An ileostomy is an opening (stoma) that has been constructed by bringing the end of the small intestine (the ileum) out onto the surface of the skin.

The surgery to create the opening is called ostomy. The opening is called a stoma. Intestinal waste passes out through the stoma.

It is then collected in an external bag stuck to the skin. Ileostomies are usually sited above the groin on the right hand side of the abdomen.

The stoma is shiny, wet, and red in colour like to the inside lining of your mouth. It is usually round or oval. After surgery, the stoma may appear swollen. The swelling will go down and shrink in size after a few months.

A stoma does not have nerve endings. It therefore does not transmit pain and other sensations. People who have this surgery are able to control their bowel movements.

Reasons for Ileostomy

Ileostomies are necessary where disease or injury has rendered the large intestine incapable of safely processing intestinal waste.

Normally the operation will be performed when a disease or injured colon cannot be treated successfully with medicine. The colon has to be wholly removed in such a case.

Several diseases of the large intestine may require its surgical removal. These include:

  • Ulcerative colitis
  • Crohn's disease
  • Familial polyposis

    The operation may also be necessary in the treatment of colorectal cancer. These are needed for example in cases where the tumour is causing a blockage. In this case, the ileostomy may be temporary.

    The common surgical procedure for colorectal cancer is to reconnect the remaining sections of colon or rectum following removal of the tumour provided that enough of the rectum remains intact to preserve sphincter function.

    In a temporary ileostomy, a loop of the small intestine is brought through the skin, and the colon and rectum are not removed.

    Ileostomy Care

    People with ileostomies need to wear an external pouch to collect intestinal waste.

    The pouches are secure, lightweight, and unnoticeable. They are also odour free. Different manufacturers have disposable or reusable varieties to fit your lifestyle. Ostomy supplies are available at medical outlets, ostomy supply houses and through mail order.

    Pouches are attached to the skin with an adhesive wafer made of pectin or similar organic material. The wafer is cut with a hole to fit comfortably around the base of the stoma to prevent leakage of waste onto the skin and possibly causing skin irritation.

    Regular pouches have an open end on the bottom for emptying which is otherwise kept closed with a leak proof clip.

    Generally, the pouch must be emptied several times a day. Most ostomates find it convenient to do this when they make a trip to the bathroom. The pouch needs to be changed every 2-5 days when the wafer starts to deteriorate.

    Ostomy pouches fit close to the body and are usually not visible under regular clothing unless the wearer allows the pouch to become too full.

    Ileostomy Lifestyle

    An ostomy does not make a person less masculine or feminine. You attitude is important in maintaining sexual performance. In some cases, professional counselling may be necessary. The ileostomy should however not interfere with normal sexual activity or pregnancy.

    An ileostomy does not interfere with work either. People with ileostomies are successful in their careers. The possible exception to this is if a job requires very heavy lifting.

    Ordinarily, one is able to wear the same clothing as before surgery. This includes the normal swimwear. With a securely attached pouch one can jog, scuba dive, swim, camp out, water-ski, play tennis and participate in practically all types of sports.

    Travel is not constrained in any way. All that is needed is advance planning and packing of adequate ostomy supplies.

    Bathing and showering may be done with or without the pouch in place.

    Ileostomy Diet

    Many people need to adjust their diet after having an ileostomy.

    Tough or high-fibre foods such as potato skins and raw vegetables are hard to digest in the small intestine and may cause blockages or discomfort when passing through the stoma.

    Chewing food thoroughly can help to minimize problems. Certain foods may cause annoying gas or diarrhoea.

    In general, many people who have an ileostomy can enjoy a "normal" diet than they could before surgery.

    Absence of a colon may cause you to lose water and electrolytes. It is therefore necessary for you to drink at least six to eight glasses of water or juice each day to prevent dehydration.

    Ileostomy Substitutes

    An increasingly popular alternative to an ileostomy is the ileo-anal pouch. With an ileo-anal pouch, an internal reservoir is formed connecting the end of the small intestine to the rectum. This eliminates the need for external equipment.

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