Ileostomy

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

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

Ileostomy procedures are relatively common in the UK. More than 9,000 are carried out each year in England.

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's been operated onfor example, if a section of bowel has been removed to treat Rectal cancer
• torelieve 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'll 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 a cut (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's sometimes possible for an internal pouch to be created that's connected to your anus (ileo-anal pouch). This means there's no stoma and stools are passed out of your back passage in a similar way to normal.

End ileostomies and ileo-anal pouches are usually permanent. Loop ileostomies are usually intended to be temporary andcan bereversed during an operation at a later date.

Duringthis time you'll be taught how to look after your stoma by a specialist stoma nurse.

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

However, with practise and support from a designated stoma nurse, many people adjust and often find their quality of life improves after surgery. This is especially true if they've been living for years with a condition such as Crohn's disease.

Some of the problems people with an ileostomy experience include:

• a bowel 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