During an ileostomy, a permanent or temporary hole is created in the abdomen, called a stoma. A stoma is a passage from the ileum, the lowest part of the small intestine to the exterior of the abdomen. This allows all the waste material to leave the body via the stomach. The stool or pee is stored in a bag that a patient carries with him or her.
Small Intestine
The small intestine is also called the small bowel. It exists between the stomach and the large intestine. We know that the large intestine consists of the colon and rectum. The function of the small intestine is to reabsorb the nutrients in the blood vessels. Important nutrients are carbs, proteins, fats, etc. The food that is left behind and can’t be digested is moved to the colon. The water is absorbed by the waste b the colon and then it waits for another bowel movement.
Why an ileostomy is performed?
A colostomy is performed to eradicate the lower part of the intestine due to:
This can be due to:
In case of the clogged or ruptured large intestine
Removal of any part of the large intestine
An infection caused by a damaged colon.
People with cancer in the ovaries, uterus cervix or prostate may have a colostomy. Also the patients with Crohn’s disease, pre-cancerous colon polyps can undergo colostomy.
It depends on the condition and reports of the patient. Most of the patients demand a colostomy just for a few weeks after cancer until the colon and rectum get fully recovered. But in some cases, it might be for a lifetime.
Main types of ileostomy
There are three main types of the ileostomy:
Standard ileostomy: This is termed Brooke ileostomy. In this process, the lower part of the small intestine is pulled from the right lower part of the abdomen and stitched to the outside of the skin. Then you need to wear a pouch over the stoma from where the stool passes outs.
Continent ileostomy: There is not a big difference between a continent and a standard ileostomy. During continent ileostomy, a surgeon creates a pouch inside the belly. This pouch is covered with valves on both of its sides. And prevent the urine flow back or leakage into the abdomen. A person needs to put a catheter into the stoma so that the urine could pass outside the body. The type of continent ileostomy depends on the pouch.
Ileo-anal reservoir: This can also be termed as a pelvic pouch or J-pouch. In this procedure, a bag is made from the small intestine and rectum. A surgeon connects this bag to the anus. Feces then pass through this pouch into the anus.
What to except about a surgery?
You will be given anesthesia. The whole procedure involves:
A surgical hole that results in a large cut in the abdomen.
A laparoscopic surgery, in which a less incisive or small cut is formed. This method lessens the pain and healing time.
This surgery may have the following risks:
Internal intestinal or stomal bleeding
Harm to neighboring organs
Any kind of infection difficulty in reabsorption of nutrients
Intestinal obstruction due to any damaged tissue
How to take care of an ileostomy?
Emptying your ileostomy bag: You must empty your colostomy bag many times every day. It will be not under your control to pass waste the waste out in the pouch. It is recommended to empty the pouch when half of its part is filled.
Ileostomy bags have two main types:
A single-piece pouch adheres to the skin barrier directly.
Double-piece pouches, having a separate skin barrier and bag that can be removed from the body.
The skin that covers the nearby areas around a stoma is termed ad peristomal skin. There might be bleeding from this skin and it always gives a red shade, that is fine. But be careful that it doesn’t bleed for a long time.
Skin Care:
The most important fact is that you must ensure that your pouch is linked with stoma properly. It might bring discomfort to the skin if not attached properly. This area needs to be neat and clean, it must be dried completely. There are chances to get an infection, so if you feel any changes in the stoma, please see your doctor immediately.
Using Catheter: In case of consistent urostomy, you need to drain urine with help of a catheter, many times a day. This should be done timely otherwise it will cause infection.
Main Concerns:
High feces output: It is observed that for few days after the surgery some patients have more stool production. As soon as the body of the patient gets used to colostomy and stoma it will get back to normal. But this should be just for a few days, in other cases, you must see your doctor. Continuous and too much feces can lead to dehydration. And you will end up with low electrolytic balance in your body.
Gas managing: The gas also needs to be released out of the pouch. It depends on your pouch. Some pouches are more well organized which helps you to avoid bursting or remove of the bag off the stoma.
The type of colostomy you had and the diet decides the amount of gas stored in a pouch. Food with more carbs and proteins such as alcohol, milk, onion can produce more gas. Avoid chewing gum or drinking via a straw it may lead to the swallowing of air in the colon. Your doctor can better help you with this issue.
Stoma Obstruction: Sometimes happens that you feel pain in the stomach or any kind of discomfort in the belly. This is due to blockage of the stoma, which has occurred due to any piece of food or any necrotic tissue stuck in the stoma.
You can overcome this issue by drinking more water and you may also remove it at home. It also demands massaging sometimes. If you still face these issues, you must look for your doctor.
