An ileostomy is a surgically made opening that connects your ileum to your abdominal wall. The ileum is the lower end of your small intestine. Through the abdominal wall opening, or stoma, the lower intestine is stitched into place. You may be given a pouch that you’ll wear externally. This pouch will collect all of your digested food.
This procedure is done if your rectum or colon can’t properly function.
If your ileostomy is temporary, your intestinal tract will be reattached inside your body once healing occurs.
For a permanent ileostomy, your surgeon removes or bypasses your rectum, colon, and anus. In this case, you’ll have a pouch that permanently collects your waste products. It may be internal or external.
Reasons for having an Ileostomy
If you have a large intestine problem that can’t be treated with medications, you might need an ileostomy. One of the most common reasons for an ileostomy is inflammatory bowel disease (IBD). The two types of inflammatory bowel disease are Crohn’s disease and ulcerative colitis.
Crohn’s disease can involve any part of the digestive tract, from the mouth to the anus, causing inflammation of the lining with sores and scarring.
Ulcerative colitis also has inflammation, sores, and scarring but involves the large intestine and rectum.
People with IBD will often find blood and mucus in their stool, and experience weight loss, poor nutrition, and abdominal pain.
Other problems that might require an ileostomy include:
- rectal or colon cancer
- an inherited condition called familial polyposis, in which polyps form in the colon that can lead to cancer
- intestinal birth defects
- injuries or accidents that involve the intestines
- Hirschsprung’s disease
Procedure of Ileostomy
An ileostomy is done in a hospital under general anesthesia.
After you’re unconscious, your surgeon will either make a cut down your midline or perform a laparoscopic procedure using smaller cuts and lighted instruments. You will know prior to the surgery which method is recommended for your condition. Depending on your condition, your surgeon may need to remove your rectum and colon.
There are several different types of permanent ileostomies.
For a standard ileostomy, the surgeon makes a small incision that will be the site of your ileostomy. They’ll pull a loop of your ileum through the incision. This part of your intestine is turned inside out, exposing the inner surface. It’s soft and pink, like the inside of a cheek. The part that sticks out is called a stoma. It may protrude up to 2 inches.
People with this type of ileostomy, also called a Brooke ileostomy, won’t have control of when their fecal waste flows into the external plastic pouch.
Another type of ileostomy is the continent, or Kock, ileostomy. Your surgeon uses part of your small intestine to form an internal pouch with an external stoma that serves as a valve. These are stitched to your abdominal wall. A few times per day you insert a flexible tube through the stoma and into the pouch. You expel your waste through this tube.
The advantages of the Kock ileostomy are that there’s no external pouch and you can control when you empty your waste. This procedure is known as a K-pouch procedure. It’s often the preferred method of ileostomy because it eliminates the need for an external pouch.
A different procedure, known as the J-pouch procedure, may be performed if you’ve had your entire colon and rectum removed. In this procedure, the doctor creates an internal pouch from the ileum that is then connected to the anal canal, allowing you to expel your waste through the usual route with no need for a stoma.