This topic is about preparing for a completion colectomy after having a subtotal colectomy. The person involved had a subtotal colectomy about a year ago and now needs surgery to remove the remaining part of their colon. They are currently managing well with their ileostomy but are facing significant issues with the remaining bowel. They are curious about whether the upcoming surgery will be more challenging, easier, or similar to their previous operation. They are also seeking practical advice.

Here are some helpful insights and advice:

1. The person is unable to retain mesalamine suppositories due to pain, which is affecting daily activities like painting.

2. They have read about the possibility of needing a permanent closed-anus procedure, often referred to as a "Barbie Butt," and hope to avoid this outcome.

3. They are eager to improve their quality of life as soon as possible.

4. Joining an active ostomy support community, such as the one at www.inspire.com, can provide valuable guidance and shared experiences from others who have been through similar situations.

5. Surgical experiences can vary greatly. Only the colorectal surgeon can provide specific predictions about whether the existing ileostomy will remain and if a "Barbie Butt" closure is necessary.

6. If the person is less acutely ill this time, the recovery might feel easier, although the surgery could take longer since the entire remaining colon needs to be removed.

7. Before surgery, it is advisable to eat very lightly, focusing on liquids or easily digested foods.

8. After surgery, reintroduce solid foods gradually. Moving too quickly can cause severe bloating and might require gastric decompression, such as stomach pumping.

9. Protect the abdominal incision by avoiding heavy activities, as an opened wound can take months to heal.

10. Allow yourself several weeks of rest to ensure optimal healing.

11. Mesalamine suppositories, a 5-ASA product, can help some patients manage residual ulcerative colitis symptoms while waiting for surgery, but they may become difficult to retain as the disease worsens.