This topic is about preparing for and recovering from a proctocolectomy, often referred to as "Barbie-butt" surgery. This procedure involves removing the remaining diseased segment of the large bowel, excising the anus, and closing the rectal opening, while leaving an existing colostomy in place. The person undergoing this surgery has lived with Crohn’s disease for 16 years and has had a colostomy since 2008. They are seeking advice and support for their upcoming surgery and recovery.

Here are some helpful insights and advice shared by others who have experienced similar surgeries:

1. Pain and Sensation after "Barbie-butt" Closure
- Most people report little to no rectal pain, with the abdominal incision being more painful.
- A temporary swelling or "wadding" sensation may be felt for 1–2 months.
- Phantom sensations, like the urge to defecate, are common but usually subside quickly.
- Some may experience residual cramps, but overall pain relief is significant compared to pre-surgery.

2. Sitting and Cushions
- A regular pillow is usually sufficient; donut rings might strain sutures and should be used only if comfortable.
- If drainage tubes are present, sitting slightly angled or using extra padding can help avoid pressure.

3. Mobility and Daily Life
- Limit bending and hip movement until healing is confirmed by a surgeon.
- Walking feels normal, and there is no visible difference, similar to a "Barbie" appearance.
- Increased hair growth around the closed area may occur due to less friction.

4. Post-surgical Discharge
- Expect drainage from the stitched anal site for several weeks. Keep sterile gauze on hand for frequent changes to maintain dry skin.

5. Dietary Guidance after Ileostomy
- Begin with low-residue foods and avoid raw fruits and vegetables until the output pattern stabilizes.
- Reintroduce new cooked foods one at a time, in small amounts, and chew thoroughly to prevent blockages.
- Consult an Enterostomal Therapy (ET) or Wound-Ostomy-Continence (WOC) nurse for personalized dietary and appliance advice.

6. Appliance Management
- Ileostomy output is typically higher and more liquid than colostomy output, so be prepared for more frequent pouch changes and have extra supplies ready.

7. Emotional Support
- Many people offer encouragement and prayers, emphasizing that life often improves significantly once healing is complete.