Ileostomy
An ileostomy is a surgical procedure that changes the way poop exits your body. It disconnects the end of your small intestine (ileum) and connects it to a new opening (stoma) in your abdomen. Your poop will now exit this stoma and collect into an ileostomy bag. Ileostomy treats serious conditions affecting your bowels, both temporary and permanent.
An ileostomy is a surgical operation that changes the way poop exits your body. Surgeons do this procedure when your colon (large intestine) can’t be used to store and move your digestive waste.
During an ileostomy, a surgeon creates an opening in your abdominal wall, called a stoma. They attach the end of your small intestine (ileum) to this new opening. Digestive waste will now exit your small intestine through your stoma, bypassing your large intestine. The waste collects into a pouch or bag.
Depending on why you need it, an ileostomy can be temporary or permanent. If the condition that’s affecting your large intestine later improves, you can discuss an ileostomy reversal with your surgeon.
There are two main types of ileostomy: loop and end.
- Loop ileostomy: This is usually temporary. Your surgeon brings a loop of your small intestine (ileum) through your belly and opens one side to create the stoma.
- End ileostomy: This is often permanent. The surgeon disconnects your small intestine from your large intestine and brings the end of the ileum to the surface to form the stoma.
A loop ileostomy keeps the connection between your small and large intestines in case you can use it again later. An end ileostomy removes that connection but saves the full length of your small intestine.
You might need an ileostomy if you have a condition in your colon or the end of your ileum that makes it currently or permanently unusable. Often, an ileostomy is part of a larger surgery to treat a condition.
Some of these conditions include:
- Bowel obstruction.
- Bowel perforation.
- Colorectal cancer.
- Diverticulitis.
- Hereditary polyposis syndromes, like FAP and JPS.
- Inflammatory bowel diseases, like ulcerative colitis and Crohn’s.
Your bowel might only need a temporary rest to heal from a disease or surgery to treat a disease. On the other hand, if you need to have part of your colon removed, you might need a permanent ileostomy.
If you need to stop using your bowel temporarily, a loop ileostomy is the only way. If you’re having your colon permanently removed, you have two alternatives: an end ileostomy or an internal ileal pouch.
While an ileostomy requires you to wear an ileostomy bag on the outside of your body to collect waste, an ileal pouch collects waste inside your body. However, it’s only an option in select cases.
You’ll need to clean out your bowels before your ileostomy. Your healthcare provider will tell you how to do this. They might prescribe an enema or a laxative formula (bowel prep) to take before your procedure. You’ll usually have a restricted eating plan for a few days before cleaning out your bowels.
You’ll be under general anesthesia for your ileostomy. Your surgeon will create an opening in your abdomen and locate your ileum. Using either the end or loop technique, your surgeon will pull your ileum up to the opening and stitch the two together. They’ll attach an ileostomy bag to the opening.
You may have open surgery (laparotomy) or minimally invasive surgery (laparoscopic surgery). Your surgeon will tell you what to expect in advance. With open surgery, they’ll make one long incision in your abdomen. With minimally invasive surgery, they’ll make several, very small incisions.
After an ileostomy surgery, you’ll spend several days recovering in the hospital. As you recover, you’ll consult with a specialized ostomy nurse (wound ostomy continence nurse, or WOCN). Your nurse will coach you on how to live with an ostomy, including caring for your stoma and using your ileostomy bag.
An ileostomy gives you another way to poop when the normal way isn’t working. This can give your bowel a chance to recover and become functional again. In other cases, an ileostomy allows you to have your diseased colon removed. This can improve your quality of life and, in some cases, save your life.
Risks of the procedure include:
- Bleeding.
- Infection.
- Abnormal scarring, which may cause a blockage
- Not being able to absorb enough nutrients from food.
An ileostomy is a major surgery and requires some downtime. On average, it takes about six to eight weeks to recover. You may also be recovering from another surgery or disease in your bowels.
You’ll be on a limited diet (soft diet) after surgery. Your provider will tell you when and how to start reintroducing food. See how it goes. Some people may need to adjust their eating plans permanently.
An ileostomy will change the way you poop. It won’t come out of your rear end (anus) anymore. Instead, it will come out of your stoma and collect in your ileostomy bag. You won’t control when this happens.
Having an ileostomy won’t affect the way you pee. It only affects your bowels.
If you had a temporary loop ileostomy, your healthcare provider will consider whether it’s safe to do an ostomy reversal after you’ve healed. This may take three to 12 months, depending on your condition.
An ileostomy has no impact on your lifespan. While all surgeries have risks, an ileostomy treats much more dangerous conditions. It’s likely to make your quality of life better and may be lifesaving.
You should call your healthcare provider if you have:
- An unpleasant odor coming from your stoma.
- Injury, bleeding or irritation around your stoma.
- Ongoing cramps, nausea or vomiting.
- More than six hours without poop coming out.
References
- American Cancer Society. What is an Ileostomy? (https://www.cancer.org/cancer/managing-cancer/treatment-types/surgery/ostomies/ileostomy/what-is-ileostomy.html) Last revised 10/16/2019. Accessed 4/15/2024.
- American Society of Clinical Oncology. Ileostomy (https://www.cancer.net/navigating-cancer-care/how-cancer-treated/surgery/types-ostomy/ileostomy). Approved 09/2022. Accessed 4/15/2024.
- National Health Services (UK). Ileostomy (https://www.nhs.uk/conditions/ileostomy/). Accessed 4/15/2024.
- National Library of Medicine (U.S.). Ileostomy (https://medlineplus.gov/ency/article/007378.htm). Review date 8/22/2022. Accessed 4/15/2024.
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