Ileostomy

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Types of ileostomies

Three major types of ileostomies may be made when all of the colon must be removed or rested. You and your surgeon should talk about your choices and together decide on the best surgery for you. Some of the things to think about when planning an ileostomy are the disease process, your age, your general health, and your preference.

Standard or Brooke ileostomy

    Reasons for the surgery:

    Ulcerative colitis

    Crohn’s disease

    Familial polyposis

    Cancer-related problems

    Output:

    Liquid or paste-like constant drainage that contains digestive enzymes

    Management:

    Skin protection is needed; use an open-ended pouch that can be emptied

The standard or Brooke ileostomy surgery is done most often. The end of the ileum is pulled through the abdominal wall and is turned back and sutured to the skin, leaving the smooth, rounded, inside-out ileum as the stoma.

The stoma is usually in the right lower part of the abdomen, on a flat surface of normal, smooth skin. The fecal output is not controlled. This means you’ll need to wear a collection pouch all the time, and empty it regularly.

Continent ileostomy (abdominal pouch)

    Reasons for surgery:

    Ulcerative colitis

    Familial polyposis

    Cancer-related problems

    Output:

    Liquid or paste-like drainage

    Management:

    Drain fairly often with a small tube (catheter) and use a stoma cover

A continent ileostomy is a different type of standard ileostomy. You don’t need to wear an external pouch with this kind of ileostomy.

It’s made by looping part of the ileum back on itself so that a reservoir or pocket is formed inside the belly (abdomen). A nipple valve is made from part of the ileum. A few times each day you put in a thin, soft tube called a catheter to drain the waste out of the reservoir inside your belly.

Ileo-anal reservoir (J-pouch or pelvic pouch)

    Reasons for surgery:

    Ulcerative colitis

    Familial polyposis

    Output:

    Soft, formed stool

    Management:

    Natural bowel movements take place, but you need to protect the skin around the anus

The ileo-anal reservoir or pelvic pouch is a pouch made from the ileum and the rectum and placed inside the body in the pelvis. Other names for this include J-pouch, W-pouch, and S-pouch depending on the surgical procedure.

The pouch is connected to the anus. Waste passes into the pouch, where it’s stored. When an “urge” is felt, the stool is passed through the anus, out of the body. The sphincter muscle around the anal opening must be intact to keep the pouch from leaking. The consistency of the output of the pelvic pouch depends on what you eat and drink, and may be managed with medicines. In most cases at least 2 surgeries are needed to make the ileo-anal reservoir or pelvic pouch.


Last Medical Review: 12/02/2014
Last Revised: 12/02/2014