In most cases, your bowel is cleaned before the surgery with enemas and medication. The surgery is performed while you are under general anesthesia. This means you are unconscious and pain-free. A cut is made in your abdomen. The diseased part of the large bowel is removed and the two healthy ends of the bowel are sewn back together (resected). The cut is closed. If the entire colon and rectum is removed, it is called a proctocolectomy. A bowel resection may be performed as a traditional "open" procedure or as a mimimally invasive laparoscopic procedure. To help your bowel heal, a temporary opening of the colon through the abdominal wall may be created. This is called a colostomy. The end of the bowel near the small intestine is then passed through the abdominal wall, and stitched in place. A drainage bag (stoma appliance) is placed around the opening. In most cases, the colostomy is temporary and can be closed with another operation at a later date. If a large portion of the bowel is removed, the colostomy may be permanent. The large bowel absorbs a significant amount of water from digested food. When the colon is bypassed by a colostomy, loose or liquid stool (feces) will collect in the drainage bag. Careful skin care and a well-fitting colostomy bag are necessary to reduce skin irritation around the colostomy.
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