An ileostomy is an artificial opening that is created in the bowel for stool to pass through. The ileum is the lower of the small bowel, which connects to the large bowel. Treatment for some bowel diseases requires removal of part or all of the bowel. If this is done, a new way for stool to leave the body must be created.
In most cases, the artificial opening in the ileum is connected to the abdominal wall. The stool can then drain through an opening through the skin. The opening of the skin in the abdominal wall is called a stoma. An ileostomy may be temporary or permanent.
Who is a candidate for the procedure?
Following are some examples of conditions that may require an ileostomy:
conditions that cause severe bowel inflammation, such as Crohn's disease
How is the procedure performed?
A liquid diet will be used for several days before surgery. Bowel cleansers will be given before surgery. Antibiotics may be given to kill bacteria in the bowel. Bowel preparation can decrease the risk of infection, but it may not be possible in emergency cases.
The abdomen is marked for placement of the stoma before surgery. When possible, the stoma is placed in the most convenient place for the person. Usually, the stoma is placed in the lower right part of the abdomen.
An ileostomy is usually done using general anesthesia. The surgeon removes or interrupts the diseased bowel. In a traditional procedure, a part of the ileum is then brought out through the skin. The bowel opening is attached to the skin of the abdomen with sutures. A plastic bag with an adhesive facing is placed over the stoma and firmly pressed onto the skin. Someone who has a traditional ileostomy has continuous drainage of bowel contents into the bag.
Alternatively, the surgeon may perform a continent ileostomy. A special pouch is created and attaches to the abdominal wall. There is no external bag with this type of ileostomy. The bowel contents do not drain constantly. The person inserts a narrow tube into the pouch several times a day to drain the bowel contents.