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Ileostomy: Treatment, Procedure, Cost and Side Effects

Last Updated: Dec 05, 2024

What is the treatment?

Ileostomy is the name given to surgically made opening in the abdominal wall of a patient. A stoma is formed on the lower right side of the abdomen, and the end of the ileum is brought through this opening. The stoma is usually covered by a plastic bag so that the waste products, those pass through the colon and is excreted out of the body through the rectum and back passage, can be collected.

Ileostomy is done to stop waste materials from traversing the entire length of the small intestine or colon, either temporarily or permanently. There are a number of reasons why a person may have to undergo this treatment. A doctor may recommend ileostomy to allow the small intestine or colon to heal after it has been operated on. It may also be done relieve the inflammation of the colon that occur in people with Crohn’s disease or ulcerative colitis. Finally, ileostomy may also be done before a complex surgery has to be carried out on the anus or the rectum.

Before the procedure, it is of paramount importance to consult a doctor and a nurse so as to discuss where to make the stoma. There are two types of ileostomy – end ileostomy and loop ileostomy.

How is the treatment done?

In end ileostomy, the whole of the colon or large intestine is removed through an incision in the abdomen. In this procedure, a stoma is formed by dividing the end of the small intestine or ileum, bringing it out through the abdomen via a small incision and then stitching it to the skin. The stitches gradually dissolve and the stoma gets healed. Waste material comes out of this opening in the abdomen and gets collected in a bag that goes over the stoma.

A loop ileostomy requires a loop of small intestine to be pulled out and through an incision in the stomach. A stoma is formed by opening up a section of the intestine and stitching it to the skin. In this procedure, there will be two openings of the stoma and they will generally be situated close together. In this case, the colon and the rectum are left as they are. One of the openings of the stoma are connected to the functioning part of the bowel and waste products are eliminated from here. The other opening is connected to the non-functioning part of the bowel.

It has to be kept in mind that the stoma has no valve or valve-like muscle in contrast to the anus. A person will, thus, not be able to control stool that passes from the stoma. For this reason, a pouch is used to cover the stoma where the excretory products are deposited. The pouch sticks to the skin around the stoma and does not cause much discomfort.

Who is eligible for the treatment? (When is the treatment done?)

Ileostomy is a surgical procedure that a doctor can recommend for a patient under certain circumstances. A person becomes eligible for this treatment if a doctor feels that the small intestine or the colon that has been operated on requires some time to heal. Other circumstances when ileostomy is recommended are to relieve the inflammation of the colon in people suffering from Crohn’s disease or ulcerative colitis or before a complex surgery in the anus or rectum.

Who is not eligible for the treatment?

If a person is not suffering from Crohn’s disease or ulcerative colitis and does not have the corresponding inflammation, he/she is not eligible for ileostomy. A doctor will decide whether a person is suffering from any such condition which requires ileostomy. A person is ineligible for this treatment without the consent of a doctor.

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Are there any side effects?

Some of the side-effects of ileostomy are bowel obstruction which implies that waste materials cannot find a proper way to get out of the body. This can cause a number of complications. A person who has undergone ileostomy can suffer from Vitamin B12 deficiency because this procedure removes a part of the intestine that absorbs the vitamin. Other side effects may include dehydration and related complications like kidney stones and kidney failure. There might also be irritation and inflammation of the skin around the stoma, narrowing and widening of the stoma and other problems as well.

What are the post-treatment guidelines?

Patients are generally required to stay in hospital for a period of about 2 weeks after ileostomy. People may experience a range of physical and psychological problems ranging from skin irritation to feelings of consciousness and anxiety. However, these are mostly short-term. However in reality, this surgical procedure requires a person to follow a number of guidelines. A person will have to learn how to take care of the skin and also how to operate the pouch around the stoma.

How long does it take to recover?

A person may need to stay in hospital for up to a period of 3 weeks. However, the time to recover depends on the general health of the patient and also on the type of surgery conducted. It can be possible for a person to resume normal activities after a period of 8 weeks. However, it is advisable that he/she undertakes strenuous activities only after 3 months. A person can also experience gas and unpredictable discharge from the stoma during the first few weeks after the surgery. These symptoms, however, will subside as soon as a person will recover from the effects of the operation.

What is the price of the treatment in India?

N/A.

Are the results of the treatment permanent?

Ileostomy is done when the colon and the rectum do not function properly. This implies that the waste materials in the body are not excreted trough the rectum and the anus. The waste materials now leave the body through the stoma and the waste materials are collected in a pouch that covers the stoma. The temporary ileostomy surgery requires removal of a part or your entire colon. Permanent ileostomy requires the removal of the rectum, colon and anus. However, in both the cases, the results are permanent.

What are the alternatives to the treatment?

There are no alternatives to the treatment but colonostomy is another surgical procedure by which the diseased portions of the bowel can be removed. A colonoscopy helps to connect the colon to the abdominal wall, unlike ileostomy, that connects the last part of the small intestine to the abdominal wall. There is another procedure called ‘continent ileostomy’ or Kock pouch wherein the feces are not emptied in to a bag worn outside but pools within the looped portions of healthy bowel.

Vitamin B1 deficiency

References

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    Written ByDr. Ojas Potdar MBBS,DNB GENERAL SURGERYGeneral Surgery
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    Reviewed ByDr. Bhupindera Jaswant SinghMD - Consultant PhysicianGeneral Physician
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