Ileostomy: An Overview

An ileostomy is a surgical procedure to treat the bowel after the lower part of the digestive tract is deceased or damaged. This surgical procedure results in the creation of an opening in the abdomen to allow waste materials to leave the body prematurely.

During the procedure, a hole is created in the abdomen. The end of the small intestine is then passed through that hope to create a stoma. Due to the rest of the bowel ahead of the ileum or small intestine bypassed, waste materials leave the body through the stoma instead of the anus. Those waste materials fall into an ostomy pouch fitted over the abdomen in a way that the stoma opens into that pouch.

You may need an ileostomy if all or a significant part of your colon is removed or bypassed. Diseases that might put you in an emergency to receive an ileostomy mainly include ulcerative colitis and Crohn’s disease.

Surgeries that usually require an ileostomy

• Colectomy, also known as colon resection
• Small bowel obstruction
• Total proctocolectomy with ileostomy

An ileostomy can be short or long term.

Having a short term ileostomy means that you may retain your rectum and anus after getting your colon removed. This ostomy will allow your rectum to recover until your surgeon decides to connect it to the digestive tract.

A long-term ileostomy is when the rectum and anus are removed. This ileostomy is usually permanent because there are not rectum and anus to allow the patient to get the normal bowel functions back.

The creation of an ileostomy involves an incision in the abdominal wall. The surgeon then disconnects the small intestine from the colon and pulls the end of the ileum through that incision in the belly. It means that a stoma is essentially a part of the intestine sticking out on the belly.

In some cases, the surgeon may want to create an internal reservoir, which sits over the anal canal. It is called a J-pouch, or ileoanal reservoir.

Before ostomy surgery

Ostomy surgery is stressful, just like other surgeries. You may have a lot of concerns in your mind before surgery. Therefore, understanding how to prepare for it and how to deal with the post-surgery situation is necessary.

First, you have to tell your doctor about the medicines and supplements that you currently take. Some of those may prove counterproductive before or after surgery. For instance, you may need to avoid taking blood thinners. Your doctor will provide complete instructions regarding which medicines to take and which to stop.

Ileostomy surgery aftercare

You will need to have bed rest for a few days after surgery. During this time, the doctor and surgeon will instruct you to avoid any physical exertion. They will, however, encourage you to walk around in the hospital to activate your bowels. A nurse will tell you how to take care of your stoma and use an ostomy pouching system.

You will need to be careful during the first six weeks after surgery. Six weeks is the minimum time your bowels will take to recover from the impact of surgery. You may have to stay away from any strenuous activities, including gym workouts, jogging, or aerobic exercises, during this time.

You will have to remain in touch with your doctor and ostomy care nurse to get direction about your physical movements and diet.

Different Types Of Colectomy Surgery

If we explain it in simple words, a colectomy is the surgical removal of the entire or a part of the colon. People suffering from inflammatory bowel disease (IBD) are usually the candidates of colectomy. This surgery aims at treating many other intestinal conditions. The spread of disease and location of the problem is the factors that determine the extent of the colon to be removed.

It is worth mentioning that not every surgery aimed at treating IBD will fall into the category of colectomy. You will have to speak to your doctor and surgical team before undergoing the surgical treatment to remove all or a part of your colon. In this article, we will discuss different types of colectomy surgery to help you understand why you may need to undergo this procedure.

Proctocolectomy

This surgical method involves the removal of the colon along with the rectum. The rectum is more like a reservoir that holds stool before it is excreted out of the body through the anus. With the rectum removed, you will need a new way to get rid of your intestinal wastes. That’s where an ileostomy comes in. This intestinal diversion results at the end of the small bowel pulled out through a cut in the belly to allow fecal wastes to leave the body.

J-Pouch surgery

This surgery can be done during proctocolectomy or after a few months of it. J-pouch refers to an internal pouch, which is also known as an ileal pouch-anal anastomosis (IPAA). During this surgery, the surgeon folds the end of the small bowel into itself to form the shape of a “J” that acts like a rectum. A cut at the bottom of this pouch connects it with the anus, allowing the patient to expel bodily wastes through the anus.

