Ileostomy: What Is It, Types, Bags, Surgery & Complications

Do you often feel uncomfortable while passing stool? Struggling with chronic digestive issues, abdominal pain, or frequent bowel movements? It can be because of serious intestinal conditions like Crohn’s disease, ulcerative colitis, or colon cancer. 

Your doctor will recommend a surgical solution for these conditions, known as an ileostomy. It is a procedure that allows the stool to pass from the body without going through the anus or colon when the intestines cannot function properly.

It’s a major lifestyle adjustment, but it significantly improves the quality of life for many patients. This blog will help you understand what an ileostomy is, how the bag works, the surgery, and the complications.

What is an Ileostomy?

An ileostomy is a surgical procedure that changes the way stool exits from your body. The last part of the intestine, known as ileum, is diverted through an opening in the abdominal wall, called a stoma. The digestive waste from the body exits through the stoma and is collected in a pouch or bag, called an ileostomy bag. 

Ileostomy is necessary when the parts of the small or large intestine are diseased, damaged, or surgically removed due to ulcerative colitis, Crohn’s disease, colon or rectal cancer, bowel obstruction or surgery, and congenital defects.

Types of Ileostomy

There are various types of ileostomy, and your healthcare provider will decide which works best for you:

• End Ileostomy: The end of the ileum is brought out to the abdominal wall to form a single stoma. The other end is stapled shut in the abdominal cavity. It is a permanent procedure.
• Loop Ileostomy: A loop of the ileum is pulled out and partially cut to make two openings. Stool passes through one opening, and mucus passes through another. It is a temporary procedure.
• Continent Ileostomy (Kock Pouch): An internal pouch is created from the ileum part that stores waste. Patients can empty the pouch by inserting a catheter through the stoma without using any external bag.
• Double-Barrel Ileostomy: In this procedure, the ileum is divided into two separate stomas. It is a less common procedure.

Ileostomy Bags

Ileostomy bags are designed to collect waste from the stoma. They are:

• Water-resistant
• Odor-proof
• Discreet under clothing

Types of Bags

There are different types of bags:

• One-Piece System: The bag and adhesive are joined together in one piece. It is simple to use.
• Tow-Piece System: The adhesive part stays on the skin, and the bag can be removed or changed without peeling. It is good for frequent bag changes.
• Drainable Bags: These bags can be emptied multiple times throughout the day as they have an opening at the bottom.
• Closed-End Bags: They are single-use bags and can be discarded after you use them. They are ideal for traveling.

Ileostomy Surgery

Before the Surgery

Several tests are performed before the surgery, such as:

• Imaging Tests: These tests assess the overall health and understand the digestive system condition.
• Bowel Cleansing: Patients need to empty their bowels to reduce the risk of infection. 
• Stoma Site Marking: The medical team will mark the ideal spot for the stoma on the abdomen to make the stoma easier to manage after the surgery.

During the Surgery

• General anesthesia is given to the patient for a painless procedure.
• An open or minimally invasive surgery is performed, which would be discussed in advance.
• In open surgery, the surgeon makes one long incision, and in minimally invasive surgery, several small incisions are made.
• The surgeon will pull the ileum through a small opening in the abdomen, using either the end or loop technique.
• The ileum is turned outward and stitched to the skin to create the stoma.

After the Surgery

• Hospital stay duration will be around 3-7 days to monitor the recovery.
• Start drinking liquids gradually, followed by soft foods as the bowel begins to work again.
• The healthcare team will teach the patient how to take care of the skin and the ileostomy bag.
• Usually, people return to their normal activities within 4-6 weeks.

Benefits of Ileostomy

There are several benefits of undergoing an ileostomy procedure:

• Relief from chronic symptoms such as ulcerative colitis, Crohn’s disease, and colon cancer
• Improve overall health and quality of life
• Life-saving approach for bowel obstruction, perforation, and severe infection
• Temporary solution to heal after the surgery, especially in colorectal cancer or injury cases

Complications

While many people live well with an ileostomy, it is important to understand the possible complications of the surgery:

• Stoma Related Problems: Several issues, such as the stoma sticking out too far, sinking below skin level, bulging near the stoma, and tissue death.
• Skin Irritation: Due to leakage or a poor fitting issue, skin can get redness, rashes, or even infections.
• Dehydration: When the large intestine is bypassed, your body loses more fluids, which leads to dehydration or electrolyte imbalance.
• Bowel Obstruction: Scar tissue from the surgery or intestinal narrowing can block the waste flow, resulting in cramping, nausea, and vomiting.
• Nutrient Deficiency: The food moves quickly through the small intestine, which reduces the time for nutrient absorption.

Also Read:- Best Gastroenterologists in India

Is Ileostomy Reversible?

If the surgeon has performed the temporary loop ileostomy, it can be reversed 8-12 weeks after the surgery, once the inflammation has subsided. It also depends on the patient’s overall condition when the reversal should be performed. 

The surgeon will reconnect the intestine and close the stoma site, so that the bowel function may take time to normalize.

Final Words

Ileostomy is a major but life-saving surgery that improves the overall quality of life of those individuals who are suffering from severe intestinal diseases. Although it may come with challenges like lifestyle adjustments and stoma care but it also brings relief from pain and restores digestive system function. With the right care and support, life after an ileostomy can be healthy, confident, and full of possibilities.