Ileostomy and colostomy are two types of ostomy surgery that treat bowel conditions. Both are involved in creating an opening in the abdominal wall called a stoma. An ostomy bag or a pouch is worn on the abdomen to collect waste as it exits the body through the stoma. An ileostomy involves the small intestine, and a colostomy involves the large intestine. Both surgical procedures reroute part of the intestines to an opening in the abdominal wall.
What are Ileostomy and Colostomy
The two most common types of ostomy surgery are ileostomy and colostomy. Though they may sound and look similar, both procedures are done for different reasons.
Ileostomy
An ileostomy is a surgical procedure that creates an opening into the last part of the small intestine, or ileum, through the abdomen as a way for waste to exit the body. The opening, or stoma, is then attached to the end of your ileum, bypassing your large intestine. This way, digestive waste will exit your ileum into a bag or pouch that is worn on the abdomen. An ileostomy can be temporary or permanent, and the procedure can be reversed if your large intestine improves later on.
Types of Ileostomy
Loop ileostomy
A surgeon pulls a loop of the ileum to the surface of the abdomen and makes an incision to create the stoma with two openings. One is for passing waste, and the other is for passing mucus. This type is usually temporary.
End ileostomy
A surgeon separates the small intestine from the large intestine. The end of the ileum is then brought to the surface to form the stoma. This type is usually permanent.
In short, a loop ileostomy keeps the small and large intestines connected in case a reversal procedure is required. An end ileostomy removes the connection but keeps the full length of your small intestine.
Colostomy
A colostomy is similar to an ileostomy, but it focuses on the large intestine, or colon, instead. This surgical procedure involves creating a stoma in the abdominal wall and connecting part of your colon to the opening. Digestive waste, like stool, will pass out through the stoma and collect in a pouch or bag on the outside of your belly. Likewise with ileostomies, a colostomy procedure can be temporary or permanent.
Types of Colostomy
These types of colostomies are named according to the section of the colon where the stoma is placed:
Sigmoid colostomy
This is done in the last section of your colon before the rectum, called the sigmoid colon. The stool is usually more solid because it passes through most of the colon before reaching the stoma.
Descending colostomy
This involves the section of the colon running down the left side of the belly, called the descending colon. The stool is still solid because it is close to the sigmoid colon, which means it still passes through slightly less of the colon before reaching the stoma.
Transverse colostomy
This is located in the section of the colon that stretches horizontally in the upper part of the belly, called the transverse colon. The stool is softer and less formed because it has only travelled about halfway through the colon, absorbing less water.
Ascending colostomy
This is done in the first section of the colon that runs along the right side of the belly, called the ascending colon. This type is rare, and the stool is liquid or semi-liquid because it forms in the first section, absorbing even less water.
Your doctor will consider and choose the best option for your situation. An important factor is deciding whether a temporary or permanent solution is most suitable.
Conditions That Require Ileostomy and Colostomy
Here are some of the conditions that may require an ileostomy or colostomy:
- Bowel infections
- Bowel inflammation
- Diverticulitis (an inflammation of diverticula in the lining of the colon)
- Crohn’s disease (affects the digestive system)
- Ulcerative colitis (affects the large intestine)
- Blocked bowel
- Bowel cancer (a tumour or cancer in the small intestine, colon, rectum, or anus)
- Familial adenomatous polyposis (a pre-cancerous condition)
- Serious injury or damage to the bowel
Ileostomy and Colostomy Procedure
Ileostomy and colostomy procedures follow similar surgical steps:
- The bowel is prepared with a liquid diet, special cleansing, and antibiotic medications.
- The patient is given general anaesthesia.
- The surgeon marks the spot on the abdomen for the stoma, and the common location is the lower right side of the abdomen.
- The abdomen is opened, and the diseased section of the bowel is removed. The healthy portion is pulled through a small incision to form the stoma.
- The bowel is then sewn to the stoma.
- A bag or pouch is attached over the stoma to collect digestive waste.
- Lastly, the large abdominal incision is closed with stitches.
Taking Care of Yourself at Home
Living with a stoma can feel uneasy at first, and it needs some adjustment. Your doctor may provide you with general suggestions to follow through. Here are some to keep in mind:
Keep your stoma clean. Gently clean the area around your skin with soap and water daily, as the bag can irritate your skin. Alert your doctor to any redness, burning, or itching on your skin.
Stay hydrated
Your colon’s function is to absorb water and minerals back into your body, so it can be harder to stay hydrated. Drink more fluids after surgery to prevent dehydration.
Diet
Follow the low-fibre diet recommended by your doctor for the first several weeks after surgery. You can gradually reintroduce foods into your diet.
Adjust medications
Some medications require different forms or dosages depending on your condition. Many medications pass through your entire digestive system, which may not be as effective if you have a stoma. Consult your doctor for any necessary adjustments to your medications.
Stay active
Once recovered from surgery, you can resume your usual activities. However, it is best to wear a stomach guard or other protective gear for heavy activities, like sports. It is also recommended to consult with your doctor for better clarity.
Ileostomy and colostomy surgeries treat conditions that affect the digestive system and can be life-saving. The right support and equipment help you adapt to life with an ostomy and lead a fulfilling life. At Sozo Wound & Stoma Care, we provide professional stoma care in Singapore, including cleaning, maintenance, and guidance on the right stoma care products to help you manage your ostomy effectively.
Frequently Asked Questions
Can an ileostomy or colostomy be reversed?
Some ileostomies and colostomies are temporary and can be reversed once healing is complete, but others are permanent.
Can you eat a normal diet with an ileostomy or colostomy?
Ileostomy patients are recommended to avoid high-fibre foods to prevent blockages, and there are fewer dietary restrictions for colostomy patients.
Does an ileostomy or colostomy bag smell?
Modern ostomy bags are odour-proof, but leaks or poor sealing can cause unwanted smells.