Ileostomy

What is an ileostomy?

An ileostomy is a surgery that changes the way poop exits your body. Surgeons do this procedure when your large intestine can’t be used to store and move waste.

The ileum is the last portion of your small intestine. During an ileostomy, a surgeon creates a hole in your abdominal wall and brings up the small intestine through this hole. Then, they’ll open part of your intestine (usually the part called the ileum) and sew it to your skin. As a result, poop exits your body through the new hole and collects in an ostomy bag that sticks to your skin. The opening created during your ostomy procedure is a stoma.

Depending on why you need it, an ileostomy can be temporary or permanent. If you have a temporary ileostomy, your surgeon can do an ostomy reversal after some time depending on why you needed the ileostomy in the first place.

Types of ileostomy

There are two main types of ileostomy: end and loop. Both ileostomies work similarly. You won’t have control of when poop comes out of the ostomy into the bag, so you’ll need to wear your bag all the time. Some ileostomies are reversible, and some are permanent.

Loop ileostomy

Your surgeon will do a loop ileostomy when there’s a connection of the intestine with the colon that needs to be protected. In that case, the surgeon goes “upstream” of the connection and brings up a loop of small intestine (the ileum) through the hole in your abdominal wall. Then, they’ll open a part of your intestine and sew it to your skin so poop can exit into an ostomy bag.

End ileostomy

During an end ileostomy, a surgeon will bring the very end of your small intestine through your abdominal wall.

Which conditions are treated with ileostomy?

Healthcare providers use ileostomy to treat a wide range of conditions.

Surgeries that might involve temporary ileostomies include:

• Colorectal cancer.
• Diverticulitis surgery.
• Ulcerative colitis surgery.
• Crohn’s disease.
• Familial adenomatous polyposis surgery.

Conditions that might call for permanent ileostomies include:

• Crohn’s disease (depending on severity).
• Colonic motility dysfunction.
• Blocked, damaged or ruptured large intestines.

How should I prepare for an ileostomy procedure?

Your healthcare provider will tell you how to prepare for your ileostomy. They’ll recommend something (like laxatives or an enema) to clean out your bowels before surgery. You’ll need to fast before your surgery, too. Your healthcare provider will give you detailed instructions.

What happens during an ileostomy?

You’ll be under general anesthesia for your ileostomy. Once you’re asleep, a surgeon will be able to enter your abdomen and find the ileum. Your surgeon will tell you if they plan to do the surgery through a large vertical incision on your abdomen or through small incisions using a very thin camera to see inside.

Using either the end or loop technique, your surgeon will pull your small intestine up to the newly created hole in your belly. They’ll suture your small intestine to the opening and attach an ostomy bag to the hole.

What happens after an ileostomy procedure?

Most people need to stay in the hospital for a few days following their ileostomy. During this time, your medical team will monitor your healing. They’ll also show you how to care for and change your ostomy bag.

What are the benefits of ileostomy?

Temporary ileostomy can give your bowels time to heal after illness or injury. Permanent ileostomy can be a life-saving procedure that allows you to live without a major organ. A permanent ileostomy can also improve your quality of life.

What are the risks of ileostomy?

Any surgical procedure carries risks. Possible complications after ileostomy include:

• Bleeding inside your small intestine or from your stoma.
• Damage to nearby organs.
• Infection.
• Not being able to absorb enough nutrients from food.
• Intestinal blockage due to scar tissue.

What is the recovery time after an ileostomy procedure?

An ileostomy is a major surgery and requires some downtime. On average, it takes about six to eight weeks to recover.

In most cases, you’ll be on a special soft diet after surgery. You’ll be given a list of foods you can and can’t eat.

If you had a temporary ileostomy, your healthcare provider will let you know when it’s safe to do ostomy reversal. Typically, this happens when you’re healed and able to poop through your anus (butthole) again.

When should I call my healthcare provider?

You should call your healthcare provider if you have:

• Cramps lasting more than two or three hours.
• Nausea and vomiting that doesn’t go away.
• Unpleasant odor lasting more than a week. (This may be a sign of infection.)
• A cut in your stoma.
• Injury to your stoma.
• Bad skin irritation or deep sores (ulcers).

In addition, tell your provider if it’s been more than six hours since poop came out of your stoma. This could mean you have a blockage in your bowel.

Are there alternatives to ileostomy?

Any ostomy surgery (ileostomy, colostomy) involves wearing a bag on the outside of your body to catch waste. But depending on your diagnosis, you may be able to have an alternative treatment (called an ileal pouch). There are very specific diagnoses that allow you to have one of these pouches.

With this procedure, a surgeon creates a pouch on the inside of your belly (made from your small intestine) to store poop until it’s time to empty. If you have an ileal pouch, you won’t need to wear an external ostomy bag.

There are three main types of ileal pouches:

• J-pouch.
• S-pouch.
• K-pouch.

If you’ve had your colon and rectum removed due to injury or illness, ask your healthcare provider if you’re eligible for an ileal pouch.

Can you have an ileostomy and still poop?

An ileostomy will change the way you poop. Instead of exiting through your anus, poop exits through your stoma and collects in an ostomy bag.

People with internal ileal pouches can still poop the way they always have, though the frequency of pooping and the consistency of the stool will be different.

Do you still urinate with an ileostomy?

Yes, you can pee the way you always have with an ileostomy.

What’s the life expectancy of a person with an ileostomy?

An ileostomy has no impact on your lifespan. Living with a permanent ileostomy is an adjustment, but it can reduce painful symptoms and improve your quality of life.

A note from Cleveland Clinic

An ileostomy can be a life-changing event, even if the ileostomy is temporary. It can be difficult adjusting to new routines, and the differences you now face can feel isolating. Be patient with yourself. Talk to a counselor or therapist about how you’re feeling. Consider joining a support group. Your healthcare provider is also here to help. Ask them about resources that can help you adjust to life with an ostomy.