomy may be preventive. For example, if you have a genetic predisposition to developing colon cancer — or if a physician identifies changes in the colon that have a high risk of developing into cancer — a colectomy may be necessary. In these cases, a colectomy would help prevent cancer or stop it from spreading to other parts of the GI tract.
How Is a Colectomy Performed?
A colorectal surgeon is usually the healthcare professional who carries out a colectomy. The amount and location of bowel removal depends on your specific health problem, as well as whether you need a stoma.
A colectomy can be performed in one of two ways: open colectomy or laparoscopic-assisted colectomy.
- Open colectomy: Open colectomies are made through a long cut, or incision, in the abdomen. These are used in emergencies or if the surgeon needs more visual access.
- Laparoscopic-assisted colectomy: Laparoscopic-assisted colectomies involve a series of smaller incisions. The surgeon uses a laparoscope (a very small video camera) attached to the end of a long, thin tube. A safe gas is used to inflate the abdomen and improve visualization of the colon. Then, special tools are inserted to remove the damaged tissue.
Laparoscopic-assisted colectomies may lessen pain and decrease recovery times.
For people with colon cancer, surgeons often remove nearby lymph nodes to reduce the risk of spread.
How Do I Prepare for a Colectomy?
Before surgery, tell your doctor about any medications you're taking. You may need to stop taking certain drugs before your procedure. In addition, your doctor may prescribe antibiotics before surgery to help prevent infection.
Be sure to follow any instructions you receive from your surgeon. You’ll need to avoid eating before your surgery, but you may be able to drink the following fluids for up to two hours before you arrive at the hospital:
- Water
- Non-cloudy apple, grape, or cranberry juices
- Sports drinks, such as Gatorade
- Black coffee (with sugar if you like)
Drinking clear liquids helps clear the bowel, which helps the surgeon perform the surgery safely.
For this same reason, your doctor may also recommend taking a laxative or performing an enema.
- Laxative: A laxative is a solution you mix with water and drink over the course of several hours or days before your surgery.
- Enema: An enema is an injection of fluids made directly into the anus. This helps you have a bowel movement.
It may also be helpful to have over-the-counter pain relievers, like ibuprofen or acetaminophen, on hand to help reduce pain and discomfort after surgery.
If a surgeon performs a colectomy as an emergency procedure, you may not be able to plan ahead.
What Should I Expect During a Colectomy?
On the day of the procedure, a nurse and anesthesiologist will discuss the surgery with you. They’ll also review your medical history and any previous issues you may have had with anesthesia.
Here’s what to expect before and during surgery:
- Removal of personal items: You’ll need to remove all personal items, such as glasses, hearing aids, dentures, jewelry, wig, or any other accessories.
- Preparation of abdomen: The operating team will shave (if applicable) and clean your abdomen.
- Compression boots: You’ll wear compression boots on your feet and lower legs. These are devices that inflate and deflate to keep blood moving through the legs.
- General anesthesia: An anesthesiologist will administer general anesthesia to put you to sleep.
- Other tubes: After anesthesia, your care team will insert a breathing tube into your airway. This helps you breathe while you’re unconscious. They’ll also insert a catheter into your bladder to drain urine during the procedure.
What Are the Potential Risks Associated With a Colectomy?
Any type of surgery with anesthesia comes with risks, which may include:
- Allergic reactions to anesthesia or medicines
- Breathing difficulties
- Blood clots
- Bleeding, particularly in the abdomen where the surgery takes place
- Infection
The colorectal surgeon will discuss the risks of the procedure with you ahead of time and make sure you understand exactly what is involved.
What Type of Care Is Needed Following a Colectomy?
Most people stay in the hospital for two to seven days after surgery. It depends on which procedure was done and how well a patient is recovering.
After surgery, you’ll be in the post-anesthesia care unit (PACU). You may receive oxygen through a tube, and you’ll also continue wearing compression boots. Other tubes will drain fluid from your abdomen and pee from your bladder.
Pain medication will be administered through a catheter, nerve block, or an IV line.
Depending on recovery, you may need to stay in the PACU overnight. Otherwise, you’ll move to a hospital room.
As you recover, you may not be able to eat solid foods immediately, but you can slowly return to them the day after surgery. A dietitian nutritionist can help you in this process.
These clinicians may recommend a low-fiber diet with increased fluid intake for a month after surgery. This reduces the amount of work the colon needs to do during healing.
Your doctor will also discuss wound care and how to look after, clean, and use an ostomy pouch if you have one.
What Are the Possible Complications and Side Effects of a Colectomy?
A colectomy may result in complications, including:
- Tissue bulging through the surgical cut, or an incisional hernia
- Nearby organ, ureter, or bladder damage
- Issues with the colostomy
- Scar tissue forming in the abdomen that causes further intestinal blockages
- Anastomotic leak, which can be life-threatening and occurs when the intestines that were connected start to detach
- Wound difficulties, such as breaking open or infection
- Peritonitis, which occurs when a thin layer of abdominal tissues becomes inflamed
As you recover, your care team will monitor your progress.
