Crohn’s disease — an inflammation of the gastrointestinal tract — can be painful and debilitating. Fortunately, an ileostomy may help improve patients’ prognosis.
Crohn’s disease is a chronic inflammatory bowel disease (IBD) that affects as many as 780,000 Americans. It typically appears in individuals between 15-35 years of age, causing persistent flare-ups that put patients at risk for colorectal cancer.
Crohn’s impacts the small intestine and beginning of the colon and is sometimes confused with colitis, a form of IBD that only affects the colon. People with the condition can experience a range of symptoms, including frequent diarrhea, rectal bleeding, persistent vomiting, abdominal pain and cramps, sudden weight loss, and low energy.
The symptoms of Crohn’s disease are not only painful, but they may cause serious damage to the colon. In many cases, a temporary or permanent ileostomy is the most effective solution to reduce the strain placed on the intestines.
An ileostomy is a form of ostomy, a procedure in which the surgeon brings part of an internal organ through an opening in the abdomen. In the case of an ileostomy, the small intestine (ileum) is brought to the surface and stitched to the skin, forming a stoma. This stoma serves as a valve that allows waste to leave the body.
There are several different types of ileostomies. A few of the most common include:
Conventional Ileostomy: A traditional, or Brooke ileostomy, is formed when the doctor brings part of the small intestine to the surface and attaches it to a pouch on the lower right side of the patient’s stomach. This pouch, sometimes referred to as an ileostomy bag, is used to collect waste.
Loop Ileostomy: A loop ileostomy is very similar to a conventional ileostomy, but in this case, a loop of small intestine is brought above the skin, cut, sewn to the abdomen, and attached to a pouch. This method of ileostomy can easily be reversed and is often used when a temporary solution is required.
BCIR: With the Barnett Continent Intestinal Reservoir (BCIR) procedure, a reservoir is created from the patient’s small intestine and connected to a small stoma on the lower abdominal wall. No waste is emitted until the patient chooses to go to the bathroom and painlessly inserts a tube into the stoma.
J-Pouch Ileostomy: This method involves creating a reservoir (j-pouch) from the intestine and connecting it to the anal canal. When the two bowels are attached in this way, waste can pass through the small intestine, into the j-pouch, and out of the anus.
Approximately 50% of Crohn’s patients will require intestinal resection surgery at some point in their lifetime due to intestinal damage. During a resection surgery, the damaged portion of the intestine is removed and the two healthy ends are reattached.
A temporary loop ileostomy can be a smart choice for Crohn’s patients because, when performed in conjunction with an intestinal resection, the risk of anastomotic leakage (a complication associated with the surgery) decreases by nearly 50%. A temporary ileostomy allows the reattached section of the intestine to heal by providing an intermediary outlet for waste and leakage. In cases where damage to the colon is too severe for it to be reattached, a permanent ileostomy offers a safe, alternative solution.
Ileostomies can also benefit Crohn’s patients at risk of developing colorectal cancer. Every flare up of Crohn’s disease causes damage to the colon, which in turn increases the risk of developing colorectal cancer. A temporary or permanent ileostomy can take pressure off of the colon and allow it to recover from any damage it has suffered.
Depending on the type of ileostomy surgery you and your doctor choose, you may need to make a few changes to your day-to-day routine:
Processing Waste: A traditional ileostomy will require the use of an ostomy pouch. Guidelines for emptying a colostomy bag indicate patients should empty the bag between 4-10 times a day, or whenever the bag is one-third to one-half full.
Stoma Maintenance: It’s important to wear a skin barrier that protects the skin surrounding the stoma from irritation-inducing waste. This barrier should be removed daily so the skin below may be cleaned with gentle soap.
Dietary Adjustments: To keep gas at a minimum after ileostomy surgery, doctors recommend limiting your consumption of gas-inducing foods, including dairy, onions, cabbage, garlic, and fish.
To learn more about ileostomies and how they can benefit patients with Crohn’s disease, contact ileostomy expert Dr. Don Schiller at 323-472-9931. You can also request an appointment online.