The Ileostomy is a medical procedure in which the lower end of the small intestine is diverted to an artificial opening in the abdominal wall so that it can expel out its contents to the exterior.
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 specific bag is placed over the stoma to collect waste products that generally passes through the colon (large intestine) and out of the body through the rectum and back passage (anus).
When is an ileostomy needed?
Ileostomies are formed to either temporarily or permanently stop the 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– 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, the patient will normally see a specialist stoma nurse to discuss exactly where he would like his stoma to be (usually somewhere on the right-hand side of the abdomen) and have a talk about living with a stoma.
There are two main types of Ileostomy:
- loop ileostomy – in this, a loop of small intestine is pulled out through a cut (incision) in the patient’s abdomen, before being opened up and stitched to the skin to form a stoma
- end ileostomy – in this, 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 the patient’s anus (ileoanal pouch). This means there's no stoma and stools are passed out of the patient’s back passage in a similar way to normal.
End Ileostomies and Ileoanal pouches are usually permanent. Loop Ileostomies are generally intended to be temporary and can be reversed at the time of an operation at a later date.
What to expect after Ileostomy?
The patient may need to stay in the hospital for up to two weeks after an Ileostomy operation. During this time the patient will be taught how to look after his stoma by a specialist stoma nurse.
Recovering from Ileostomy can be challenging. Most of the people experience short-term physical and psychological problems, ranging from skin irritation around the stoma to feelings of anxiety and self-consciousness.
However, with practice 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 related to Ileostomy
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
Which are the different tests that should be performed before Ileostomy?
Some of the tests which should be performed before Ileostomy are:
- Blood Test
- Urine Test
- Chest X-ray