An ileostomy is one of the three main types of ostomies performed in order to bypass problems, disease, or aid in healing the large intestine or colon. Ileostomies are considered lifesaving procedures and are only done as a last resort. While there are many negative stigmas associated to ostomy surgeries like an ileostomy, there’s nothing to be ashamed of. In this article, we’ll go over what an ileostomy is and everything you need to know about ileostomy surgery.
Reasons for an Ileostomy
An ileostomy is used if your colon is damaged, inflamed, or not working properly. There are many different reasons that someone might need an ileostomy, but the most common reasons are due to Crohn’s disease, ulcerative colitis, and bowel cancer.
Crohn’s Disease
Crohn’s disease is a chronic condition that occurs when the entire digestive tissue and system is inflamed. Many people who experience Crohn’s disease don’t realize they have it for years as it can progress slowly. Symptoms include diarrhea, abdominal pain, fatigue, and a general feeling of malaise.
Ulcerative Colitis
Ulcerative colitis is another chronic and long-term condition that involves inflammation. In this condition, only the large intestine (colon) or bowel (rectum) become inflamed, but it still requires treatment. People with ulcerative colitis oftentimes feel abdominal pain in conjunction with bloody diarrhea and a frequent need or feeling like they have to pass stools. Medication works well to control ulcerative colitis, but in extreme cases surgery is required.
Bowel Cancer
If you or a loved one is diagnosed with bowel cancer, the best course of action is to surgically remove the cancer before it spreads. Many doctors recommend first undergoing chemotherapy or radiotherapy to shrink the cancer prior to surgery, but for the best cases a combination ileostomy and colostomy is performed. This can be temporary or permanent depending on the stage and severity of the cancer.
Some of the less common reasons that people may need to undergo an ileostomy include:
· Familial Adenomatous Polyposis
· Bowel Obstruction
· Injury
Temporary vs. Permanent Ileostomies
Depending on your individual circumstances and the reason behind getting an ileostomy, you may receive either a temporary or permanent surgery.
Temporary ileostomies are done when a surgical site or injury lower in the digestive tract needs time to heal.1 This allows your digestive tract to be diverted away from the site for optimal healing and to avoid premature use or restoration of function. Temporary ileostomies are usually done with a loop ileostomy surgery.
Permanent ileostomies are required if your large intestine cannot be reconnected to the anus for whatever reason.1 This is often due to cases where your colon or rectum cannot be repaired or needs to be removed, such as in the case of Crohn’s disease or certain cancers. Permanent ileostomies are done using end ileostomies.
Understanding Ileostomy Procedures
Having an ileostomy will bring some significant changes to your life. Whether it’s temporary or permanent, you need to be prepared both mentally and physically for the surgery and associated post-op care. When you take the proper precautions, you reduce your chances of any complications and give your body the care it needs to recovery.
Preparation
Before the procedure, it’s important to make sure that you’re both physically and mentally prepared. Always tell your doctor about any medications you’re taking including over-the-counter supplements or herbs. Ask any questions that you may be having and make sure that you feel comfortable going into the surgery. It’s better to be over prepared and your doctor is well versed in answering these types of questions. About two weeks before the surgery, you’ll need to stop taking certain medications and your doctor will advise you to quit smoking to allow for better recovery. The day before your surgery, you should avoid drinking anything other than clear liquids. You will need to stop eating at a certain point and you may need to use an enema or laxative to clear out your intestines. Your doctor will give you a thorough pre-surgical list of instructions and it’s important to follow them exactly as they are.
The Procedure
There are many different ways that your surgeon can perform an ileostomy—each depending on the underlying reason regarding why you need an ileostomy. Generally speaking, your surgeon will create a small incision on the right side of your abdomen for waste materials to exit your body after the operation. This is called the stoma. There are three main types of ileostomies performed: end ileostomies, loop ileostomies, and ileo-anal pouches.
· End Ileostomy – in this procedure, the entire large intestine (colon) will be removed through a cut in your abdomen and the small intestine (ileum) is brought out through the incision to form a stoma. End ileostomies are often permanent but can be temporary.
· Loop Ileostomy – this procedure involves looping a piece of your small intestine out through the cut in your abdomen and opening it up to attach to your skin to form a stoma. In a loop procedure, the colon and rectum are left in place and you’ll have two separate openings very close together. Loop ileostomies are often temporary.
· Ileo-Anal Pouch – in certain cases, your surgeon may recommend placing a permanent internal ileo-anal pouch (J pouch) instead of an ileostomy. This pouch is created from the ileum and joined to the anus so that you can have normal bowel movements. The J pouch requires some healing time, so you will often need a temporary, reversable ileostomy to allow this to happen.
Post-Op Care
After an ileostomy surgery, it’s imperative that you stay in the hospital to recovery properly. During this time, you’ll be slowly removed from the intravenous drip and your nurse will help you familiarize yourself with your stoma. A stoma nurse will walk you through everything you need to know about taking care of your stoma, changing your pouch, and answer any questions that you might have. Most patients recover within two weeks, but this timeline varies by person and type of operation. Your abdomen will likely feel sore during your recovery, but most normal activities can be resumed within eight weeks to three months.
Potential Complications of an Ileostomy
As with all surgeries, there are complications of getting an ileostomy. To reduce your risk of infection or other serious complications, your doctor will have you stay in the hospital during the most crucial parts of your recovery. During this time, don’t be afraid to ask any questions or get clarifications on your ileostomy. It’s also important to make sure that you and your doctor go over the following risks prior to undergoing surgery so that you can understand the plan of action if anything does go wrong.
· Obstruction – in some cases, the ileostomy does not work for a short time after surgery. If this continues for longer than six hours, you likely have an obstruction that needs attention.
· Dehydration – your large intestine is no longer functioning, and your body will now need more water to properly be absorbed into your body.
· Rectal Discharge – mucus may occur as a discharge following your surgery. This is fairly normal, but if you notice any pus or blood in the discharge call your doctor immediately.
· Vitamin B12 Deficiency – certain parts of your large intestine are responsible for absorbing vitamin B12 from your food. Ileostomies can remove this area, making deficiency more common.
· Stoma Problems – every ostomy comes with stoma-related risks. To avoid any complications, keep an eye on your stoma and report any changes to your nurse.
· Phantom Rectum – some people feel like they need to use the bathroom, even when they no longer have a working rectum. Sitting on the toilet may help relieve this feeling.
· Pouchitis – this occurs when an internal J pouch becomes inflamed.
Living with an Ileostomy
After you’ve had an ileostomy surgery, whether temporary or permanent, you’ll go through an adjustment period. The hardest thing for those receiving a permanent ileostomy is often the management of a social life or sexual relationship. It’s not uncommon to feel embarrassed or depressed after a surgery, but people who receive an ileostomy can live perfectly healthy, normal lives. With the discreet products available today, people will only know you have an ileostomy if you tell them you do. Having an ileostomy does not affect your sexual function, pregnancy, participation in sports, most jobs, and even diet. Always talk to your doctor if you have any questions and if you’re struggling with your ileostomy, consider joining a local support group.
Conclusion
If you need an ileostomy, make sure you talk to your doctor about any concerns you might have. There are plenty of great pouches that help you lead a normal life and maintain your privacy. To get the most out of your ileostomy, always opt for high-quality, medical grade ostomy supplies. You’ll need ostomy pouches, ostomy flanges, stoma powder, and skin prep essentials to get the most out of your ostomy skin care. At Byram Healthcare, we’re committed to helping improve the life of people living with an ostomy and offer a wide range of ostomy supplies, ostomy bags, and support systems. Check out our product catalog today!
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