An ileostomy is a surgical procedure in which an opening is made in the abdominal wall and a small part of the ileum is removed. Ileum is the lower part of the small intestine. This surgery is performed when the instestine does not function properly. Ileostomy can be temporary or permanent. In temporary ileostomy, the colon is removed partially or completely leaving behind only part of the rectum. In permanent ileostomy, the surgeon removes the rectum, colon and anus. In permanent ileostomy the patients has to wear a punch externally to collect all the waste materials from the body.
Reasons for an ileostomy
Inflammatory bowel disease is the common cause for ileostomy. There are two types of bowel inflammatory disease named as Crohn’s disease and ulcerative colitis. These conditions can cause pain and presence of blood in the stool.
Crohn’s disease affects the ileum that’s the end part of the small intestine and also the large intestine and digestive tract. Ulcerative colitis is caused by the inflammation of the inner lining of the intestine causing pain and ulcer in the colon and rectum that leads to painful ulcers in the colon and rectum.
Other reasons that require an ileostomy include:
- rectal or colon cancer
- formation of polyps in the rectum
- intestinal birth defects
- injuries or accidents that involve the intestines
- Hirschprung’s disease
The surgery begins with a general anesthesia. An incision is made in the abdomen and removes the rectum and colon and then stitched and closed.
Types of ileostomies
Conventional ileostomy: In conventional ileostomy also known as Brooke ileostomy, a small incision is made in the abdomen. A small loop of the ileum is pulled out and a rod is placed in the loop. Then a cut is made in the loop and one side of the loop is stitched to the abdomen. This part is turned in such a way the inside of the intestine is facing outward and forms a stoma. Stoma is soft and pink and projects outward. The feces get collected in the bag attached to the stoma.
Continent ileostomy: Also known as Kock ileostomy eliminates the need for external pouch. In this surgery the surgeon makes an internal pouch of the small intestine with an stoma that acts as a valve and get attached to the intestinal wall. An external tube is inserted though the stoma to the pouch to collect the waste discharged. As there is no need for external pouch this method of ileostomy is now widely used method of treatment.
After ileostomy patients have to stay in the hospital for almost one week. Diet will be limited with only ice chips one the first day followed by liquids on second day. Solid foods are provided only when the bowels get used to the new system in the body. Patients are provided training on how to use the external pouch and how to maintain hygiene in the stoma and area around it. Care should be taken not to develop any infection from unhygienic methods.