Ileostomy surgery involves diverting part of the gut so it opens into a pouch. This kind of surgery is used when part of the intestines is removed, due to the effects of cancer or other diseases which damage the gut. Different types of ileostomy surgery exist, and the procedure may be temporary, as in a loop ileostomy, or permanent. The pouch may be an artificial one, which is worn outside the body, as in an end ileostomy, or it may be constructed from intestines and contained inside the body, as in the case of a continent ileostomy or ileo-anal pouch.
In conditions such as ulcerative colitis and Crohn’s disease, the immune system attacks the intestines causing inflammation, diarrhea and pain. When medication has failed to work, an ileostomy may be required to bypass damaged bowel so that digested food passes straight out into a pouch. Normally, a type of ileostomy surgery known as an end ileostomy is used for patients with inflammatory bowel diseases. In an end ileostomy, the gut passes through a hole in the skin of the abdomen and opens into a synthetic pouch worn outside the body. This is preferred to methods where an internal pouch is created from another part of the gut, as there is a risk that the pouch itself could become affected by the inflammatory bowel condition in time.
When a person has bowel cancer, this sometimes means that a section of intestine has to be removed. After the remaining intestines have recovered, the gut can be joined together again. A type of temporary ileostomy surgery, known as a loop ileostomy, may be used, in which part of the gut is connected to a hole, or stoma, on the surface of the abdomen. This allows feces to pass out into a pouch while the remaining bowel is allowed to heal. Ileostomy reversal surgery allows the stoma to be closed and the intestines connected once more.
An ileo-anal pouch is a type of ileostomy surgery technique where a pouch made from intestines is joined to the muscles around the anus. It is used when the final parts of the gut, the colon and rectum, have been removed and allows feces to be passed relatively normally. If an ileo-anal pouch cannot be created, a continent ileostomy could be used instead. In a continent ileostomy, a pouch is formed from gut tissue and is contained inside the abdomen. As it cannot be emptied like an external pouch, a valve is created in the skin through which a tube can be inserted to drain the contents.