Explanation of terminology
An ileostomy is a surgical procedure that involves creating an opening in the abdomen, known as a stoma. Part of the small intestine - specifically the ileum - is brought to the surface of the skin.
Different types of ileostomies
There are basically two different types of ileostomy: End ileostomy and Loop ileostomy. In most cases, an end ileostomy is created; in special cases, a loop ileostomy may also be considered.
End ileostomy
If the entire colon has to be removed, an end ileostomy is created. This stoma is usually located in the right lower abdomen and cannot be reversed. As the large intestine is now missing for faecal thickening and water absorption, the faeces are thin and can severely irritate the skin due to aggressive digestive enzymes.
Loop ileostomy
A loop ileostomy is usually created temporarily to protect certain sections of the bowel. It is usually created in the right lower abdomen. A loop of the small intestine is brought outwards and placed above skin level. Once the healing process of the immobilised section of bowel is complete, the stoma can be repositioned. For a loop ileostomy two openings are created in the abdominal wall, only one of them draining waste into a stoma pouch.
Reasons for an ileostomy
An ileostomy is created if it is necessary to surgically remove part or all of the colon, including the sphincter.
Possible indications for an ileostomy
Inflammatory intestinal disease: ulcerative colitis, Crohn's disease
Bowel cancer
Diverticulitis
Trauma due to severe abdominal injuries or accidents
Birth defects
What happens during the surgical procedure?
Creating an ileostomy involves a surgical procedure that can be performed as open surgery or laparoscopically, depending on the specific circumstances and the surgeon's preference.
Here are the most important steps of the procedure:
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Incision: A small incision is made in the abdominal wall and the corresponding part of the small intestine is moved outwards through this opening to form the stoma.
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Stoma formation: The exposed end of the ileum is then sutured to the skin of the abdomen.
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Stoma pouch: A suitable and, above all, transparent stoma pouch is now attached to the skin around the stoma to collect the faeces. Ostomy pouches are available in various shapes, colours, systems and different skin protection materials.
Challenges after surgery
An ileostomy changes your life - there's no denying that. For the vast majority of people, such a major change leads to great emotionality, both positive and negative. For some, a stoma finally represents the long-awaited and above all pain-free freedom, while others find it difficult to accept the new accessory. Both feelings are completely normal. However, it is important to realise that you will continue to live a full and active life even with a stoma.
You can find more information about recovery after stoma surgery here.
Body image and self-esteem
Adapting to changes of your own body can be emotionally challenging. Body image is the aspect of self-concept that focuses on our perceptions of our physical appearance and how we compare ourselves to others. After surgery, your body is changed, especially by the new stoma. It is often a long process to become aware of this change, to slowly get used to it and to continue to treat yourself and your body with respect. Your body is no less beautiful because of a stoma!
Psychological counselling and support groups can help you to navigate your feelings and regain your self-confidence.
Nutrition
Eating is a big part of our lives and not only ensures our survival, moreover, it also has an effect on our mood. Having a stoma should not affect your enjoyment of food or cause anxiety.
Most people are supported by their doctor or stoma care nurse after their operation, but food tolerance varies from person to person. Patients often return to their normal diet quite quickly after the operation, as what they were able to tolerate before the stoma surgery can usually also be tolerated afterwards.
The most important things for ostomates are to avoid constipation and foods that cause unpleasant odours, flatulence or excessive bowel movements. This does not mean that you have to give up your favourite foods - anything that tastes good and is well tolerated is allowed!
Tips & Tricks:
Make sure you eat a balanced diet: Favour easily digestible foods.
Drink enough: Approx. 2 to 2.5 litres/day.
Make sure your food is prepared gently and with low fat levels.
Take your time when eating and drinking: Chew well and drink in small sips.
Eat at regular times, several meals a day: Approx. 3 to 8 meals.
Exercise regularly.
Make sure your body weight is stable. Significant fluctuations in weight can change the position of your stoma and possibly lead to leakage.
Dehydration with an ileostomy
An ileostomy makes it more difficult to stay well hydrated. This is because the large intestine (colon) is responsible for absorbing most of the body fluids you need. But after the ileostomy surgery, your colon is "taken out of circulation" and is either disconnected or completely removed.
It is therefore even more important to consume enough fluids and watch out for signs of dehydration if you have an ileostomy.
Headache
Increased thirst
Exhaustion & fatigue
Dry mouth
Dark urine
Concentration problems
Ostomy care & hygiene
Proper stoma hygiene is crucial to avoid infection and skin irritation. This includes cleaning and caring for the stoma and the skin around it.
The skin around the stoma is nonetheless subjected to a great deal of stress due to the regular changing of the baseplate and any excretions that may leak out. Sore and irritated skin is therefore nothing unusual. Conscientious treatment and the right products are essential.
Tips & Tricks:
Gently wash the stoma and the surrounding skin with warm water.
Avoid using perfumed soaps, lotions and creams as these can irritate your skin and cause itching.
Gently dab your skin with fleece compresses when drying off.
If your skin is already slightly sore, it may be helpful to use a special skin protection lotion.
For travelling: If you don't have a washbasin available, pack unscented wet wipes for cleaning. Please only use these in an emergency!
If you still have difficulties with sore skin, please speak to your stoma care nurse.
Everything you need to know about stoma & skin can be found here.
Daily change of your ostomy supply
For most ostomates, it is a milestone when they can take over their ostomy care completely on their own. Changing the stoma pouch every day is also an essential part of stoma hygiene. You will soon feel confident changing your appliance and be able to recognise when it is the best time to do so.
Information about changing your supply is available here.
You should pay particular attention to the correct fit of the ostomy pouch when changing your appliance. Check for the following signs and adjust your ostomy pouch.
Leakages
Removal of the skin protection plate
Unpleasant feeling on the skin
Bad odours
Physical activity
Sport is important and keeps you healthy. Exercise is also an essential part of well-being for people with a stoma and should never be neglected or ignored. Attention:We do not recommend doing sports immediately after stoma surgery. Your body needs adequate time to fully recover!
Which sports are recommended?
Except for extreme sports such as boxing and weightlifting, you can do any sport you feel comfortable with.
Tips & Tricks:
Use a stoma bandage or similar supportive garments when exercising: This will ensure that your ostomy appliance stays in place and reduce the risk of hernias.
Start slowly: Your body needs to get used to the strain in its new situation.
Make sure you drink enough fluids.
Ostomy care from FORLIFE
We know what a difference the right products can make. Comprehensive support with products for ostomy, continence and wound care as well as enteral nutrition is therefore very important to us. In order to be able to offer you the best possible selection of products at all times, we are continuously developing and improving our product range - we create products for life.
Discover our extensive range of ostomy products and accessories here.
For more information about us or our products, please visit our website. There you will find, among other things, our detailed FAQ and other interessting blogarticles all about the topic stoma. You can also contact us via our social media channels or send us an e-mail. We look forward to hearing from you!
The contents of this blog, including all text, graphics, images and information, are intended for informational purposes only. They are not a substitute for professional medical advice, diagnosis or treatment. Always consult a qualified healthcare professional if you have any questions about a medical condition or treatment, and before starting any new healthcare treatment. Reliance on any information provided on this website regarding health related decisions are solely at the reader's own risk.
