What Is an Ileostomy?

An ileostomy is an opening in the belly (abdominal wall) that’s made during surgery. It's usually needed because a problem is causing the ileum to not work properly, or a disease is affecting that part of the colon and it needs to be removed. The end of the ileum (the lowest part of the small intestine) is brought through this opening to form a stoma, usually on the lower right side of the abdomen. An ileostomy may only be needed for a short time (temporary), maybe for 3 to 6 months, because that part of the colon needs time to rest and heal from a problem or disease. But sometimes a disease, such as cancer, is more serious and an ileostomy may be needed for the rest of a person's life (permanent).

A Wound Ostomy Continence nurse (WOCN or WOC nurse) will probably work with the surgeon to figure out the best location and way to care for your stoma. (A WOC nurse is a specially trained registered nurse who takes care of and teaches ostomy patients. This nurse may also be called an ostomy nurse.)

When you look at your stoma, you are actually looking at the lining (the mucosa) of your small intestine, which looks a lot like the inside lining of your cheek. The stoma will look pink to red. It’s warm and moist and secretes small amounts of mucus. It will shrink shortly after surgery. Its shape will be round to oval. Some stomas may stick out a little, while others are flat against the skin.

Unlike the anus, the stoma has no valve or shut-off muscle. This means you won’t be able to control stool passing from the stoma. There are no nerve endings in the stoma, so the stoma itself is not a source of pain or discomfort.

As part of this surgery, the colon (the main part of large intestine) and rectum (the lowest part of large intestine where formed stool is held until it’s passed out of the body through the anus) are often removed (this is called a colectomy). This means that colon and rectum no longer function as they used to. Sometimes, only part of the colon and rectum are removed.

What does an ileostomy do?

After the colon and rectum are removed or bypassed, waste no longer comes out of the body through the rectum and anus. Digestive contents now leave the body through the stoma. The drainage is collected in a pouch that sticks to the skin around the stoma. The pouch is fitted to you personally. It’s worn at all times and can be emptied as needed.

Ileostomy output will be liquid to pasty, depending on what you eat, your medicines, and other factors. Because the output is constant, you’ll need to empty the pouch 5 to 8 times a day.