OBJECTIVES: To investigate the factors that potentially influence the UC patients’ anxiety and depression after having a colectomy utilizing patient survey tools. METHODS: A cross-sectional survey was administered online or via paper to patients ≥ 18 years of age with UC who had a colectomy surgery within the last 10 years in Canada, Australia, and the UK. Anxiety and depression was measured using the Hospital Anxiety and Depression Scale (HADS); scores > 8 on the respective anxiety and depression scales indicate the presence of the condition.  Other scales used included the Inflammatory Bowel Disease Questionnaire (IBDQ), 5-item EuroQol (EQ-5D) questionnaire, Body Image Questionnaire (BIQ), Medical Outcomes Study Sexual Functioning Scale (MOS-SFS), dietary restriction questions, and World Health Organization Health and Work Performance Questionnaire-Absenteeism and Presenteeism Questions (WHO-HPQ-AP). Logistic regression was used to investigate factors associated with anxiety. RESULTS: A total of 424 patients participated from Canada, UK, and Australia.  Gender was equally distributed with a mean age of 42 ± 13 years.  Respondents were diagnosed with UC with a mean of 11.8 ± 8.5 years ago and first surgery occurred a mean of 4.2 ± 2.5 years ago. Based on the HADS, 31% and 16% of patients had clinically meaningful anxiety and depression, respectively.  Depression was significantly associated with  poorer totaI IBDQ scores (p<0.0001) and higher BIQ scores (p<0.0001). Females are 2.15 times more likely to have anxiety than males (OR 2.15, 95% CI 1.19-3.88).  Other factors associated with anxiety include loss of work productivity (OR 1.39, 95% CI 1.18-1.64) and  poorer body image (OR 1.12, 95% CI 1.04-1.20). CONCLUSIONS: The findings from this multi-national study provide insight on important factors to inform patient-physician communications both prior to and post-colectomy.