Preparation, Aftercare, and Expectations: A Guide to Ileostomy Procedure
An ileostomy is a surgical procedure that provides a new opening in the abdominal wall, allowing the end of the small intestine (ileum) to release stool. This procedure is often recommended by doctors to manage various serious intestinal conditions, such as cancer, trauma, inflammatory bowel disease, bowel obstruction, intestinal infection/perforation, and severe diverticulitis.
The most common reasons for an ileostomy include gastrointestinal malignancies, abdominal trauma, inflammatory bowel diseases, bowel obstruction, intestinal infection/perforation, and severe diverticulitis. Approximately 25% of ileostomies are performed due to cancers affecting the intestines, including colorectal cancer, to remove or bypass diseased sections.
Injuries to the intestines often necessitate an ileostomy to manage bowel contents safely while healing takes place. Conditions such as Crohn's disease and ulcerative colitis that severely damage the intestines may also require an ileostomy to control symptoms or after surgical removal of affected bowel segments.
Severe obstructions that cannot be relieved may require diverting the intestinal contents via an ileostomy. Serious infections or perforations that compromise intestinal integrity are indications for ileostomy to protect the patient and allow healing. Inflammatory conditions resulting in damage or risk to the colon or small intestine can lead to ileostomy formation.
Following surgery, the skin around the stoma may be itchy, red, or uncomfortable. Recovery typically involves a hospital stay for several days, pain medication, dietary instructions, and checks for postoperative complications. A person should seek immediate medical attention if they notice sudden, significant changes in the stoma's color or shape, excessive bleeding, prolonged stool output, severe diarrhea, vomiting, or other signs of complications.
A person with an ileostomy must wear a pouch or another device to collect stool at all times. There are two types of pouch systems: a two-piece system and a one-piece system. In a two-piece system, a sticky ring fits around the stoma, and a separate pouch connects to the ring. In a one-piece system, a sticky back adheres around the stoma, with the pouch integrated into the same piece.
Nutrition is an important consideration after surgery, and a low-fiber diet is usually recommended initially to give the bowel time to heal. Adjusting to an ileostomy can be difficult, and support groups exist for people with ostomies to discuss diet-related challenges and seek assistance.
An ileostomy may be temporary or permanent, depending on the severity of the disease or damage affecting the colon or rectum. A person may need an ileostomy if they have certain conditions like cancer, Crohn's disease, familial adenomatous polyposis (FAP), or ulcerative colitis.
Before an ileostomy surgery, a person will typically meet with a surgeon and an ostomy nurse to discuss pouch options, prepare for life after surgery, and order supplies. The surgeon makes an incision in the ileum and attaches it to an opening in the abdominal wall. Depending on the person's condition, the surgeon may remove the colon or sew it in such a way that it can rest and heal before reattachment.
[1] National Institute of Diabetes and Digestive and Kidney Diseases. (2021). Ileostomy. Retrieved from
- An ileostomy is often recommended to manage various medical-conditions such as cancer, inflammatory bowel diseases, and colon trauma by bypassing or removing affected sections of the intestines, as stated by the American Cancer Society.
- A colonoscopy, while not directly related to an ileostomy, is a diagnostic tool used to examine the entire colon and rectum, which can help diagnose conditions like cancer or inflammatory bowel disease that might necessitate an ileostomy, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
- When considering health-and-wellness and lifestyle factors, it's important to note that people with ileostomies must wear a pouch or device to collect stool, and they may face challenges with diet and adjusting to this new lifestyle, as explained by the Mayo Clinic.
- After an ileostomy, the focus shifts to managing digestive-health and postoperative complications, including maintaining a low-fiber diet to aid healing and seeking immediate medical attention for any abnormal signs or symptoms, as advised by the American Cancer Society.
