Ileostomy Procedure

An ileostomy is a surgical procedure that involves creating an opening in the abdominal wall, known as a stoma, to which the bottom of the small intestine (ileum) is attached. This allows waste to leave the body through the stoma, rather than passing through the anus.

Purpose

The purpose of an ileostomy can vary depending on the individual's condition. Some common reasons for undergoing an ileostomy include:

• Treatment of inflammatory bowel diseases such as Crohn's disease or ulcerative colitis
• Removal of a portion of the intestine due to cancer, injury, or other conditions
• Diverticulitis or other conditions that affect the large intestine
• Bowel obstruction or blockage

Types of Ileostomy

There are several types of ileostomy, including:

• End ileostomy: This is the most common type, where the end of the ileum is brought through the abdominal wall to create a stoma.
• Loop ileostomy: This involves creating a loop in the intestine and bringing it through the abdominal wall to create a stoma. The loop can be reversed at a later time if necessary.
• Double-barrel ileostomy: This involves creating two separate stomas, one for the small intestine and one for the large intestine.

Surgical Procedure

The surgical procedure for an ileostomy typically involves:

• General anesthesia to ensure the patient is comfortable and pain-free during the procedure
• An incision in the abdominal wall to access the intestine
• Location and preparation of the ileum for attachment to the stoma
• Creation of the stoma by bringing the ileum through the abdominal wall
• Attachment of the ileum to the skin around the stoma using sutures or staples

Post-Operative Care

After an ileostomy, patients typically require:

• Pain management through medication and other methods
• Wound care to promote healing of the stoma site
• Dietary changes to manage output and prevent dehydration
• Ostomy care and management, including emptying and cleaning the pouching system

Risks and Complications

As with any surgical procedure, there are risks and potential complications associated with an ileostomy, including:

• Infection of the stoma site or surrounding tissue
• Bleeding or hemorrhage
• Adhesions or bowel obstruction
• Nutritional deficiencies due to malabsorption
• Psychological and emotional adjustment to living with an ostomy

Reversal of Ileostomy

In some cases, it may be possible to reverse the ileostomy and reattach the intestine. This is typically considered if:

• The underlying condition has been resolved or managed
• The patient's overall health has improved
• The stoma is no longer necessary for waste management

Reversal of an ileostomy requires additional surgery and may involve reattachment of the intestine, closure of the stoma, and restoration of normal bowel function.