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Ileostomy, Colostomy, and Ileoanal Reservoir Surgery
Article provided by the National Digestive Diseases
Information Clearinghouse
Sometimes treatment for Crohn's disease, ulcerative colitis, and
familial adenomatous polyposis involves removing all or part of
the intestines. When the intestines are removed, the body needs
a new way for stool to leave the body, so the surgeon creates an
opening in the abdomen for stool to pass through. The surgery to
create the new opening is called ostomy. The opening is called a
stoma.
Different types of ostomy are performed depending on how much
and what part of the intestines are removed. The surgeries are
called ileostomy and colostomy. When the colon and rectum are
removed, the surgeon performs an ileostomy to attach the bottom
of the small intestine (ileum) to the stoma. When the rectum is
removed, the surgeon performs a colostomy to attach the colon to
the stoma. A temporary colostomy may be performed when part of
the colon has been removed and the rest of it needs to heal.
Ileoanal reservoir surgery is an alternative to a permanent
ileostomy. It is usually completed in two surgeries. In the
first surgery, the colon and rectum are removed and a pouch or
reservoir is constructed from the last 18 inches of the small
intestine. This pouch is attached to the anus. In the second
surgery, the ileostomy is closed. The muscles surrounding the
anus and anal canal are left in place, so the stool in the pouch
does not leak out of the anus. People who have this surgery are
able to control their bowel movements.
If an ileoanal reservoir is not possible or feasible, a
continent ileostomy may be an alternative to using an outside
collecting bag. In continent ileostomy, an internal reservoir
pouch is created from part of the small intestine. A valve is
constructed and a stoma is placed through the abdominal wall. A
tube is inserted through the stoma and valve to drain the pouch. |
