Total colectomy or proctocolectomy - discharge

During and after surgery, you received intravenous (IV) fluids. You also may have had a tube placed through your nose and into your stomach. You may have received antibiotics.

Follow your surgeon's instructions for how to take care of yourself at home.

If your rectum or anus remains, you may still have the feeling that you need to move your bowels. You may also leak stool or mucus from here during the first few weeks.

If your anus and rectum have been removed, you may feel the stitches in this area. It may feel tender when you sit.

You will probably have pain when you cough, sneeze, or make sudden movements. This may last for several weeks but will improve over time.

Activity:

• It may take several weeks for you to get back to your normal activities. Ask your surgeon if there are activities you should not do.
• Start by taking short walks.
• Increase your exercise slowly. Do not push yourself too hard.

Your surgeon will prescribe pain medicines for you to take at home. Make sure you:

• Take them at the same times each day for 3 to 4 days, if you are taking them 3 or 4 times a day. They regulate pain better this way. Ask your surgeon if you can take acetaminophen (Tylenol) or ibuprofen (Advil or Motrin) to help with pain and to avoid taking narcotic pain medicine.
• Do not drive or use other heavy machines if you are taking narcotic pain medicines. These medicines may make you drowsy and slow your reaction time.
• Press a pillow over your incision when you need to cough or sneeze. This helps ease pain.

Ask your surgeon when you should begin taking your regular medicines again after surgery.

If your staples have been removed, you will probably have Steri-Strips (small pieces of tape) placed across your incision. These pieces of tape will fall off on their own. If your incision was closed with dissolving sutures, you may have glue covering the incision. This glue will loosen and come off on its own. Or, if your surgeon agrees, it can be peeled off after a few weeks.

Ask your surgeon when you can shower or soak in a bathtub.

Things you should know include:

• It is OK if the tapes get wet. Do not soak or scrub them.
• Keep your wound dry at all other times.
• The tapes will fall off on their own after a week or two.

If you have a dressing, your surgeon will tell you how often to change it and when you can stop using it.

Make sure you:

• Follow instructions for cleaning your wound daily with soap and water. Look carefully for any changes to the wound as you do this.
• Pat your wound dry. Do not rub it dry.
• Ask your surgeon before putting any lotion, cream, or herbal remedy on your wound.

Do not wear tight clothing that rubs against your wound while it is healing. Use a thin gauze pad over it to protect it if needed.

If you have an ileostomy, follow care instructions from your surgeon.

You may get nutrition through a tube (catheter) in a large vein. Keep the skin dressing in place and clean. If you are taking in food by mouth, eat small amounts several times a day. You should:

• Space out your small meals.
• Add new foods back into your diet slowly.
• Try to eat protein every day.

Some foods may cause gas, loose stools, or constipation as you recover. Avoid foods that cause problems.

If you become sick to your stomach or have diarrhea, contact your surgeon.

Ask your surgeon how much fluid you should drink each day to prevent getting dehydrated.

Return to work only when you feel ready. These tips may help:

• You may be ready when you can be active around the house for 8 hours and still feel OK when you wake up the next morning.
• You may want to start back part-time and on light duty at first.
• Your surgeon can write a letter to limit your work activities if you do heavy labor.

Contact your surgeon if you have any of the following:

• Fever of 101°F (38.3°C) or higher, or fever that does not go away with acetaminophen (Tylenol)
• Swollen belly
• Feel sick to your stomach or throwing up a lot and cannot keep food down
• Not had a bowel movement 4 days after leaving the hospital
• Have been having bowel movements, and they suddenly stop
• Black or tarry stools, or there is blood in your stools
• Belly pain that is getting worse, and pain medicines are not helping
• Your colostomy has stopped putting out any water or stools for a day or two
• Changes in your incision such as the edges are pulling apart, drainage or blood coming from it, redness, warmth, swelling, or worsening pain
• Shortness of breath or chest pain
• Swollen legs or pain in your calves
• Increased drainage from your rectum
• Feeling of heaviness in your rectal area

End ileostomy - colectomy or proctocolectomy - discharge; Continent ileostomy - discharge; Ostomy - colectomy or proctocolectomy - discharge; Restorative proctocolectomy - discharge; Ileal-anal resection - discharge; Ileal-anal pouch - discharge; J-pouch - discharge; S-pouch - discharge; Pelvic pouch - discharge; Ileal-anal anastomosis - discharge; Ileal-anal pouch - discharge; Ileal pouch - anal anastomosis - discharge; IPAA - discharge; Ileal-anal reservoir surgery - discharge

Efron JE, Pogacnik JS. Management of Crohn colitis. In: Cameron JL, Cameron AM, eds. Current Surgical Therapy. 15th ed. Philadelphia, PA: Elsevier; 2026:chap 32.

Horesh N, Emile S, Wexner SD. Colon and rectum. In: Tyler DS, Hayes-Dixon A, Hines OJ, et al, eds. Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 22nd ed. Philadelphia, PA: Elsevier; 2026:chap 95.

Updated by: Ann M. Rogers, MD, FACS, Professor Emeritus, Department of Surgery, Penn State College of Medicine, Hershey, PA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.