Ileostomy
Ileostomy (also called "enterostomy") is the surgical diversion of the ileum, the last 12 feet of the small intestine, to an opening (stoma) created in the abdominal wall. It is performed to keep digestive waste from passing through the small and large intestines. Depending on the reason it is being performed, ileostomy is either temporary or permanent. A temporary ileostomy is performed to allow the intestine to heal without the complication of stool, and can be reversed with little or no loss of intestinal function. A permanent ileostomy is performed when damage or disease requires the removal of the large intestine and rectum.
Types of Ileostomy
There are three basic types of ileostomy. The patient's condition, age, overall health and preference determine the type performed.
Ileonal Reservoir
Also known as a "J-pouch" or "pelvic pouch," an ileonal reservoir involves the creation of an internal pouch that is placed in the patient's pelvis.
Brooke Ileostomy
During Brooke ileostomy, the end of the ileum is positioned through a stoma, requiring an external pouch for collection.
Continent Ileostomy
A continent ileostomy, also known as an "abdominal pouch," does not require an external pouch. Instead, a reservoir that is periodically drained through a catheter is created inside the abdomen.
Reasons for Ileostomy
Ileostomy is performed when serious gastrointestinal disorders, including the following, do not respond to other treatments, and can only be treated with surgery:
- Cancer complications
- Crohn's disease
- Ulcerative colitis
- Familial polyposis
- Traumatic injury of the bowel
At times, a birth defect is reparable only through an ileostomy.
Risks of Ileostomy
In addition to those of any surgery, risks of ileostomy include the following:
- Intestinal blockage
- Electrolyte imbalance
- Short bowel syndrome
- Internal bleeding
- Infection
- Widening of the stoma
Certain ongoing diseases, such as Crohn's disease or ulcerative colitis, are not cured by ileostomy, and still require continuous medical treatment. After ileostomy, however, patients are able to return to normal activities with relatively few restrictions. Patients who have undergone ileostomy may require supplemental B12, which can no longer be absorbed in the normal fashion.