January 20, 2015

What is an Ileostomy

By Jeana Scroggins

An ileostomy is a small procedure where the small intestine is detached from the large intestine. During this, it might remove either the full colon and rectum, or a section of this.  This ca be done as a temporary means, or permanent. 

The small intestine of course, is where you digest food, and it’s where you absorb all of the nutrients in your body. Any food that isn’t absorbed goes into the large intestine as either pee or stool.

An ileostomy is an intestinal stoma, in which the ileum is attached to the abdominal wall in a surgical manner so that the digestive waste is able to exit the body through the opening in which the appliance is then attached to collect the intestinal succus from the body.

What causes this though? Well, ulcerative colitis, bowel obstruction, colon and rectal cancer, congenital bowel defects, a bleeding from the large intestine, injury to your intestinal tract, and various inflammatory diseases are a cause of this.

Now, there are two types of ileostomies that you might get.  There are conventional ones, and continent ones, and we’ll go over both of these.

Conventional is basically taking the terminal area of your small intestine so it stays connected to your stomach, and from there adhering to the abdominal cavity opening. At that point, the undigested intake waste goes through there.  This is called the stoma.  The patient in essence loses their sphincter and controls the evacuation feces through the stoma, rather than through the anus.  This then used a bag to collect this waste, and the surgeon will extract the rest of the ileum along with the colon and rectum.  This was first used to help with advanced ulcerative colitis in 1912.  This can help because it will help with getting better control over that area, without the pain of ulcers. For many with an UC however, this end ileostomy is still preferred to the proctocolectomy, and usually is the more preferred alternative. The proctocolectomy is used with Crohn’s disease.

Usually, you might get this for other colon issues, but the best way to find out if you need it is to talk to your doctor about this.

The continent ileostomy is usually where you have an internal pouch and a value that’s used from the lower part of your ileum, and this then protrudes to the outside cavity, but only mucus comes from it.  Usually, you evacuate this a couple times a day through a tube that’s within the valve.  You can use a band-aid to cover this to contain the mucus.

With these, usually you’ll get a J pouch, which is essentially a type of ileostomy, and usually this is used for those with precancerous or dysplastic colonic mucosal changes to those who might need medical management, such as pain, frequency, and urgency.

With these, you might get them as a temporary means. The temporary one usually happens after a partial colon dissection is done, and from there, once this heals, the specialist will restore that connection. Usually, this is done and after about 6-12 weeks is reversed, but you might need to wait a little bit longer.

Usually, these are more commonly permanent. This is usually if you have UC, bowel obstruction, cancer, congenital conditions, or various trauma.  It does result in complications.

And there you have it, everything you need to know to have a basic understanding of an ileostomy, and why someone might end up getting one of these.