An ileostomy is a stoma that has been constructed by bringing the end of the small intestine (the ileum) out onto the surface of the skin. Intestinal waste passes out of the ileostomy and is collected in an external bag stuck to the skin. Ileostomies are usually sited above the groin on the right hand side of the abdomen.

Reasons for having an ileostomy

Ileostomies are necessary where disease or injury has rendered the large intestine incapable of safely processing intestinal waste, typically because the colon has been wholly removed. Diseases of the large intestine which may require surgical removal include:

• Crohn's disease
• ulcerative colitis
• Familial adenomatous polyposis

An ileostomy may also be necessary in the treatment of colorectal cancer, for example in cases where the tumor is causing a blockage. In this case the ileostomy may be temporary, as the common surgical procedure for colorectal cancer is to reconnect the remaining sections of colon or rectum following removal of the tumor provided that enough of the rectum remains intact to preserve sphincter function.

Living with an ileostomy

People with ileostomies must wear an external pouch to collect intestinal waste. Modern pouches are made of lightweight plastic and are attached to the skin with an adhesive wafer made of pectin or similar organic material. The wafer is cut with a hole to fit snugly around the base of the stoma to prevent leakage of stool onto the skin (and consequent skin irritation). The pouch and wafer may be purchased as a one-piece unit or as two separate pieces which attach with a plastic locking ring. The latter arrangement allows pouches to be swapped without removing the wafer; for example, some people prefer to temporarily switch to a "mini-pouch" for swimming or other activities. Regular pouches have an open end on the bottom for emptying which is otherwise kept closed with a leakproof clip. Ordinarily the pouch must be emptied several times a day (many ostomates find it convenient to do this whenever they make a trip to the bathroom to urinate) and changed every 2-5 days, when the wafer starts to deteriorate.

Ostomy pouches fit close to the body and are usually not visible under regular clothing unless the wearer allows the pouch to become too full.

Some people find they must make adjustments to their diet after having an ileostomy. Tough or high-fiber foods (including, for example, potato skins and raw vegetables) are hard to digest in the small intestine and may cause blockages or discomfort when passing through the stoma. Chewing food thoroughly can help to minimize such problems. Some people also find that certain foods cause annoying gas or diarrhoea. Nevertheless, people who have an ileostomy as treatment for inflammatory bowel disease typically find they can enjoy a more "normal" diet than they could before surgery.

Other options

Since the late 1970's an increasingly popular alternative to an ileostomy has been the ileo-anal pouch. With such a pouch an internal reservoir is formed connecting the end of the small intestine to the rectum, thus removing the need for an external appliance.

External links

• The Ileostomy and Internal Pouch Support Group
• United Ostomy Association
• Shaz's Ostomy Pages
• Ulcerative Colitis/Ileostomy Case History