Ileostomy surgery is performed to “bypass” the colon or large intestine, allowing stool to be removed from the body through the small intestine before it has a chance to enter the colon. During ileostomy surgery, the end of the small intestine (called the ileum) is “disconnected” from the colon and attached to the abdominal wall, creating an opening called a stoma. As waste is produced by the small intestine, it’s collected either in an external pouch or internally (sometimes called a K-pouch ileostomy or a continent ileostomy). Both internal and external pouches need to be emptied regularly, but internal pouches allow the patient greater control over when the waste is emptied.
While some people will have an ileostomy for the rest of their lives, in some instances, the ileostomy may be temporary, used for a specific period of time and then “reversed” during a second surgical procedure.
In general, a temporary ileostomy is used when a portion of the intestine needs to be temporarily bypassed, allowing that portion of the bowel to heal. A good example is when a portion of the colon is removed due to cancer. In some instances, a temporary ostomy may be performed to enable the surgical site to heal without the stress of bowel movements. The ostomy allows the bowel to rest and remain free of stool throughout the healing process. Once the area is healed, the ostomy will be reversed and the bowel will contribute to function as it did prior to surgery. A temporary ileostomy may remain in place for weeks, months or longer, depending on the condition that’s being treated and the speed at which the area heals. A temporary ileostomy may also be performed as part of a multi-stage surgical procedure, like J-pouch surgery (also called ileoanal pouch surgery).
Permanent ileostomies are used when a large portion of the colon or the entire colon and rectum are removed, or when the bowel is badly diseased and can no longer perform its normal functions. In the case of a permanent ileostomy, you and your surgeon will discuss all your options, selecting the best type of surgery for your needs, your health and your lifestyle.
Having an ileostomy, whether permanent or temporary, represents a major change in your bowel habits, and for many patients, the change is disconcerting and even alarming. The good news is, ostomy surgery has experienced significant advances during the past couple of decades, and today’s ostomy patients find they can enjoy the same types of activities, foods, and lifestyles as before surgery. The key is to work with an experienced surgeon who’s skilled in multiple treatment options so you can feel confident your procedure will be optimized for your lifestyle and your medical needs.
Dr. Don Schiller is recognized as a leading ileostomy surgeon, providing state-of-the-art care for patients in and around Los Angeles. To learn more about ileostomy procedures, including K-pouch ileostomy and BCIR ileostomy that eliminates the need for external bags, or to find out more about adjusting to an ileostomy after surgery, call Dr. Schiller at 323-472-9931 and schedule an office visit today.