Colectomy: What is it?

If your colon could talk, it would probably say: “I do a lot more than you think.” It helps absorb water, turns leftovers into
something your body can actually use, and quietly keeps your digestion movinguntil it doesn’t. When part (or all) of the colon
is badly damaged or diseased, surgeons may recommend a colectomy, also called a colon resection.

This guide breaks down what a colectomy is, why it’s done, the main types, what happens in the hospital, and what recovery
tends to look likewithout turning your stomach or your brain into a pretzel.

What is a colectomy?

A colectomy is surgery to remove all or part of the colon (large intestine). Depending on the reason
for surgery, the surgeon may remove a small segment, a larger section (like the right or left side), or the entire colon.
When possible, the healthy ends of the intestine are then reconnected so stool can pass normally.

Sometimes, reconnecting the bowel right away isn’t the safest option. In those cases, the surgeon may create an
ostomyan opening on the abdomen that lets waste leave the body into a poucheither temporarily while the bowel heals,
or permanently when reconnection isn’t possible or isn’t recommended.

Why would someone need a colectomy?

A colectomy can be done to treat a serious colon condition or to prevent a problem from getting worse.
Common reasons include:

• Colon cancer (removing the tumor and nearby lymph nodes)
• Large or high-risk polyps that can’t be removed safely during colonoscopy
• Inflammatory bowel disease (ulcerative colitis or Crohn’s disease) when medicines aren’t enough
• Diverticulitis with complications or repeated severe episodes
• Bowel obstruction (blockage), twisting (volvulus), or severe narrowing (stricture)
• Bleeding that can’t be controlled other ways
• Ischemia (poor blood flow) causing colon tissue damage

Real-world example: A person with recurrent diverticulitis might do well for years, then suddenly develop complications
that make surgery the safest long-term plan. Another person might have a colon cancer found on screening colonoscopy and need a
planned (non-emergency) colectomy to remove the cancer and stage the disease properly.

Types of colectomy

The “type” mostly refers to how much of the colon is removed and which part.
Here are common terms you’ll hear:

Partial (segmental) colectomy

Removes a portion of the colon and leaves the rest. This is common for localized diseaselike a tumor in one section
or diverticulitis affecting a specific area.

Hemicolectomy

Removes roughly half of the coloneither the right side or the left sidedepending on where the problem is.

Subtotal colectomy

Removes most of the colon but leaves some behind (the exact remaining portion varies by case).

Total colectomy

Removes the entire colon. Stool must still exit the body, so the surgeon either connects the small intestine to the
rectum (if the rectum remains healthy) or creates an ileostomy (an ostomy from the small intestine).

Proctocolectomy

Removes the colon and rectum. This may be recommended for certain severe diseases or cancers. Some people with
ulcerative colitis, for example, may have surgery that removes the colon/rectum and then creates an internal pouch (often called
a J-pouch) or an ileostomy, depending on what’s safest and most appropriate.

How is a colectomy performed?

Colectomies are usually done under general anesthesia (you’re asleep). There are two main approaches:

Open colectomy

The surgeon makes a larger incision to reach the colon directly. This may be preferred in emergencies, complex cases, or when
there’s extensive scarring or inflammation.

Laparoscopic or robotic colectomy

The surgeon uses several small incisions and special instruments (sometimes with robotic assistance). Many patients have less
pain and a faster early recovery with minimally invasive approaches, though the best choice depends on your condition, anatomy,
and the surgical team’s judgment.

What actually happens during the operation?

While every surgery is individualized, most colectomies include these core steps:

1. Remove the diseased colon segment (or the entire colon, if needed)
2. Control blood supply to the removed section
3. Reconnect the bowel (anastomosis) when it’s safe to do soso digestion can function as normally as possible
4. Create an ostomy if needed (temporary or permanent), especially if reconnection would be risky

For colon cancer: surgeons typically remove nearby regional lymph nodes along with the tumor so the cancer
can be staged accurately and treated appropriately afterward if needed.

Before surgery: what to expect

Planned surgery usually includes a pre-op evaluation such as blood work and (depending on your case) imaging or colonoscopy.
Many hospitals use “Enhanced Recovery After Surgery” (ERAS) pathways that focus on preparing the body for surgery
and helping it bounce back fasterthink better pain control, earlier walking, and earlier return to eating.

You may be told to adjust medications (especially blood thinners), stop smoking, and follow specific instructions about eating
and drinking before surgery. Some patients need bowel preparation, and some do notyour surgeon decides based on the procedure
and current best practices.

After surgery: hospital stay and early recovery

Many people stay in the hospital for several days. A common range is roughly 3 to 7 days, though
it can be longer after emergency surgery or if complications occur. Early recovery often focuses on:

• Walking early (yes, even if you feel like a folded lawn chair at first)
• Pain control using a mix of medications to reduce heavy opioid use when possible
• Gradually restarting foodoften starting with liquids, then advancing as bowel function returns
• Breathing exercises to lower pneumonia risk
• Preventing blood clots with movement and sometimes medication

If you have an ostomy, an ostomy nurse typically teaches you how to care for it, how to fit the pouch, and how to spot skin
irritation earlyskills that can feel intimidating on day one and surprisingly routine by week two.

