Ileostomy Meaning: Types, Risk Factors & Tips to Manage

• Written by Bhawika Khushlani

  Reviewed by Ritika Malik

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After struggling for so long with gut issues, like pain, discomfort and endless doctor visits, now your doctor is recommending an ileostomy. 

A word which can be completely new to you, but it’s about to shape your everyday life. It’s okay if it sounds scary or unfamiliar.

An ileostomy is not just a surgical procedure; it’s a lifestyle shift that requires courage, knowledge, and a good dose of humour. 

Remember, life doesn’t end with an ileostomy; it just takes a bold new turn. You must be afraid of how to carry a waste pouch on your stomach, or managing a daily lifestyle with a stoma. The journey from taking care of the stoma to embracing body confidence, everything can be smoother if you are well-informed. Let’s dig deeper into ileostomy and learn essential tips for your new normal life.

What is an Ileostomy?

An ileostomy is a surgical procedure to create another way to pass the stool from the body instead of the colon or rectum. When any disease, injury or due to any other accident, if the colon or intestine gets fully or partially damaged, an ileostomy surgery is advised to let the stool pass through the abdominal wall by creating an opening, also called the stoma. A pouch is used to exit the stool, called an ileostomy bag. This could be temporary or permanent, depending on the criticality. 

Ileostomy Types: Loop, End, Continent, and Ileoanal Reservoir

There are four major types of ileostomy mentioned below:

Loop ileostomy

It is a surgical procedure where a loop of the small intestine, called the ileum, is brought through a hole in the abdominal wall. Here, the stoma is created with two openings. The first opening is called proximal and is used for exiting the stool, while the second opening is called distal and allows exit for mucus and other fluids. It is a temporary procedure and can be reversed later via an operation after healing. 

End ileostomy

In the End ileostomy, the small intestine is separated from the large intestine to bring the end of the ileum to the abdominal surface. Here, again, the stoma is created but with one opening for stool exit. It is generally performed when the colon needs to be healed or removed, and as a result, it can be temporary or permanent according to the situation. 

Continent ileostomy or Kock Pouch

Continent ileostomy is the same surgical procedure; the only difference is that an internal pouch is created from a part of the ileum inside the belly wall. It has a valve that prevents the leakage of the waste. This procedure is preferred by people who don’t want to use an external pouch. To empty the pouch, a catheter is used through the stoma, which can be several times a day depending on the amount. Continent ileostomy is not common due to its complexity and risk factors. 

Ileoanal Reservoir or J-Pouch (The Alternative)

Ileoanal Reservoir is a surgical process where a pouch is created from the ileum and rectum, then connected to the anus. It allows the stool to be stored and then expelled through the anus as in natural bowel movements. 

Need for an Ileostomy Surgery

When the large intestine, also called the colon, or the rectum, suffers from any disease, injury, or damage, it leads to improper waste processing. And due to this, an ileostomy surgery is performed to safely process waste outside the body. Some common ileostomy causes are as follows: 

• Colon or rectal cancer
• IBD or Inflammatory Bowel Disease
• Bowel Blockage
• FAP or Familial adenomatous polyposis (Cancerous Polyps)
• Trauma or injury
• Diverticulitis complications (infection or tears in the colon)
• Congenital ( Hirschsprung disease or anal atresia at birth)
• Healing from surgery

Risks Associated with Ileostomy

There are two major types of risks associated with ileostomy surgery. These are

Stoma-related Complications

Stoma-related complications refer to the issues that affect stoma health and maintenance of the artificial opening in the belly. Some common risks to keep an eye on are:

• Skin irritation
• Leakage from the pouch to the belly
• Tissue death or necrosis in the stoma
• Hernia
• Narrowing the stoma opening
• Bleeding (Common within a month of surgery)
• The stoma may sink below, which makes it difficult to attach the ileostomy pouch.
• Prolapse
• Stoma detachment from the skin

It is suggested to consult with your doctor in case of any of these signs. Immediate attention is required in the case of stoma-related complications. 

Bowel-Related Complications

Bowel-related complications are those that affect the internal health of your bowel due to surgical changes in the abdomen. These are as follows:

• Constipation: Constipation is a real challenge in an ileostomy. As you don’t have control over your bowel, a poor diet can cause constipation and then blockage of the stoma or intestine.
• Adhesions: Scar tissue after the surgery may cause limited blood flow or blockage. 
• Diarrhoea: It is common to empty the pouch 4 to 6 times a day. In case of excessive stool output, contact your doctor. 
• Restricted diet: With a stoma, your diet can be restricted to easily digestible foods depending on the situation. The liquid form of food is preferred to avoid any blockage in the stoma. 
• Dehydration: Fluid loss will be increased with a stoma on your abdomen, which can lead to dehydration, especially in the early days of the surgery. 

