What Is an Ileostomy?
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Ileostomy: How It’s Performed, What to Expect, and More

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Published on October 11, 2024
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An ileostomy is a surgical procedure that changes how the body releases stool (poop) from the body. Ileostomies are performed to treat various health conditions. Some ileostomies are temporary while others are permanent.

Overview

What Is an Ileostomy?

As mentioned, an ileostomy is a surgical procedure that alters the way stool leaves the body. Typically, ileostomies are performed when the large intestine (also known as the colon) is not functioning properly and is unable to store and process waste as it should.

During an ileostomy, a surgeon will create a small hole in your abdominal wall. Then, they’ll bring the bottommost part of your small intestine, called the ileum, through the hole. The ileum is then sewn to the skin to hold it in place, and a bag (called an ostomy bag) is placed over the hole to collect stool. This hole is called a stoma.

An ileostomy may be temporary or permanent, depending on why you need it. If you need a temporary ileostomy, that likely means your stool will be temporarily diverted away from the large intestine to give it time to heal, leaving the connection between the ileum and the large intestine so that the surgery can be reversed later.

If both your large intestine and rectum will be removed, your ileostomy will likely be long-term or permanent. Your doctor will talk to you about your options and help you decide which one would work best for you.

Most people who undergo ileostomy are able to return to their usual activities, including working, traveling, gardening, hiking, or sports. If your ileostomy was needed because of a chronic condition, you may need continued treatment afterward.

Loop Ileostomy vs End Ileostomy

There are two main types of ileostomies: loop ileostomies and end ileostomies.

A loop ileostomy is usually a temporary one. It’s used for a short time to protect part of the colon that may need some time to rest and heal, including in situations where a portion of the colon is removed because of disease.

To perform this type of ileostomy, a surgeon will bring a section, or “loop,” of your small intestine through the opening made in your abdominal wall while leaving a connection between the small and large intestines. This allows the ileostomy to be reversed later if needed.

An end ileostomy can be temporary or permanent, depending on why you need the ileostomy. An end ileostomy is done by separating the small intestine from the large intestine and pulling the ileum of the small intestine through the hole made in the abdominal wall. Some or all of your large intestine may be removed during this procedure.

Why Is an Ileostomy Done?

Doctors may recommend an ileostomy if a health issue involving the large intestine can only be improved with surgery. This may include conditions such as:

Of these conditions, ulcerative colitis, colonic dysfunction, and damaged, blocked, or ruptured large intestine are most likely to require a permanent ileostomy.

Illustrative graphic titled What to Know Before an Ileostomy shows Your bowels must be completely emptied out, Your doctor may tell you to take laxatives or enemas beforehand, You’ll have to fast for several hours prior — follow your doctor’s instructions
Here’s what you need to know as you prepare for an ileostomy.Everyday Health

How Is an Ileostomy Performed?

An ileostomy is performed by a surgeon. You’ll be put under general anesthesia, meaning you’ll be asleep for the whole procedure. Your surgeon will discuss with you whether your surgery will be done laparoscopically, which means using a few small incisions and a tiny camera, or if it will be an open surgery, which means it’s performed through a singular large incision.

Using either the loop or end technique, your surgeon will pull your ileum up through your abdominal wall to form a stoma, which will function to empty stool into the ostomy bag that will be stitched to your skin.

How Do I Prepare for an Ileostomy?

Your doctor will talk to you about any prep you need to do before your ileostomy. This often includes taking laxatives or enemas to help empty your bowels prior to your surgery.

 You may also have to fast, or refrain from eating or drinking, for at least six hours prior to your procedure. Your doctor will give you dietary instructions for the days and hours leading up to the ileostomy.

Be sure to tell your doctor about any medications or supplements you’re taking. They’ll give you specific instructions about how to take your medicines safely as you prepare for your ileostomy or whether you need to hold off on any medicines. For example, your doctor may tell you to stop taking any drugs that make it difficult for your blood to clot, such as aspirin, ibuprofen, or naprosyn.

What Should I Expect During an Ileostomy?

On the day of your surgery, you may be asked to shower with a special soap to help cleanse the area of skin where your incision will be made. You’ll also be asked to avoid using lotions, deodorants, or perfumes beforehand. You’ll be asked to change into a hospital gown and compression stockings and to remove any jewelry, makeup, nail polish, glasses, contacts, or dentures if you have them.

