Ileostomy

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What is an Ileostomy?

An ileostomy is an opening in the belly (abdominal wall) that is made during surgery. 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.

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 lining of your cheek. The stoma will look pink to red. It is warm and moist and secretes small amounts of mucus. It will shrink over a short period of time after surgery. The shape will be round to oval. Some stomas may stick out a little, while others are flush with the skin.

Unlike the anus, the stoma has no valve or shut-off muscle. This means you will not be able to control of the passage of stool 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 (large intestine) and rectum (the lowest portion of colon where formed stool is held until it is passed out of the body through the anus) are often removed (this is called a colectomy). This means that the normal colon and rectum functions are no longer present. 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 is worn at all times and can be emptied as needed. The ileostomy output will be liquid to pasty, depending on what you eat, your medicines, and other factors. Because the output is constant, you will need to empty the pouch 5 to 8 times a day.

The major job of the small intestine is to absorb nutrients and water from what you eat and drink. Enzymes (chemicals made by the body to break down food) are released into the small intestine to break food into small particles so that proteins, carbohydrates, fats, vitamins, and minerals can be taken into the body. These enzymes are also in the ileostomy output and can irritate the skin. This is why the skin around your stoma must always be protected. (See "Protecting the skin around the stoma" in the "Helpful Hints" section.)

Why have an ileostomy?

Ileostomy surgery is done for many different diseases and conditions. Ileostomy surgery is usually done when the bowel has disease or damage that cannot be treated by other methods. The most frequent reason for having surgery is inflammatory bowel disease (IBD) which includes Crohn’s disease and ulcerative colitis. Ileostomies are also done because of birth defects, familial polyposis, injury, or cancer.

Certain bowel problems may be treated by giving part of the bowel a rest or with surgery to remove the damaged part. The bowel must be kept empty so it can heal. To keep stool from getting to the bowel, a short-term (temporary) ileostomy is created. Healing may take a few weeks, months, or even years. In time, the ileostomy will be surgically reversed (removed) and the bowel will work much like it did before. A temporary ileostomy can also be done as the first stage in forming an ileo-anal reservoir (or J-pouch), which we discuss in the section, "Types of ileostomies."

When part of the bowel becomes diseased, a long-term (permanent) ileostomy must be made. The diseased part of the bowel is removed or permanently rested. In this case, the ileostomy is not expected to be closed in the future.


Last Medical Review: 03/17/2011
Last Revised: 03/17/2011