Ileoanal Anastomosis

This procedure also allows the patient to expel bodily wastes through the anus. During this surgery, the surgeon connects the small intestine to the anus after removing the colon and rectum. Initially, you may have to live with an ileostomy for a few weeks or months to allow your small bowel to recover well enough to ensure Ileoanal Anastomosis.

Total colectomy

During a total colectomy, the surgeon removes your entire colon. Some people confuse it with proctocolectomy. However, the difference here is that a patient retains all or a part of the rectum after a total colectomy. Generally, you will need an ileostomy after this surgery. Your surgeon may choose to give you an ileorectal anastomosis, which can eliminate the need for an ostomy. Depending on your condition, the ileostomy you get may be permanent or temporary.

Partial colectomy

The surgical procedure aimed at removing a part of your colon is known as a partial colectomy. People who have Crohn’s disease, colon cancer, or diverticulitis are the candidates for this treatment. This procedure results in the removal of the diseased part of the colon and the connection of two healthy ends. It can also result in the creation of a colostomy, which is a bowel diversion that brings the end of the colon out through the belly.

You can discuss all these types of colectomy with your doctor.

An Overview Of A Stoma

Before an ostomy surgery, you may have a lot of questions regarding what a stoma is and how to manage it properly. In this article, we will discuss the types of stomas and how to take care of them properly.

What is a stoma?

In a literal sense, a stoma is an opening that your doctor creates on your abdomen to reroute the passage of wastes away from their natural pathway. This alternative pathway essentially bypasses a diseased segment of the excretory tract. A stoma either connects ureters or intestines to the outside of the body.

Looks and feel of the stoma

A stoma is generally quite swollen right after surgery. Its size, however, reduces gradually over time. It takes about six weeks for the stoma to settle down to a permanent shape and size.

The color of the stoma may range from pink to red. This color is due to the mucous membrane, which is also present at the inside of the mouth. Due to the absence of any nerve endings, a stoma doesn’t have any sensation, which means that it is not painful to touch. There can be a little bleeding when you clean the stoma, especially in the first few weeks after surgery, but it is not something to worry about. The bleeding should stop in a minute or two.

Understanding the digestive and urinary system

The digestive system

When you eat, your food travels down to the stomach through a food pipe. The stomach churns the food into pieces, and digestive juices there turn solid bits into the liquid.

The food then travels to the small intestine where absorption of nutrients takes place. These nutrients are supplies to the other organs.

The leftover waste materials move to the large intestine where absorption of moisture and electrolytes takes place. The large intestine turns liquid waste into a solid material, which is then expelled out through the anus.

The urinary system

The urinary system consists of kidneys, ureters, bladder, and urethra. Kidneys filter blood to extract urine, which is transported to the bladder through two small tubes called ureters. When the bladder fills with urine, you feel the need to urinate. The bladder squeezes to push urine to the urethra, from where it leaves the body.

Impact of a stoma on daily life

You will need some time to recover from the impact of stoma surgery. It generally takes six weeks for your bowel to adapt to its shortened length. Until you achieve that recovery, you are going to need to follow some restrictions to ensure proper prevention of complications.

The first thing that you are going to have to learn is the use of an ostomy pouch. An ostomy pouch fits over the stoma to collect waste materials. When this bag is full, you will need to empty or discard it, depending on the type of ostomy appliance you are using.

The skin of the stoma holds a key value in an ostomy care regimen. The optimum health of the peristomal skin allows the ostomy appliance to adhere to the body properly. You do not want this part of the skin to develop an irritation or any other complications.

You will need to follow a few food restrictions during the six-week period after surgery. These restrictions will help you avoid any complications related to digestion. In case you have a urostomy, you will not have to follow many food restrictions.

You may want to remain in touch with your ostomy care nurse or doctor to find answers to any questions that you may have in your mind.