Ileostomy Surgery

An ileostomy surgery is a procedure that redirects a section of the small intestine to an external opening in the abdomen or to a newly created internal pouch. The external opening is called a stoma or ostomy. The opening may include a valve. External pouches are attached to the stoma to collect waste since the waste can no longer travel through the rest of the bowel. Where the stoma is located and what it looks like depends on the type of ileostomy performed. An external opening with a valve is emptied with a catheter. An ileostomy may be temporary or permanent. The hospital stay after this procedure is typically 3 to 7 days.

LET YOUR CAREGIVER KNOW ABOUT:

  • Allergies to food or medicine.

  • Medicines taken, including vitamins, health supplements, herbs, eyedrops, over-the-counter medicines, and creams.

  • Use of steroids (by mouth or creams).

  • Previous problems with anesthetics or numbing medicines.

  • History of bleeding problems or blood clots.

  • Previous surgery.

  • Other health problems, including diabetes and kidney problems.

  • Possibility of pregnancy, if this applies.

RISKS AND COMPLICATIONS

General surgical complications may include:

  • Reaction to anesthesia.

  • Damage to surrounding nerves, tissues, or structures.

  • Infection.

  • Blood clot.

  • Bleeding.

  • Scarring.

Specific risks for ileostomy, while rare, may include:

  • Difficulty absorbing nutrients or vitamins from foods.

  • Large volume of drainage from the ileostomy.

  • Dehydration.

  • Intestinal blockage.

  • Skin irritation around the stoma.

  • Poor wound healing.

  • Narrowing or collapsing of the stoma.

  • Hernia.

  • Needing to repeat the procedure.

BEFORE THE PROCEDURE

It is important to follow your surgeon's instructions prior to your procedure to avoid complications. Steps before your procedure may include:

  • A physical exam, blood and stool tests, rectal exam, X-rays, colonoscopy, and other procedures.

  • A review of the procedure, the anesthesia being used, and what to expect after the procedure. You may meet with an ostomy advisor.

You may be asked to:

  • Stop taking certain medicines for several days or weeks prior to your procedure, such as blood thinners (including aspirin).

  • Take certain medicines, such as antibiotics or stool softeners.

  • Avoid eating and drinking after midnight the night before the procedure. This will help you to avoid complications from the anesthesia.

  • Quit smoking. Smoking increases the chances of a healing problem after your procedure.

PROCEDURE

There are several types of ileostomy procedures. You will be given medicine that makes you sleep (general anesthetic). The procedure may be done as open surgery, with a large cut (incision), or as laparoscopic surgery, with several small incisions. The 3 main procedure types are:

  • Loop ileostomy. The surgeon pulls a piece of small intestine out toward the abdomen, cuts it, which causes it to open into 2 openings. This procedure is often temporary. It is often performed as part of another procedure. Once the areas of the small intestine have rested or healed, the intestine may be reconnected.

  • End ileostomy. The surgeon pulls the cut end of small intestine out toward the abdomen and sews it to your skin. This can be temporary or permanent. It is often performed as part of another procedure.

  • Continent ileostomy. The surgeon creates an internal pouch from part of the small intestine. The pouch stays inside your body and connects to your stoma through a valve your surgeon creates. Waste is emptied through a catheter.

AFTER THE PROCEDURE

  • You will be given pain medicine.

  • You may be able to suck on ice. You may begin drinking clear fluids as early as the next day. You may begin a normal diet as early as 2 days after surgery, or as directed by your surgeon.

  • Your stoma will be covered with bandages or a pouch.

  • Initial drainage from the stoma or rectum will be liquid.

  • The stoma may be dark-colored, swollen, and bruised until it has more time to heal.

  • Arrange for someone to help you with activities at home while you recover.