Perhaps this is a stupid question but..

Since they're just beginning to realize the importance of gut flora as an organ in itself and as an integral part of the immune system, what happens post colectomy? Is immunity weakened at all and are there any studies on the impact of removing the flora on general health long term. I'm guessing not but since there's so much in the news about the centrality of the gut to everything I'm curious if anyone has any thoughts?

Can't speak to perm ileos but a j-pouch actually becomes colonized with some bacteria that are more typically large intestine. I think because it's functioning like a rectum (holding output for longer periods of time) it has an environment that is hospitable to similar bacteria to what would be found in the colon. I'm sure it's not the same but at least it's something.

Meredith, that's interesting. I've heard of both scenarios, peoples extra intestinal stuff clearing up after surgery, and people whose immune system has lost it's favorite punching bag and then goes heywire and starts attacking other things. Scary.
Liz, that's interesting. I didn't know that about a jpouch. It would make an interesting study, comparing the gut flora of some long time jpouchers and some coloned people to see what the similarities and differences were. It might go some way toward telling if the flora can be replicated (? regrown? what's the word, mental blank)?
Gary, yeah, i know they thought the spleen was pretty useless, gallbladder not important, appendix is now more than just a little bit hanging off of the colon etc. It's one issue if you have no choice but go for surgery (many people here) but since we are not far from "elective surgery" (meaning we have no other options but are not at death's door quite yet) it's important to think this through. Of course, can't ask the MDs.