The food that travels through our digestive system, begins its way in the pharynx, continues through the esophagus to the stomach, and finally passes through the intestines and anus. Various disorders of the gastrointestinal tract may lead to the need to "divert" the regular trajectory of food by external removal of the stoma - an external opening with a bag into which secretions from the gastrointestinal tract will be drained.
An ileostomy is a creation of a stoma from the small intestine.
When should an ileostomy be performed?
A stoma from the small intestine can be used as a temporary or permanent treatment for a variety of medical and surgical conditions. When intestinal damage occurs - for example due to surgery, infection, blockage, perforation or uncontrolled inflammatory bowel disease - sometimes the damage can not be repaired immediately. In these instances the intestine is given time to heal and recover.
Healing occurs when a stoma is constructed at the small intestine, so that the digestive products are secreted into the stoma at an early stage of digestion, and can allow the rest of the intestine to 'rest'.
On occasion, after recovery, the parts of the intestine can be reconnected and the stoma closed, whilst other times it becomes a permanent stoma. The stoma can also be used to treat uncontrolled inflammatory bowel disease.
The course of the surgery
There are several possible techniques for performing an ileostomy. The technique is determined, among other things, by the purpose of the stoma - permanent or temporary.
A temporary stoma is often performed by a loop ileostomy, in which a small incision is made in the abdominal wall and a small loop from the small intestine is pulled out through the incision. The same loop is opened and sewn to the skin wall.
In contrast, a permanent stoma is usually performed by the end ileostomy method, in which the small intestine is separated from the large intestine. The opening of the small intestine is sutured to the skin to create the stoma. In both cases, the intestinal stump is attached to an outer sac.
The operation is performed under general anesthesia and lasts about an hour.
Preparation before surgery
Before removing the stoma, an evaluation must be performed by a surgeon in order to adjust the stoma and give better understanding to the meanings of life with a stoma.
In addition, a preliminary evaluation by an anesthesiologist should be performed. You should be in complete food and liquid fast according to staff instructions.
Recovery after ileostomy
Hospitalization after ileostomy may be prolonged and depends on the individual's personal recovery rate, as well as the initial reason for performing the ileostomy. During the hospitalization you will receive full instruction on how to manage the stoma.
It is important to gradually get used to living with a stoma. Maintaining the hygiene of the stoma and the skin around it reduces the rate of complications. Despite the initial difficulty, the stoma often improves quality of life after a while.
In the case of a temporary stoma, the closure is usually performed within about 12 weeks of the ileostomy, after the small intestine has recovered.
Possible complications
Removing the small intestine through the abdominal wall may involve some unique complications. Among other things, there may be a bowel obstruction, or alternatively an increased outflow of intestinal contents through the stoma due to changes in digestion. On occasion it is a problem that improves over time, but in some cases it is necessary to seek medical attention.
Vitamin deficiencies, and in particular vitamin B12 absorbed through the small intestine, may develop over time and should be monitored by medical staff in order to deal with them properly.
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