Post-Ileostomy Surgery Tips for Living with Confidence & Ease

Ileostomy surgery can be challenging for your health, as well as for your mental health. But with smart tips and utmost care, you can continue living your life with confidence & ease. Whether you are having a temporary or permanent ileostomy, proper care is a must to boost the healing and avoid complications. Here are some essential tips for post-ileostomy care with the pouch system. 

The Pouch System

The pouch system refers to an entire system of attaching the pouch, regularly emptying it, and changing it every 3-4 days. After the surgery, your doctor will suggest which pouching system will work the best for you, and introduce you to a wound ostomy continence or WOC nurse expert in ostomy care. 

You can learn from them how to change or empty your bag and analyse which bag fits perfectly around the edge of your stoma. There are two layers of the bag: the wafer and the pouch. The wafer sticks around the edge of your stoma on your skin, and then the bag is attached to the wafer. There is also a belt that improves the hold of the pouch. It is advised to change the bag within 8-9 days. In case of leakage, get it changed immediately to protect your skin. 

Stoma Care

It is important to take care of your stoma to avoid any complications in the future. Just after surgery, it will look red, swollen and moist, sticking at 1 inch above your abdomen. After 4 to 8 weeks, it will become small and look perfectly attached to your skin. You shouldn’t let it be pressed or held by something, as it can depress it under your skin and can cause difficulty, leakage or even blockage of the stoma. 

When you stick the bag to the wafer, be careful not to stick it on the part above the stoma. Use high-quality supplies for skin protection and prevention of infections, as well as make them long-lasting without the risk of leakage. 

Skin Care

Skin irritation is a common concern for people with an ileostomy. It can happen due to fluid leakage, which is acidic, and the reaction of the adhesive to your skin. You can buy barrier cream and irritation powder, which are specific to ileostomy, for proper skin care. 

Odor Control

Although the ileostomy pouches are odour-proof, during their emptying process, you may feel discomfort. For this, you can avoid eating food that causes odour in the stool. Also, you can use odour elimination or a deodorant for a quick solution. 

Daily lifestyle, like bathing, clothing 

There is no restriction on bathing for people with a stoma. However, avoid directing the showering spray on the stoma, which can cause injury. Also, there is no particular clothing option for people with an ileostomy. Wear what you feel comfortable in, just avoid any tight clothes over the stoma.

Travelling

Travelling with an ileostomy is possible. You just need to carry some extra pouches and other maintenance items in case of any leakage.

Exercise

After proper healing and recovery from surgery, you can do light exercises for flexibility and to improve your digestive system. You can start with short walks and then increase the limit gradually.

Intimacy

With just a few adjustments, you can still be involved with intimacy. Some tips to follow are emptying it beforehand, checking for odours, and covering the pouch with clothes. 

Diet Management with Ileostomy

Wondering what you can eat and what you should avoid? Here are some diet management tips:

• Food to include: Refined Grains, soft and cooked vegetables, tender meats and proteins, dairy, foods that thicken stools, like Bananas, creamy peanut butter, and pasta. 
• Food to avoid: Beans, lentils, broccoli, cabbage, high-fibre food, gas-producing food, odour-causing food, and food that can cause blockage, like corns, peas, mushrooms, and Chinese vegetables.
• Minimum package food: Avoid greasy, fried and spicy foods.
• Stay hydrated: Drink plenty of fluids, and eat small and frequent meals. 
• Eat properly: Eat slowly and chew thoroughly to eliminate the risk of blockages. 

Does Ileostomy Treatment Cover Under the Health Insurance Plan?

Yes. Ileostomy treatment is covered under the health insurance plan as it is a medically necessary surgical process. An insured person is entitled to receive coverage for hospitalisation, surgery, and related medical care. What many people overlook is the cost of pre- and post-hospitalisation care consultations, which are quite expensive, especially in cases like ileostomy.

Apart from this, diagnostic tests and follow-ups can add up quickly to the overall expenses. Hence, the importance of health insurance coverage shouldn’t be overlooked. With a well-rounded plan like Care Health Insurance, you get coverage not just for surgery, but also for essential expenses before and after hospitalisation. 

A Fresh Start with an Ileostomy

A fresh start with an ileostomy is all about finding strength in a new version of your life. Show a little bit of bravery in your everyday routine, and you are good to go. It's not the weakness but a treatment that allows you to live a healthy life with a new digestive tract. Healing doesn’t happen overnight, and neither does acceptance, but with some time, support and self-confidence, peace does show up. It's time to flaunt your scars and tell a story of survival boldly!

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