An ileostomy is an artificial opening that is created in the ileum for stool to pass through. The ileum is the lower part 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. If this is done, a new way for stool to leave the body must be created.
Who is a candidate for the procedure?
Examples of conditions that may require an ileostomy include:
- 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?
Ileostomy education begins before surgery. The healthcare professionals may use diagrams, photographs, and examples of equipment to explain what the person can expect after surgery. Concerns related to changes in body image and sexuality can be explored.
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 right lower 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 with 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 from bowel tissues and attached 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.
Textbook of Medical-Surgical Nursing, Ninth Edition, 2000, Smeltzer, et al.