ILEOSTOMY

General Information

DEFINITION--Creation of an opening in the ileum, the lower part of the small intestine. After surgery, all feces leave the body through this opening, which is called an "ostomy" or "stoma."

BODY PARTS INVOLVED--Ileum; cecum.

REASONS FOR SURGERY--Ileostomy is the last step of many surgeries performed in the lower gastrointestinal tract, especially after the colon has been removed.

SURGICAL RISK INCREASES WITH

• Adults over 60.
• Obesity; smoking; poor nutrition.
• Excess alcohol consumption.
• Newborns and infants.
• Recent respiratory infection.
• Chronic heart or lung disease or diabetes mellitus.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon; colon-rectal surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays; ECG; sigmoidoscopy; colonoscopy (See Glossary for all).
• After surgery: Blood and urine studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen over the diseased intestinal tract.
• The muscles of the abdominal wall are separated to expose the abdominal organs, which are inspected for undetected disease. Other surgeries may be performed at this time.
• The ileum is clamped on both sides of the area to be opened and cut between the clamps. The part closer to the stomach is brought through another small incision in the abdominal wall to accept the stoma.
• The part of the intestinal tract below the ileum, usually around the diseased part of the intestine, is closed with sutures. The abdominal contents are replaced. The muscles and skin are closed with sutures, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Incisional hernia.
• Skin irritation around the stoma.
• Intestinal obstruction.
• Scarring.

AVERAGE HOSPITAL STAY--15 days.

PROBABLE OUTCOME--Expect complete cure without complications. Allow about 6 weeks for recovery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
• An "enterostomy nurse" (See Glossary) can provide education and counseling for you and your family.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medicine longer than 4 to 7 days. Use only as much as you need. > Antibiotics to fight infection.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. > Resume driving about 4 weeks after returning home weeks. > Resume sexual relations when able.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing. Use salt liberally.

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You have abdominal swelling or pain.
• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• Skin around stoma becomes inflamed and painful.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.