After discharge, immediately contact your doctor if you have any of the following symptoms:
- Fever, or a body temperature of 100.4 degrees F (38 degrees Celsius) or higher
- Chills and shivering
- Coughing
- Breathlessness
- Rapid or irregular heartbeat
- Chest pains you didn’t have before
- Redness, warmth, pain, or fluid leakage around the cut, which could be due to infection
- Incisions that are opening up or pulling apart
- Abnormal or excessive bleeding that soaks through the bandage
- Changes to peeing habits or the appearance of pee
- Swollen hands, arms, or chest that doesn’t improve within two weeks of surgery
- Pain, swelling, warmth, or redness in a limb
What’s Next?
Full recovery may take up to six weeks, but many people return to their normal routine within two weeks.
During recovery, you may feel weak, so try to keep movements gentle for the first few days after surgery.
Depending on the type of surgery you had, further procedures may be needed. For example, some stomas are temporary, and a surgeon may perform another procedure to reattach the colon and rectum once they heal.
Additionally, people who have a proctocolectomy may need an ileal pouch. This doesn’t always occur during the first procedure, and further surgery might be necessary to fit the ileal pouch.
If you live with an ostomy, you can still have a full, active life. But perceived changes in appearance may lead to emotional and mental health symptoms, such as depression or anxiety.
A proctocolectomy may also cause sexual changes, such as erectile dysfunction or painful intercourse, but these are usually temporary.
Talk to your doctor if you have any concerns about living with a stoma.
If you have ongoing health problems like inflammatory bowel disease or cancer, you may still need to attend consultations and checkups to monitor disease progression.
The Takeaway
During a colectomy, a surgeon removes part or all of the colon to treat a health condition, such as cancer, inflammatory bowel disease, or diverticulitis. Colectomies are a major procedure, and you may be required to stay in the hospital for up to one week. Talk to your doctor about your specific health needs and concerns before a colectomy.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Colectomy. Mayo Clinic. November 8, 2022.
- Colectomy (Bowel Resection Surgery). Cleveland Clinic. April 24, 2022.
- Large Bowel Resection. MedlinePlus. March 11, 2023.
- Proctocolectomy and Colectomy. Crohn’s & Colitis Foundation.
- Surgery to Remove All of or a Part of Your Bowel (Colectomy). Cancer Research UK. February 1, 2022.
- Diverticulitis. Cleveland Clinic. April 10, 2023.
- Colectomy. Johns Hopkins Medicine.
- About Your Colon Resection Surgery. Memorial Sloan Kettering Cancer Center. June 4, 2024.
- Enema. Cleveland Clinic. November 20, 2023.
- Peritonitis. Mayo Clinic. April 6, 2023.
Meet Our Experts
Ira Daniel Breite, MD
Medical Reviewer
Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patients and helps run an ambulatory surgery center.
Dr. Breite divides his time between technical procedures, reading about new topics, and helping patients with some of their most intimate problems. He finds the deepest fulfillment in the long-term relationships he develops and is thrilled when a patient with irritable bowel syndrome or inflammatory bowel disease improves on the regimen he worked with them to create.
Breite went to Albert Einstein College of Medicine for medical school, followed by a residency at NYU and Bellevue Hospital and a gastroenterology fellowship at Memorial Sloan Kettering Cancer Center. Working in city hospitals helped him become resourceful and taught him how to interact with people from different backgrounds.
Adam Felman
Author
Adam is a freelance writer and editor based in Sussex, England. He loves creating content that helps people and animals feel better. His credits include Medical News Today, Greatist, ZOE, MyLifeforce, and Rover, and he also spent a stint as senior updates editor for Screen Rant.
As a hearing aid user and hearing loss advocate, Adam greatly values content that illuminates invisible disabilities. (He's also a music producer and loves the opportunity to explore the junction at which hearing loss and music collide head-on.)
In his spare time, Adam enjoys running along Worthing seafront, hanging out with his rescue dog, Maggie, and performing loop artistry for disgruntled-looking rooms of 10 people or less.
EDITORIAL SOURCES
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
- Colectomy. Mayo Clinic. November 8, 2022.
- Colectomy (Bowel Resection Surgery). Cleveland Clinic. April 24, 2022.
- Large Bowel Resection. MedlinePlus. March 11, 2023.
- Proctocolectomy and Colectomy. Crohn’s & Colitis Foundation.
- Surgery to Remove All of or a Part of Your Bowel (Colectomy). Cancer Research UK. February 1, 2022.
- Diverticulitis. Cleveland Clinic. April 10, 2023.
- Colectomy. Johns Hopkins Medicine.
- About Your Colon Resection Surgery. Memorial Sloan Kettering Cancer Center. June 4, 2024.
- Enema. Cleveland Clinic. November 20, 2023.
- Peritonitis. Mayo Clinic. April 6, 2023.
Additional Sources
- Colectomy. Mayo Clinic.
- Colectomy: Frequently Asked Questions. University of Chicago Medicine.
- Colectomy. Johns Hopkins Medicine.
- Total Abdominal Colectomy. MedlinePlus.