What is an Ileostomy?

What is a stoma?
Meaning
The word Stoma derives from the Greek word meaning mouth or opening.
The reasons why a stoma is created, is to treat serious (often life threatening) disease or medical conditions such as:
  • Bowel or bladder cancer
  • Inflammatory bowel disease (Ulcerative colitis or Crohn’s Disease)
  • Diverticular disease
  • Congenital abnormalities or injury
  • Fistulas or bladder disease

    • Many will be temporary but generally those with bladder disease will have a permanent stoma.

    Categories
    There are two categories of stoma:
    Input stomas - this is when an opening is created in order to assist those who are unable to eat by mouth.
    Output stomas - this is when an opening is created surgically onto the abdomen to enable waste to be discharged. This is necessary when disease or trauma has compromised the body's natural elimination process.

    Types of Outputs
    There are three main types of output stoma, they are:

  • Colostomy - coming from the colon (large bowel)
  • Ileostomy - coming from the ileum (small bowel)
  • Urostomy - coming from the kidneys and draining urine.

    • Ileostomy
    An ileostomy is the result of an operation where part of the ileum (the last section of the small intestine) is brought out onto the surface on the abdomen which would normally be on the right hand side of the abdomen.
    Food waste exits the body via the ileostomy rather than from the anus. This waste is collected in an appliance that is worn on the abdomen, over the ileostomy. These appliances are usually referred to as stoma bags or pouches.

    An ileostomy operation is done to treat medical conditions such as

  • Ulcerative colitis a condition that causes inflammation and ulceration of the colon. Permanently removing the colon is usually recommended in a small number of cases when other treatments prove ineffective.
  • Familial Adenomatous Polyposis (FAP) This is a rare condition that affects one in every 10,000 people and triggers the growth of non-cancerous lumps of tissue inside the colon.
  • Bowel cancer after chemotherapy or radiotherapy to shrink the cancer, it is usually necessary to remove the section of the bowel or rectum that contains the cancerous cells.
  • Crohn’s disease a condition that causes chronic (long-term) inflammation of the digestive system. An ileostomy is usually recommended if the symptoms can't be controlled using medication, or if a serious complication occurs.
  • Injury

    • “Panproctocolectomy” - is the removal of the entire colon, rectum and anal canal. This type of stoma is permanent.
    “Total Colectomy” - is the removal of the entire colon, the rectum is left in place. This type of stoma is reversible.
    “Anterior resection” - is the removal of the upper part of the rectum, the remaining colon is then sewn onto the remaining rectum.

    Types
    Loop ileostomy
    During a loop ileostomy, a loop of the small intestine is brought out through the stoma. The procedure is usually only used as a temporary measure when it is necessary to remove part of the rectum. Once the remaining colon has healed it can be reconnected to the small intestine and the stoma can be closed. Loop ileostomies are often used to treat bowel cancer.

    End ileostomy
    During an end ileostomy the colon and rectum are removed and the end of the ileum is brought out through the stoma and attached to an external bag. An end ileostomy is usually permanent. An ileo-anal pouch (also known as a J pouch) is sometimes used as an alternative to an external bag. This is an internal pouch surgically constructed from the small intestine and connected to the sphincter muscle that surrounds the anus. It means bowel actions can be controlled in the normal way.
    Ileo-anal pouches are now preferred because they eliminate the external bag. However, they are not suitable for every patient. Disadvantages include having to go to the toilet frequently to empty the pouch.

    Continent ileostomy
    A continent ileostomy is similar to an end ileostomy, but rather than having to wear an external bag, an internal pouch is created inside the abdomen. This is connected to a valve that is implanted into the skin, so the internal pouch can be emptied using a catheter (thin tube). The continent ileostomy provides an option for those unable to have an ileo-anal pouch due to health or technical reasons, or in cases where an ileo-anal pouch stops working and needs to be removed.