You’ll then be taken to the operating room, and you’ll be given an anesthetic so that you stay asleep throughout surgery. Then, your surgeon will operate.

What Type of Care Is Needed After an Ileostomy?

After an ileostomy, you’ll need to stay at the hospital for 3 to 10 days while you wait for your stoma to start functioning properly. You’ll likely be started on a liquid-only diet at first while your gastrointestinal tract recovers from the effects of the anesthesia. You’ll then progress to eating soft, easily digestible foods. You can likely go back to eating normally after a few days.

If your doctor clears it, try to get moving again as soon as possible after surgery. This can help you get your bowels back to normal more quickly, as well as help your lungs start functioning normally again. Your care team will suggest activities to help with this, such as sitting in a chair or walking.

During your hospital stay, your stoma nurse will teach you about your stoma and ostomy bag, including how to clean your stoma, how to change the ostomy bag, and what to expect as your body heals after surgery.

What Are the Potential Complications and Side Effects of an Ileostomy?

Any surgery comes with side effects and risks. The most common risks associated with ileostomy are:

  • Bowel obstruction A blockage can occur due to the development of scar tissue or other reasons. This could increase your hospital stay while doctors wait for it to heal. If it’s serious enough, this could cause the need for another surgery.
  • Colic and gas Once your stoma starts functioning properly, you’ll likely experience some colic and gas. Although uncomfortable, this will pass.
  • Damage to surrounding organs
  • Dehydration This happens because having an ileostomy makes it more challenging to stay hydrated. It’s important for you to know the symptoms of dehydration, such as dry mouth or fatigue, and let your care team know if you’re having them.
  • Inability to absorb enough nutrients from food to meet your body’s needs
  • Infection There’s a chance your stoma could become infected. If that happens, you’ll likely receive antibiotics for the infection.
  • Problems with your stoma These could include bleeding from your stoma, development of a hernia, your stoma falling back into your abdomen, your stoma sticking too far out, or skin issues around the stoma site.

What’s Next?

An ileostomy is a major surgery. It can take six to eight weeks for your body to heal afterward, so you’ll need to take it easy for a while. Your doctor will give you specific instructions to follow during this recovery period. These may include temporary diet and activity restrictions. You’ll have follow-up appointments with your doctor and ostomy nurse to ensure you’re healing well after your surgery.

If your ileostomy is temporary, your doctor will let you know when it’s safe to complete the reversal surgery. That’s usually after your large intestine has healed and can function properly again.

The Takeaway

An ileostomy is a surgical procedure that reroutes the way the body removes stool by creating an opening in the abdominal wall. It can be a temporary or permanent solution to manage gastrointestinal issues, such as Crohn’s disease or ulcerative colitis. Post-surgery, a stoma care nurse will guide you through managing your new lifestyle, which includes caring for your stoma and ostomy bag.

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Ira Daniel Breite, MD

Medical Reviewer
Castle Connolly Top Doctor

Ira Daniel Breite, MD, is a board-certified internist and gastroenterologist. He is an associate professor at the Icahn School of Medicine at Mount Sinai, where he also sees patients and helps run an ambulatory surgery center.

Dr. Breite divides his time between technical procedures, reading about new topics, and helping patients with some of their most intimate problems. He finds the deepest fulfillment in the long-term relationships he develops and is thrilled when a patient with irritable bowel syndrome or inflammatory bowel disease improves on the regimen he worked with them to create.

Breite went to Albert Einstein College of Medicine for medical school, followed by a residency at NYU and Bellevue Hospital and a gastroenterology fellowship at Memorial Sloan Kettering Cancer Center. Working in city hospitals helped him become resourceful and taught him how to interact with people from different backgrounds.

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Shelby House, RN, BSN

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Shelby House, RN, BSN, has been a registered nurse for almost 10 years. She currently serves as a nursing director for a program that provides healthcare services to underserved Missourians, specifically aiding those with mental health disorders in achieving their best state of physical health.

She received her bachelor's degree in nursing from Maryville University in Missouri. She has worked in the specialty areas of medical-surgical nursing, cardiopulmonary rehabilitation nursing, mental health nursing, and nursing leadership.

Outside of the office, Shelby enjoys spending time with her husband and two young children, volunteering in her local community, and soaking up the countryside scenery of rural America where she lives.

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