An ileostomy is where the
small bowel (small intestine) is diverted through an opening in the tummy
(abdomen). The opening is known as a stoma. A special bag is placed over
the stoma to collect waste products that usually pass through the colon
(large intestine) and out of the body through the rectum and back passage
(anus).
Ileostomy
procedures are relatively common in the UK. More than 9,000 are carried out
each year in England.
When is an ileostomy needed?
Ileostomies
are formed to either temporarily or permanently stop digestive waste passing
through the full length of the small intestine or colon. There are
a number of reasons why this may be necessary, including:
- to allow the small intestine or colon to heal after it's been operated on – for example, if a section of bowel has been removed to treat bowel cancer
- to relieve inflammation of the colon in people with Crohn's disease or ulcerative colitis
- to allow for complex surgery to be carried out on the anus or rectum.
The ileostomy procedure
Before an
ileostomy is formed, you will normally see a specialist stoma nurse to discuss
exactly where you'd like your stoma to be (usually somewhere on the right-hand
side of the abdomen) and to talk about living with a stoma.
There are
two main types of ileostomy:
- loop ileostomy – where a loop of small intestine is pulled out through a cut (incision) in your abdomen, before being opened up and stitched to the skin to form a stoma
- end ileostomy – where the ileum is separated from the colon and is brought out through the abdomen to form a stoma.
Alternatively,
it's sometimes possible for an internal pouch to be created that's connected to
your anus (ileo-anal pouch). This means there's no stoma and stools are passed
out of your back passage in a similar way to normal.
End
ileostomies and ileo-anal pouches are usually permanent. Loop ileostomies are
usually intended to be temporary and can be reversed during an
operation at a later date.
After surgery
You may need to stay in hospital for up to two weeks after an ileostomy
operation. During this time you'll be taught how to look after your stoma
by a specialist stoma nurse.
Recovering from the procedure can be challenging. Many people
experience short-term physical and psychological problems, ranging from skin
irritation around the stoma to feelings of anxiety and self-consciousness.
However, with practise and support from a designated stoma nurse, many
people adjust and often find their quality of life improves after surgery. This
is especially true if they've been living for years with a condition such as
Crohn's disease.
Complications
As with any surgical procedure, having an ileostomy carries a risk of
complications. Some of the problems people with an ileostomy experience
include:
- a bowel obstruction – where the output of digestive waste is blocked
- vitamin B12 deficiency – caused by the removal of part of the intestine that absorbs vitamin B12
- stoma problems – such as widening or narrowing of the stoma, making it difficult to attach the external bag.
