What is Ileostomy and Colostomy, Why & How is it Done?

As stated in the Medical chronology, Ostomy is said to be a procedure mandating for the creation of an opening in the body that allows easy discharge of body wastes. It is a surgical process requiring the patient to be hospitalized 24 hours before surgery. Segregating the term of Ostomy, Ileostomy and Colostomy are the ones taking place frequently. Being associated with stomach, they are carried out with utmost care. Ileostomy is a surgical process wherein the end part of the small intestine known as the Ileum is brought to the surface of the stomach through a surgical opening known as stoma. Colostomy, on the other hand, is also done for creating a stoma to let out the healthy part of the colon or large intestine through a surgical procedure. Both the procedures, Ileostomy and Colostomy are done to help in the process of excretion.

What is Ileostomy?

Ileostomy – The How’s and Why’s

What is Ileostomy?

The process of Ileostomy is described by creating a surgical opening called stoma in the small intestine by bringing its loop over the surface of the skin. As the surgical process is carried out, an ostomy pouch is connected to the area that collects intestinal waste in it. Indeed, this medical procedure is carried out because large intestine fails to process intestinal waste safely. These are viewed over the Groin at the right side of abdomen.

Being a slightly new technology with well-developed post-operative care measures, ileostomy has been considered effective in treating ulcerative colitis and Crohn’s disease. Though, the first example of Ileostomy was seen in 1879 by a German surgeon by the name of Baum; but, it was a temporary treatment. From there on, the technique of Ileostomy developed and bettered for having excellent results.

Why is Ileostomy Done?

Ideally stating, Ileostomy is carried out on a patient because of the fact that their large intestine becomes incapable of eliminating the intestinal waste. The reason behind this fact is partially or completely removal of rectum and colon. Problems with large intestine which might necessitate ileostomy could be Crohn’s Disease, Hirschsprung’s Disease, familial polyposis, ulcerative colitis, etc. Besides this, the process of Ileostomy might also be mandatory in the case of ovarian cancer. In this matter, the Ileostomy is carried out on a temporary basis to recombine the remaining parts of rectum or colon as a result of removing tumor. As a part of this procedure, a loop of ileum is exclusively brought through the skin by generating a stoma. The lower part of the ileum is kept untouched for further treatment on need. As the wound gets heeled, surgical repairing is done effectively.

How is Ileostomy Done?

Certainly, Ileostomy is done to make way for the intestinal waste to be released through large intestine because the small intestine gets blocked. The colon and rectum is removed under the effect of general anesthesia. For conducting the surgery, an 8-inch long incision is made in patient’s midline through abdominal skin, muscle as well as sub-cutaneous tissues. On opening the cavity of abdomen, rectum and colon are secluded as well as removed. There are many patients undergoing provisional circumvent of colon and rectum.

With two kinds of permanent ileostomy, the surgeons apply conventional or continent method of operation. Also called as Brooke Ileostomy, conventional way calls for making a separate and small sized incision through the lower side of the abdominal wall and the cut end of ileum is sewed. As the conventional ileostomy gets completed, a plastic bag is attached to the stoma with the help of a medicated adhesive. On the other hand, Continent Ileostomy enables a sufferer to exercise control of the occurrence of waste from stoma. An internal pouch is created where the waste gets collected and it also prevents leakage. The waste is then drained out using a catheter.

What Are The Post Ileostomy Complications?

There are no general complications post-surgery because of the fact that patients are required to take care extensively. The pouch is required to be changed regularly as advised by the doctor or nurse for maintaining hygiene of the body. As a colostomy bag is light enough to be easily carried under the clothes, doctors recommend wearing little loose dresses; rather than the fitted ones. On essentiality, the healing process can be carried out for better feeling by making sutures. However, common post-surgical complications viz., bleeding in waste or catheter, infection, weakness, discomfort in the surgical site etc. could be present. Yet, none of the post-surgical complications should be taken lightly.

Colostomy: The How’s and Why’s?

What is Colostomy?

Basically, Colostomy is defined as a surgical procedure calling for linking of a colon’s part with that of the anterior abdominal wall. As a part of it, the patient is given an opening on the stomach naming Stoma. The stated opening is created by drawing out the end of large intestine through a specialized incision made by the surgeon and sutured to the skin. On completion of the colostomy surgery, feces gets extracted from a patient’s body through stoma and gets collected in a colostomy pouch, which is attached to the abdomen of the patient. The pouch can be changed as per need or when it gets filled.

Indeed, first ever record of a colostomy surgery was carried out in 1710 by Dr. A De Littre, who christened the stoma as a treatment of anustresia. This is a congenital abnormality, which talks about anus not being completely developed. As per this treatment method, an artificial output was created towards the left side of the abdomen.

Why is Colostomy Done?

There are certain issues associated with stomach injury that requires colostomy procedure for extraction of intestinal waste. In fact, infection in stomach because of punctured diverticulitis leads the patient to undergo colostomy. Apart from this, injury to the rectum or colon, partial or complete blockage of large bowel, rectal cancer, and fistulas coming in perineum are some of the other reasons that demands for immediate colostomy surgery. Definitely, whether a temporary or permanent colostomy needs to be done is decided by the surgeon on analyzing the condition of abdominal disease.

How is Colostomy Done?

Essentially, the procedure of colostomy is done for the purpose of bowel resection and injuries in the abdomen. At the very first outset, colostomy patient is given a general anesthesia. Further to this, the procedure may start with a large surgical cut in the abdomen or by using a smaller camera as well as varied small cuts. The latter part of surgery is called laparoscopy. Definitely, the decision of the procedure rests on surgeon. Well, a surgical incision is made in the middle of stomach, which follows by bowel resection. Followed by it, healthier part of the colon was brought out via an opening created in the abdominal wall. Then, the edges of a bowel are joined together to the opening of a skin through sutures. A colostomy bag is then attached to the opening called stoma for the waste collection. In case of temporary colostomy, the first colostomy may last for a couple of weeks depending on the healing process. Then, another minor surgery takes place to close the stoma.

What Are The Post Colostomy Complications?

There are many surgical procedures that come with certain risk factors or post-operative complications. Likewise, colostomy also carries away some complications that must be treated well on time for avoiding any kind of medical emergency. Bleeding within stomach, damage to nearby organs, hernia, urinary tract infection, narrowing of opening in colostomy, skin inflammation and scar tissue creating intestinal blockage are some of the other complications that might occur in a patient undergone colostomy. Other complications could be infection, pain and cramps that last for more than 2 to 3 hours etc. In the state of emergency, one should always rush to the respective surgeon, who has done colostomy.

Diet Post Ileostomy and Colostomy:

The patients having undergone Ileostomy and Colostomy are required to take a balanced diet with introducing one food item at one time. Along with this, a lighter meal in morning and night is always preferable. Do not forget to chew the food properly or swallow large parts of leafy vegetables as it can lead to blockage in stoma. In order to enjoy a better dietary lifestyle, having a diet chart made by a dietician after surgery will definitely help in maintaining the ideal weight. After all, it is the matter of staying healthy and not messing with eating habits.

Pramod Kerkar, M.D., FFARCSI, DA
Pramod Kerkar, M.D., FFARCSI, DA
Written, Edited or Reviewed By: Pramod Kerkar, M.D., FFARCSI, DA Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:December 4, 2018

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