Ileostomy

Ileostomy is a stoma (surgical opening) constructed by bringing the end or loop of small intestine (the ileum) out onto the surface of the skin, or the surgical procedure which creates this opening. Intestinal waste passes out of the ileostomy and is collected in an artificial external pouching system which is adhered to the skin. Ileostomies are usually sited above the groin on the right hand side of the abdomen. Ileostomy is a stoma (surgical opening) constructed by bringing the end or loop of small intestine (the ileum) out onto the surface of the skin, or the surgical procedure which creates this opening. Intestinal waste passes out of the ileostomy and is collected in an artificial external pouching system which is adhered to the skin. Ileostomies are usually sited above the groin on the right hand side of the abdomen. Ileostomies are necessary where injury or a surgical response to disease has rendered the large intestine incapable of safely processing intestinal waste, typically because the colon and rectum have been partially or wholly removed. Diseases of the large intestine which may require surgical removal include Crohn's disease, ulcerative colitis, familial adenomatous polyposis, constipation, and total colonic Hirschsprung's disease. An ileostomy may also be necessary in the treatment of colorectal cancer or ovarian cancer. One example is a situation where the cancer tumor is causing a blockage. In such a case the ileostomy may be temporary, as the common surgical procedure for colorectal cancer is to reconnect the remaining sections of colon or rectum following removal of the tumor provided that enough of the rectum remains intact to preserve internal/external anal sphincter function. In a temporary or loop ileostomy, a loop of the ileum is surgically brought through the skin creating a stoma, but keeping the lower portion of the ileum for future reattachment in cases where the entire colon and rectum are not removed but need time to heal. Temporary ileostomies are also often made as the first stage in surgical construction of an ileo-anal pouch, so fecal material doesn't enter the newly made pouch until it heals and has been tested for leaks—usually requiring a period of eight to ten weeks. When healing is complete the temporary ileostomy is then 'taken down' (or reversed) by surgically repairing the loop of intestine which made the temporary stoma and closing the skin incision. In an end ileostomy, the end of the ileum is everted to create a spout and the edges are sutured under the skin to anchor the ileum in place. An end ileostomy can be temporary or permanent, but is normally the choice for a permanent ileostomy. An end ileostomy may be constructed temporarily if some or most of the large intestine is removed and the current state of bowel or overall health is not considered amenable to performing further surgery, such as an anastomosis to rejoin the small and large intestines. People with ileostomies must use an ostomy pouch to collect intestinal waste. People with ileostomies typically use an open-ended (referred to as a 'drainable') one- or two-piece pouch that is secured at the lower end with a leakproof clip, or velcro fastener. The alternative is the closed-end pouch that must be thrown away when full. Ordinarily, the pouch must be emptied several times a day. The pouch and flange (both one and two piece pouches) are usually changed every 2–5 days.