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Ileostomy

Enterostomy

An ileostomy is used to move waste out of the body. This surgery is done when the colon or rectum is not working properly.

The word "ileostomy" comes from the words "ileum" and "stoma." Your ileum is the lowest part of your small intestine. "Stoma" means "opening." To make an ileostomy the surgeon makes an opening in your belly wall and brings the end of the ileum through the opening. The ileum is then attached to the skin.

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Description

Before you have surgery to create an ileostomy, you may have surgery to remove all of your colon and rectum, or just part of your small intestine.

These surgeries include:

An ileostomy may be used for a short or long time.

When your ileostomy is temporary, it most often means all of your large intestine was removed. However, you still have at least part of your rectum. If you have surgery on part of your large intestine, your health care provider may want the remainder of your intestine to rest for a while. You will use the ileostomy while you recover from this surgery. When you do not need it anymore, you will have another surgery. This surgery will be done to reattach the ends of the small intestine. You will no longer need the ileostomy after this.

You will need to use it long-term if all of your large intestine and rectum have been removed.

To create the ileostomy, the surgeon makes a small surgical cut in the wall of your belly. Part of your small intestine that is farthest from your stomach is brought up and used to make an opening. This is called a stoma. When you look at your stoma, you are actually looking at the lining of your intestine. It looks a lot like the inside of your cheek.

Sometimes, an ileostomy is done as the first step in forming an ileal anal reservoir (called a J-pouch).

Why the Procedure Is Performed

Ileostomy is done when problems with your large intestine can only be treated with surgery.

There are many problems that may lead to the need for this surgery. Some are:

Risks

Talk with your provider about these possible risks and complications.

Risks of anesthesia and surgery in general are:

Risks of this surgery are:

Before the Procedure

Always tell your provider what medicines you are taking, even medicines, supplements, or herbs you bought without a prescription.

Before your surgery, talk with your provider about the following things:

During the 2 weeks before your surgery:

The day before your surgery:

On the day of your surgery:

After the Procedure

You will be in the hospital for 3 to 7 days. You may have to stay longer if your ileostomy was an emergency operation.

You may be able to suck on ice chips on the same day as your surgery to ease your thirst. By the next day, you will probably be allowed to drink clear liquids. You will slowly add thicker fluids and then soft foods to your diet as your bowels begin to work again. You may be eating again 2 days after your surgery.

Outlook (Prognosis)

Most people who have an ileostomy are able to do most of the activities they were doing before their surgery. This includes most sports, travel, gardening, hiking, and other outdoor activities, and most types of work.

If you have a chronic condition, such as Crohn disease or ulcerative colitis, you may need ongoing medical treatment.

Related Information

Total abdominal colectomy
Total proctocolectomy and ileal-anal pouch
Total proctocolectomy with ileostomy
Crohn disease
Ulcerative colitis
Colon and rectal cancer
Colorectal polyps
Ileostomy and your child
Ileostomy and your diet
Ileostomy - caring for your stoma
Types of ileostomy
Ileostomy - discharge
Living with your ileostomy
Bland diet
Ileostomy - changing your pouch
Crohn disease - discharge
Low-fiber diet
Ulcerative colitis - discharge
Ileostomy - what to ask your doctor
Total colectomy or proctocolectomy - discharge

References

Araghizadeh F. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 117.

Mahmoud NN, Bleier JIS, Aarons CB, Paulson EC, Shanmugan S, Fry RD. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 20th ed. Philadelphia, PA: Elsevier; 2017:chap 51.

Reddy VB, Longo WE. Ileostomy. In: Yeo CJ, ed. Shackelford's Surgery of the Alimentary Tract. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 84.

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Review Date: 9/3/2018  

Reviewed By: Debra G. Wechter, MD, FACS, general surgery practice specializing in breast cancer, Virginia Mason Medical Center, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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