Ileostomy

An ileostomy is where the small intestine (small bowel) is diverted through an opening in the abdomen (tummy).

The opening is known as a stoma. A special bag is placed over the stoma to collect waste products that would usually pass through the colon (large intestine) and out of the body through the rectum and anus (back passage).

Ileostomy procedures are relatively common in the UK. In England, over 9,000 such operations are carried out each year.

When is an ileostomy needed?

Ileostomies are formed to either temporarily or permanently stop digestive waste passing through the full length of the small intestine or colon.

There are a number of reasons why this may be necessary, including:

to allow the small intestine or colon to heal after it has been operated on (for example, if a section of bowel has been removed to treat bowel cancer)
to prevent inflammation of the colon in people with Crohn’s disease or ulcerative colitis
to allow for complex surgery to be carried out on the anus or rectum

The ileostomy procedure

Before an ileostomy is formed, you will normally see a specialist stoma nurse to discuss exactly where you'd like your stoma to be (usually somewhere on the right-hand side of the abdomen) and to talk about living with a stoma.

There are two main types of ileostomy:

loop ileostomy – where a loop of small intestine is pulled out through an incision in your abdomen, before being opened up and stitched to the skin to form a stoma
end ileostomy – where the ileum is separated from the colon and is brought out through the abdomen to form a stoma

Alternatively, it is sometimes possible for an internal pouch to be created that is connected to your anus. This is known as an ileo-anal pouch. This means that, unlike with an ileostomy, there is no stoma and stools are passed out of your back passage in a similar way to normal.

Of these techniques, end ileostomies and ileo-anal pouches are usually permanent. Loop ileostomies are usually intended to be temporary and are reversed during an operation at a later date.

Read more about how an ileostomy is formed and reversing an ileostomy.

After surgery

You may need to stay in hospital for up to two weeks after an ileostomy operation, during which time you will be taught how to look after your stoma by a specialist stoma nurse.

Recovering from the procedure can be challenging. Many people will experience both short-term physical and psychological problems, ranging from skin irritation around the stoma to feelings of anxiety and self-consciousness.

However, with practice and support from a designated stoma nurse, many people do adjust and often find that their quality of life improves after surgery, particularly if they have been living for years with a painful digestive condition, such as Crohn’s disease.

Complications

As with any surgical procedure, having an ileostomy carries a risk of complications. Some of the problems people with an ileostomy experience include:

an obstruction – where the output of digestive waste is blocked
vitamin B12 deficiency, caused by the removal of part of the intestine that absorbs vitamin B12
stoma problems, such as widening or narrowing of the stoma, making it difficult to attach the external bag

Read more about the risks of having an ileostomy.