Colectomy risks and possible complications

A colectomy is a major operation, and risks depend on your overall health, the reason for surgery, and whether it’s planned or
emergent. Possible complications can include:

• Bleeding
• Infection (wound or internal)
• Pneumonia or other lung complications
• Blood clots in the legs or lungs
• Ileus (the bowel “goes sleepy” and takes longer to wake up)
• Bowel obstruction from scarring or narrowing later on
• Anastomotic leak (a leak where the bowel is reconnected), which is uncommon but serious
• Need for an ostomy (temporary or permanent), depending on safety

Your surgical team weighs these risks against the risk of not having surgerylike cancer progression, uncontrolled
inflammation, or recurrent infections.

Recovery at home: timelines, diet, and activity

Recovery isn’t usually a straight line. It’s more like a phone battery: you recharge a little, then suddenly need a nap after
folding two towels. Many people need weeks to feel more like themselves.

Diet after colectomy

Your team may recommend a low-fiber / low-residue diet for a few weeks to reduce stool volume while the bowel
heals. Over time, most people gradually expand what they eat. Hydration mattersespecially if a large portion of colon was
removed, since the colon plays a big role in water absorption.

Bowel changes

It’s common to have temporary changes in stool frequency and consistency. Some people notice looser stools for
a while; others deal with constipation. These changes often improve with time, diet adjustments, and guidance from the care team.

Activity

Most people are encouraged to walk often, avoid heavy lifting for a period of time, and gradually rebuild strength.
Your surgeon will give personalized guidelines based on your incision and operation type.

Living well after colectomy (with or without an ostomy)

Many people return to work, travel, exercise, and enjoy a normal social life after colectomy. If you have an ostomy, there’s a
learning curvebut it’s a skill set, not a personality trait. People with ostomies often find that life becomes more predictable
over time once routines and supplies are sorted out.

Follow-up is important. After cancer surgery, follow-up may include pathology review, possible additional treatment, and
surveillance. After surgery for IBD or diverticular disease, follow-up often focuses on symptoms, nutrition, and preventing
recurrence or complications.

Questions to ask your surgeon

• Which type of colectomy am I having, and why?
• Will you reconnect my bowel, or will I need an ostomy? If so, is it expected to be temporary?
• Is minimally invasive surgery an option for me?
• What is my expected hospital stay and recovery timeline?
• What symptoms after surgery should make me call you right away?
• What diet plan do you recommend for the first month?

Experiences related to colectomy (what people commonly report)

The facts matter, but so does the “what does it feel like to live through this?” part. Everyone’s experience is different,
yet there are patterns many patients describeespecially with planned surgery.

Before surgery: People often say the emotional build-up is harder than they expected. There’s the practical stuff
(time off work, rides, meals at home), but also the mental soundtrack: “What if I wake up with a bag?” or “How bad will this hurt?”
Many patients describe a turning point when they finally say, “I don’t want to keep living around bathrooms / flare-ups / fear of
cancer. I want a plan.” That shiftmoving from uncertainty to a decisioncan bring real relief.

The hospital phase: A common surprise is how quickly the care team wants you moving. Patients often joke that the
first hallway walk feels like running a marathon in socks, but the walking helps wake up the bowels and lowers complication risk.
People also mention that pain can be less “sharp” than they feared and more “sore and tight,” especially with minimally invasive
surgerythough pain is still real and deserves good management. Another frequently reported moment: the first time you tolerate
liquids or soft foods again. It sounds minor until you’ve been living on IV fluids and optimism.

Learning the new normal: If there’s an ostomy, many patients describe day one as overwhelming and day seven as
“Okay, I can do this.” The pouch system becomes a routine: empty, clean, check the skin, move on with life. People often say the
best support is a good ostomy nurse and a simple checklist at home (supplies, how often to change the appliance, what irritation
looks like early). If there’s no ostomy, some patients are surprised by bowel habit changesmore frequent stools at first, or a
period of unpredictability. The encouraging pattern is that the body adapts over time, and diet experiments (introduced slowly)
help you learn what’s “safe” for your gut.

Recovery at home: Many people describe recovery as a series of small wins: standing up easier, walking farther,
needing fewer naps, eating more normally. The most common frustration is fatiguepatients often feel mentally ready to “be done”
while the body is still clearly in repair mode. A practical tip patients mention again and again is to treat walking like a daily
prescription: short, frequent, and consistent. Another common lesson: accept help. Colectomy recovery is not the time to prove you
can carry groceries like a competitive sport.

Long-term perspective: Looking back, many patients say the hardest part wasn’t the incision or the hospitalit was
the uncertainty beforehand and the patience required afterward. Over time, people often report that the surgery gave them back
something valuable: fewer symptoms, less fear of emergencies, and more confidence making plans. Not every journey is smooth, and
complications can happen, but a lot of patients describe colectomy as a “reset button” that made life bigger again.

Conclusion

A colectomy is surgery to remove part or all of the colon, often done to treat conditions like colon cancer, diverticulitis, or
inflammatory bowel disease. The specific type and approach depend on the disease and your overall health. While it’s major
surgery, modern techniques and recovery pathways help many patients heal safely and return to full livessometimes with a new
routine, sometimes with a new digestive “operating system,” and often with a lot more peace of mind.