An Ileostomy closure is a surgery to close the patient’s temporary ileostomy. The doctor will reattach the patient’s ileum to his colon. The doctor will also close the patient’s stoma.
How to Prepare:
Before Ileostomy Closure:
- Write down the correct date, time, and location of the patient’s surgery.
- Ask the caregiver if the patient needs to stop using aspirin or any other prescribed and over-the-counter medicine before his procedure or surgery.
- Bring medicine bottles or a list of the medicines when the patient sees his caregiver. Tell the caregiver if the patient is allergic to any medicine. Tell the caregiver if the patient uses any herbs, food supplements, or over-the-counter medicine.
- The patient may need an enema (liquid put in your rectum) before his surgery. The enema has a dye in it that shows up on an x-ray. The enema and x-ray check for leaks in the patient’s colon where his past surgery was done. The healthcare provider may also check the patient’s anal sphincter to make sure it is working properly.
The night before the Ileostomy Closure:
- The patient may need to drink a medicine the night before his surgery to help empty the intestines.
- Ask caregivers about directions for eating and drinking.
The day of Ileostomy Closure:
- Ask the caregiver before the patient takes any medicine on the day of his surgery. Caregivers will check that the patient’s medicines will not interact poorly with the medicine he needs for surgery.
- Caregivers may insert an intravenous tube (IV) into the patient’s vein. A vein in the arm is usually chosen. Through the IV tube, he may be given liquids and medicine.
- An anesthesiologist will talk to the patient before his surgery. The patient may need medicine to keep him asleep or numb an area of the body during surgery. Tell caregivers if the patient or anyone in his family has had a problem with anesthesia in the past.
What will happen at the time of Ileostomy Closure?
- The healthcare provider will make an incision around the patient’s stoma. The doctor will bring the ends of the patient’s ileum and colon out of his abdomen. He will connect them with stitches or staples. He may inject salt water to check for leaks.
- The healthcare provider will place the patient’s reattached intestines back into his abdomen through the incision. The doctor will close the opening of the patient’s abdomen with stitches.
- The doctor may place a drain under the patient’s skin to remove extra fluid. He may also leave a part or all of your skin open to heal on its own. Your wound may be covered with a bandage.
After the Ileostomy Closure:
The patient will be taken to a room to rest until he is fully awake. Healthcare providers will monitor the patient closely for any problems. Do not get out of bed until the healthcare provider says it is okay. When the doctor sees that the patient is okay, he will be able to go home or be taken to the hospital room.
Contact the doctor if:
- The patient cannot make it to his surgery.
- The skin around the patient’s stoma is red, warm, and sore.
- The patient has a fever.
- The patient has an itchy skin rash around his stoma.
- The patient has nausea or is vomiting.
- The patient has abdominal pain or swelling.
Seek Care Immediately if
- Bowel contents will not drain through the patient’s stoma.
- The patient has pus draining from his stoma.
- The patient’s abdomen is swollen, hard, or painful, or he is vomiting.
- The patient’s stoma has sunk back into his abdomen.
- The patient’s stoma slips farther out of his abdomen than it should be.
Risks associated with Ileostomy Closure
- The patient may bleed from where his ileum is stitched or stapled. After surgery, bowel contents may leak into your abdomen and cause an infection. The patient may also get an infection or abscess where his stoma was closed. The patient may have narrowing in his intestine that makes it difficult to have a bowel movement. The patient’s intestines may also stop working for a short time after the surgery.
- A fistula (abnormal tissue opening) may form between the patient’s intestines and a nearby organ. He may get a hernia (part of intestine pushes through the weak muscle in the abdomen). The patient may get a blood clot in his leg or arm. This may become life-threatening.
- If the patient does not have his ileostomy closed, he may have an increased risk of infection, dehydration, or intestinal narrowing. The patient’s stoma may come too far out of the abdomen or sink inside the abdomen.