Ileostomy – NHS inform

An ileostomy is a significant surgical procedure that diverts waste from the small intestine to an external bag through an opening in the abdomen, known as a stoma. This surgery is typically necessary for patients suffering from severe bowel diseases or injuries, allowing them to lead healthier lives post-surgery.

Understanding the implications and care involved in ileostomy is essential for patients and their families. This article delves into various aspects of the ileostomy procedure, providing comprehensive insights on preparation, types, risks, and post-operative care.

Why is an ileostomy done?

An ileostomy is often performed when there are serious health conditions affecting the large bowel. The primary reasons for needing an ileostomy include bowel cancer, inflammatory bowel disease (IBD), and bowel obstructions. In such cases, removing or resting the colon allows for better health outcomes.

Patients might also undergo this procedure in emergencies, such as severe infections or injuries that necessitate immediate surgical intervention. By creating a stoma, the body is able to eliminate waste without passing it through the diseased portion of the bowel.

The decision to perform an ileostomy is typically made after careful consideration of the patient’s overall health and specific medical conditions. In many cases, it can be a temporary solution, with the possibility of reversal after the underlying issues have been addressed.

What are the types of ileostomy?

There are several types of ileostomy procedures, depending on the patient’s condition and needs:

  • Temporary ileostomy: This is often used to allow the bowel to heal after surgery, especially in cases of inflammatory bowel disease or following bowel resection.
  • Permanente ileostomy: This is necessary when the entire colon needs to be removed, often due to cancer or severe disease.
  • Continent ileostomy: In this technique, a pouch is created inside the abdomen, which can be emptied through a valve.

Choosing the right type of ileostomy is crucial and is determined by the underlying medical conditions. Patients should consult with their healthcare providers to understand which option is best suited for their situation.

What are the risks associated with ileostomy surgery?

Like any surgical procedure, ileostomy comes with its own set of risks. Some of the potential complications include:

  • Infections: At the site of the stoma or within the abdomen, infections can occur and may require treatment.
  • Blood clots: These can develop in the legs or lungs, particularly during the recovery phase.
  • Stoma complications: Issues such as retraction, prolapse, or skin irritation can arise and should be addressed promptly.

Patients must be aware of these risks and engage in discussions with their surgical teams to mitigate them effectively. Proper post-operative care and regular check-ups contribute significantly to a smoother recovery process.

How is an ileostomy performed?

The ileostomy procedure generally involves the following steps:

  • Preparation: Before surgery, patients undergo various assessments and may need to follow a specific diet and bowel prep.
  • Incision: The surgeon makes an incision in the abdomen to access the small intestine.
  • Stoma creation: The end of the ileum is brought through the abdominal wall, forming a stoma.
  • Closure: The incision is closed, and a bag is fitted over the stoma to collect waste.

The surgery can be performed via traditional open surgery or laparoscopic techniques, which are less invasive and may result in quicker recovery times. The choice of technique depends on the patient’s condition and the surgeon’s expertise.

What happens after an ileostomy procedure?

Following the ileostomy procedure, patients enter a crucial recovery phase. Initially, they may experience some discomfort and will be closely monitored in the hospital.

During this time, education on stoma care will be provided, as it is essential for managing the stoma and preventing complications. Patients will learn how to change the bag, care for their skin, and recognize signs of potential issues.

As recovery progresses, most patients can gradually return to normal activities. However, dietary adjustments may be necessary, and individuals are encouraged to stay hydrated, especially as the ileostomy can lead to changes in bowel habits.

How to care for a stoma at home?

Caring for a stoma is vital for preventing complications and ensuring quality of life. Here are some essential tips for stoma care:

  • Keep the area clean: Regularly clean the skin around the stoma to prevent irritation.
  • Change the bag regularly: Ensure that the stoma bag is changed according to healthcare provider recommendations.
  • Monitor for issues: Look for signs of redness, swelling, or unusual discharge, and consult a healthcare provider if any concerns arise.

Additionally, maintaining a balanced diet and staying active can aid in the adjustment period after surgery. Patients should reach out to their healthcare teams for personalized advice on managing their new lifestyle.

What are the alternatives to an ileostomy?

For patients facing bowel issues, there are alternatives to an ileostomy that can be considered:

  • Colostomy: Similar to an ileostomy, but involves the large intestine, allowing waste to exit through a stoma.
  • Sigmoid colectomy: A procedure that removes the sigmoid colon and connects the remaining parts of the colon.
  • Ileoanal pouch: In this approach, the ileum is connected to the anus, allowing for natural waste elimination.

Selecting the best alternative depends largely on the patient’s specific medical condition and their healthcare provider’s recommendations. Open conversations with healthcare professionals can help patients make informed decisions about their treatment options.

Questions related to ileostomy

What is the biggest patient problem for an ileostomy?

One of the most significant challenges faced by patients post-ileostomy is managing their stoma and adjusting to changes in bowel habits. Many experience psychological impacts, such as anxiety about body image and social interactions. Support groups and counseling can be beneficial in helping manage these issues.

Is an ileostomy considered a disability?

An ileostomy can be classified as a disability, particularly if it significantly impacts daily living activities. Many patients are eligible for disability benefits depending on their specific circumstances and local legislation.

Are stoma bags free on NHS?

In the UK, patients are generally provided with stoma bags and associated supplies free of charge under the NHS. It’s essential for patients to consult their healthcare provider for detailed information on obtaining these supplies.

Can you get PIP if you have an ileostomy?

Patients with an ileostomy may be eligible for Personal Independence Payment (PIP), which is intended to assist those who face extra costs due to their health condition. Eligibility is assessed based on individual needs rather than the condition itself, so patients should apply and provide the necessary supporting documentation.