Proctocolectomy vs. Total Colectomy vs. Subtotal Colectomy: Key Things to Know

This blog will share insights into the types of surgeries like proctocolectomy, total colectomy, and subtotal colectomy, and how they impact diet and lifestyle.

Before I became a dietitian, my mom underwent an intestinal resection, having one foot of her distal ileum and one foot of her proximal colon removed due to three perforations. The temporary ileostomy she needed was ultimately reversed, a journey that brought our family close to the realities patients face during such challenging times. This blog will share insights into the types of surgeries like proctocolectomy, total colectomy, and subtotal colectomy, and how they impact diet and lifestyle.

Graphic courtesy of Renata Cauchon-Robles

Proctocolectomy: Total Care for a Total Change

A total proctocolectomy involves the removal of the rectum and entire colon, which may be necessary for conditions such as ulcerative colitis. This procedure often results in a proctocolectomy with ileostomy, which requires a careful approach to diet to help reduce symptoms such as diarrhea, odor, and gas; help you avoid a blockage; and help your body get more nutrients from your food as you heal from surgery.

Understanding what a proctocolectomy entails is crucial, as it’s more than just a surgery—it’s a change that affects every aspect of your life, including your diet and digestion. I help patients navigate these changes, offering strategies to manage symptoms and to ensure a balanced diet post-surgery.

Total Colectomy: Managing Health Beyond Surgery

A total colectomy, or total abdominal colectomy, requires the removal of the entire colon, leaving the rectum intact. Post-surgery, you might have a total colectomy with ileostomy, and it’s vital to understand that life expectancy after a total colectomy can remain normal with the right lifestyle changes.

My expertise comes into play in managing your diet after surgery, ensuring that you receive the right balance of nutrients and hydration to compensate for the loss of your colon’s natural functions.

Subtotal Colectomy: Tailored Nutrition for Recovery

Subtotal colectomy involves removing part of the colon. This surgery can be a little less daunting when it comes to dietary adjustments long-term, but it still requires careful planning post-surgery. As a dietitian, I focus on tailoring your post-operative diet to meet your specific needs to help you heal faster.

Your Dietary Guide Through Recovery

Whether you’re facing a proctocolectomy, total colectomy, or subtotal colectomy, each surgery comes with its own set of challenges and dietary needs. As your IBD dietitian, I provide personalized care, ensuring you understand your surgery, manage your diet, and maintain your quality of life throughout your recovery.

We will work together to create a nutrition plan that supports healing, considers the new dynamics of your digestive system, and incorporates all the necessary nutrients to keep you healthy. From managing the small intestines’ increased workload to preventing complications like bowel obstruction, my goal is to be your trusted partner in health.

Take Home Message: You’re Not Alone on This Journey

Surgery can be a daunting prospect, and its impact on daily life is significant. I’ve seen firsthand through my mom’s experience with her temporary ileostomy and her path to recovery. It’s these personal insights, combined with my professional expertise, that I bring to each patient I work with. You’re not alone on this journey. As your IBD dietitian, I’m here to support you in understanding these changes and in finding a diet that’s right for you. Together, we’ll create a plan that keeps you nourished, healthy, and ready to enjoy life to its fullest.


  1. Cleveland Clinic. Proctocolectomy. Available at: Accessed December 21, 2023.
  2. United Ostomy Associations of America. Ileostomy. Available at: Accessed December 21, 2023.
  3. Mount Sinai. Total Abdominal Colectomy. Available at: Accessed December 21, 2023.
  4. United Ostomy Associations of America. What is an Ostomy? Available at: Accessed December 21, 2023.
  5. Yale Medicine. Subtotal Colectomy. Available at: Accessed December 21, 2023.


About the Author

Picture of Danielle Gaffen, MS, RDN, LD

Danielle Gaffen, MS, RDN, LD

Understanding the link between nutrition and gut disease prompted me to obtain my master’s degree in Nutritional Sciences at San Diego State University and become an IBD Registered Dietitian Nutritionist. Now I work with people who have Crohn’s and colitis who are struggling with confusion around what to eat. My favorite part is helping them to build confidence to eat without fear while managing their symptoms.

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