Ileostomy

An ileostomy is a surgical procedure in which a portion of the intestines, called the ileum, is removed.  The ileum is part of the intestinal tract located past the stomach, just before the colon. The remaining end of the intestines is then re-attached to the abdomen. An opening, called a stoma, allows wastes to drain from the intestines. The surgery to create the new opening is called ostomy.

This procedure is performed to divert the intestinal contents from damaged or diseased section of the bowel. Patients with an ileostomy need to wear a small external ileostomy pouch to collect the material that enters the intestines, or stool.  The pouch can be emptied and replaced several times a day. An ileostomy can be performed temporarily to allow the intestines to heal following injury or repair. In other cases, an ileostomy may be permanent.

Some conditions that can require an ileostomy include cancers, injuries, and gastrointestinal disorders.  Crohn's disease, Ulcerative Colitis, and familial adenomatous polyposis are disorders that sometimes require an ileostomy. One of the most common reasons an ileostomy is performed is for intractable cases of Ulcerative Colitis.

Recent advances in surgical technology have created two significant alternatives to permanent ileostomy: the ileoanal reservoir and continent ileostomy.   In some cases, an ileostomy can be a temporary step towards either of these procedures.  The ileoanal reservoir can hold waste materials from the intestines in a pouch surgically created from the remaining healthy ileum. A temporary ileostomy allows the intestines to heal and is later reversed. When the rectum remains functional and can control bowel movements, the ileoanal reservoir eliminates the need for any external collecting bags. 

A continent ileostomy may be an option for people who are not able to have an ileoanal reservoir constructed.  Using healthy portions of the small intestine, an internal pouch is created to hold stool. A valve keeps the pouch from leaking.  A stoma is created to allow access to a valve in the pouch through which the contents are drained, usually with a tube. Although these patients still have an appliance and a stoma, no external collection bag is needed.

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