Ileostomy - How an ileostomy is formed

There are several different ways an ileostomy can be formed, depending on the reason why the operation is being carried out.

The opening in your abdomen (tummy) where waste material will exit the body after the operation, called a stoma, will normally be located on the right-hand side of your abdomen. However, you will usually meet a specialist stoma nurse before the operation to discuss specific possible locations.

The stoma nurse may draw a dot on your abdomen to let the surgeon know where the preferred site is.

Types of ileostomy

Ileostomy operations are carried out under general anaesthetic, which means you will asleep during the procedure and won't experience any pain as it is carried out.

The two main types of ileostomy are described below.

End ileostomy

An end ileostomy normally involves removing the whole of the colon (large intestine) through an incision in your abdomen. The end of the small intestine (ileum) is divided and brought out of the abdomen through a smaller incision and stitched onto the skin to form a stoma. Over time, the stitches will dissolve and the stoma will heal onto the skin.

After the operation, waste material comes out of the opening in the abdomen into a bag that goes over the stoma.

This type of ileostomy is often, but not always, permanent.

Loop ileostomy

To form a loop ileostomy, a loop of small intestine is pulled out through an incision in your abdomen. This section of intestine is then opened up and stitched to the skin to form a stoma. The colon and rectum are left in place.

In these cases, the stoma will have two openings, although they will be close together and you may not be able to see both. One of the openings is connected to the functioning part of your bowel. This is where waste products will leave your body after the operation. The other opening is connected to the 'inactive' part of your bowel that leads down to your rectum.

The loop ileostomy is usually temporary and may be reversed during a second operation at a later date. Read more about ileostomy reversal.

Ileo-anal pouch

In some cases, it may be possible to have a permanent internal ileo-anal pouch (also known as a J pouch) formed instead of an ileostomy.

An ileo-anal pouch is created from the ileum and joined to the anus, so waste material passes out of your body in the normal way. The pouch stores the waste material until you excrete it when you go the toilet.

The area around the pouch usually needs to heal before it is used, so a temporary loop ileostomy (see above) may be created above the pouch. A second, smaller operation is usually carried out a few months later to close the loop ileostomy.

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