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Ileostomy Functions

An ileostomy is a surgical procedure that is necessary when disease or injury has damaged the intestinal tract to the point that the body can no longer excrete waste. Many digestive health conditions lead to the need for an ileostomy. Some of these are, Irritable bowel disease, colon or rectal cancer, injury to the area by an accident, or familial polyposis. According to the textbook "Colon and Rectum," the need for surgery evolves over a period of time, usually after acute flare-ups

  1. Types of Ileostomies

    • The most common ileostomy performed is the standard ileostomy. In this surgical procedure the ileum, or the small intestine, is rerouted through an opening made in the abdomen called a stoma. The stoma is red in appearance and protrudes approximately 1 inch above the skin of the abdomen. This ileostomy requires a drainage pouch and leaves the individual fecal incontinent. A second type is a continent ileostomy, which loops the ileum back onto itself forming a pocket within the abdominal cavity. A permanent nipple valve is created in the ileum for drainage of stool. With a continent ileostomy a cover is applied over the stoma to collect any mucous discharge and the need for an external pouch is eliminated. The third type is a iIleoanal reservoir. The surgeon creates a pocket within the pelvic cavity by making a pouch from the ileum and rectum and connecting it to the anus. Stool is passed through the pouch, to the anus, and out of the body.

    Stool Excretion

    • With a standard ileostomy, the stool will be a paste-like consistency and may occur regularly or at infrequent intervals. Draining the pouch is necessary throughout the day as stool collects. Continent ileostomies allow for freedom of an external device; however, it requires the insertion of a catheter into the stoma site for drainage of stool several times throughout the day.

    Stoma Management

    • Stool contains harsh enzymes that are extremely irritating if in contact with the skin. With a standard ileostomy, the waste collection pouch must be fitted and sealed properly over the stoma site at all times. The area should be thoroughly cleaned between each appliance change to ensure that the skin does not become irritated. If cared for properly there should not be an offensive odor present from the site. A continent ileostomies stoma lies flat against the skin, and usually just above the pubic area. Skin care is also necessary around the stoma as mucous drainage is normally present. The stoma cap should be fitted properly and cleaned regularly. A stoma is not present with an ileoanal reservoir, as the pouch is created internally to function with the bowel to mimic normal bowel excretion. Each individual may react differently to intestinal diversions.

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