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'll 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 2 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.
You may need to stay in hospital for up to 2 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.
But with practise and support from a nurse with training in stoma care, many people adjust and often find their quality of life improves after surgery.
This is especially true if they have been living with a condition like Crohn's disease for years.
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 a change in the size of the stoma making it difficult to attach the external bag