An ileostomy is a surgical technique employed to establish an aperture in the abdominal wall. This allows waste to exit the body when the colon or rectum is unable to function normally.
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An ostomy may be performed in certain cases of:
- Small intestine cancer
- Colorectal cancer
- In other cases of cancer when they have invaded the colon or rectum (this may, for example, be the case with ovarian cancer)
- Inflammation of the stoma site
- Death of the tissue surrounding the stoma
- Laceration of the stoma
- Shrinkage of the skin around the stoma
- About two hours under general anesthesia
- After 3 months
What is ileostomy?
An ileostomy is the surgical diversion of a portion of the small intestine, typically the lower end known as the distal ileum, to the outside of the body. It serves as a replacement for the natural anus, facilitating the expulsion of stool before it reaches the normal passage for fecal discharge.
During the procedure, a small incision is made in the abdomen and a pouch is placed to collect fecal waste. The stoma, which lacks the muscular control to hold stool, allows stool to pass unimpeded but requires containment by the collection pouch.
When is an ileostomy indicated?
An ileostomy is recommended in many situations:
- In cases of colorectal cancer: An ileostomy can be performed in conjunction with colon resection surgery to divert stool flow and protect the anastomosis (intestinal junction).
- In the presence of intestinal obstruction.
- To treat intestinal lesions following abdominal trauma.
- For Crohn's disease, although it is not the first surgical option.
- For ulcerative colitis, when the disease no longer responds to medical treatment.
In addition, ileostomy may be temporary, when recovery of bowel function is expected, or permanent.
Types of ileostomy
| Type of Ileostomy | Description | Purpose |
| Temporary ileostomy | A temporary opening in the ileum that allows stool to pass out of the body. | To allow the colon or rectum to heal after surgery or to treat a condition that is causing problems with the colon or rectum. |
| Permanent ileostomy | A permanent opening in the ileum that allows stool to pass out of the body. | When the colon or rectum cannot be saved or when the condition is so severe that it is not possible to reverse the ileostomy. |
| Standard ileostomy or Brooke ileostomy | The most common type of permanent ileostomy. | To create a stoma that allows stool to pass out of the body. |
| Continent ileostomy or Kock pouch | Less common than the standard ileostomy. | To create an internal reservoir that can be emptied by catheter several times a day. |
| Ileal-anal reservoir (J-pouch or pelvic pouch) | Even less common than the continent ileostomy. | To create an internal reservoir that is similar to the rectum and connected to the anus, allowing stool to pass through the anus. |
Pre-operative preparation for surgery
Since this is a delicate and complex operation, a series of tests and precautions are necessary before proceeding with an ileostomy in Turkey.
In this respect, these preparations involve:
- Blood and urine test results.
- An electrocardiogram.
- A chest X-ray.
After a thorough analysis of the patient's medical history (previous surgeries, any allergies, or current pathologies) and an assessment of his or her surgical suitability, preoperative preparation will be necessary. This includes:
- Appearance on an empty stomach for at least the previous day.
- Stopping of anticoagulant and antiplatelet medications.
- Taking a laxative a few hours before surgery.
The course of the ileostomy in Türkiye's clinics
During an ileostomy in Türkiye, part of your thick intestine, otherwise known as the ileum, is pulled across the surface of the abdomen to create a stoma. Indeed, an ileostomy is usually performed in cases where the colon is reached and put in the right area of your abdomen. Thus, the ileostomy can be temporary or chronic. It depends on the reasons that led to the surgery or how difficult your situation is. In this part of the intestine, the stools are watery. Since an ostomy does not have muscles that are used to control the evacuation, the stool must be assembled through a pouch.
A stoma is red and looks like the inside of your mouth. It is delicate and can bleed easily when touched.
The ileostomy follows the movement of the bowel. It can expand and contract during bowel movements. It is measured by sutures, which disappear within the first two months.
Post-operative diet and medications
Before your operation, and during the consultation, your doctor will tell you to avoid caffeine, alcohol, tobacco, or other drugs. Using any of these products before or after surgery can affect the outcome of the surgery.
Post-operative Diet
After an ileostomy, it is important to follow a diet that is low in fiber and easy to digest. This will help to prevent blockages and allow your stoma to heal properly.
| Low-fiber foods | White bread, pasta, rice, cooked vegetables, and canned fruits. |
| High-protein foods | Lean meats, poultry, fish, eggs, nuts, and seeds |
| Plenty of fluids | Drink plenty of water and other fluids throughout the day to stay hydrated |
Post-operative medications
Your doctor may prescribe medications to help you manage your ileostomy. These may include :
- Pain relieveers for post_surgery discomfort.
- Antispasmodics to control bowel spasms and reduce cramps.
- Stool softeners to prevent constipation and ensure smooth bowel movements.
You will also need a stoma care products, such as ostomy pouches, barriers, and skin protectants, to manage your ileostomy.
It is strongly recommended that you avoid activities that require exertion for about four to six weeks after surgery.
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Yes, most individuals with an ileostomy can continue to enjoy a varied diet. However, it may be necessary to make certain dietary modifications to prevent blockages and ensure adequate nutrition. Consult with a healthcare professional or registered dietitian for personalized dietary advice.
No, an ileostomy should not hinder your ability to engage in physical activities and exercise. With proper care and precautions, individuals with an ileostomy can pursue a wide range of activities, including sports, yoga, and weightlifting.
In some cases, it may be possible to reverse an ileostomy. This procedure, known as ileostomy reversal, reconnects the small intestine to the remaining part of the digestive tract. However, the decision to undergo ileostomy reversal depends on individual circumstances and should be discussed with a healthcare professional.
