An ileostomy is an artificial opening that is created in the bowel for stool to pass through. The ileum is the lower end of the small bowel, which connects to the large bowel. Treatment for some bowel diseases requires removal of part of or the entire large bowel.
Who is a candidate for the procedure?
Following are some examples of conditions that may require an ileostomy:
- bowel infections
- bowel injuries
- bowel obstructions
- conditions that cause severe bowel inflammation, such as Crohn's disease or ulcerative colitis
How is the procedure performed?
A liquid diet will be used for several days before surgery. Bowel cleansers will be given before surgery. Antibiotics may be given to kill bacteria in the bowel. Bowel preparation can decrease the risk of infection, but it may not be possible in emergency cases. The abdomen is marked for placement of the stoma before surgery.
When possible, the stoma is placed in the most convenient place for the person, usually, the lower right part of the abdomen. An ileostomy is usually done using general anesthesia. The surgeon removes or interrupts the diseased bowel.
In a traditional procedure, a part of the ileum is then brought out through the skin. The bowel opening is attached to the skin of the abdomen with sutures. A plastic bag with an adhesive facing is placed over the stoma and firmly pressed onto the skin. Someone who has a traditional ileostomy has continuous drainage of bowel contents into the bag.
Alternatively, the surgeon may perform a continent ileostomy. A special pouch is created and attaches to the abdominal wall. There is no external bag with this type of ileostomy. The bowel contents do not drain constantly; rather, the person inserts a narrow tube into the pouch several times a day to drain the bowel contents.
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Textbook of Medical-Surgical Nursing, Ninth Edition, 2000, Smeltzer, et al.