Ileostomy Closure

What you should know

An ileostomy closure is surgery to close your temporary ileostomy. Your surgeon will reattach your ileum to your colon. He will also close your stoma.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Risks

  • You may bleed from where your ileum is stitched or stapled. After surgery, bowel contents may leak into your abdomen and cause an infection. You may also get an infection or abscess where your stoma was closed. You may have narrowing in your intestine that makes it difficult to have a bowel movement. Your intestines may also stop working for a short time after the surgery.

  • A fistula (abnormal tissue opening) may form between your intestines and a nearby organ. You may get a hernia (part of your intestine pushes through weak muscle in your abdomen). You may get a blood clot in your leg or arm. This may become life-threatening.

  • If you do not have your ileostomy closed, you may have an increased risk for infection, dehydration, or intestinal narrowing. Your stoma may come too far out of your abdomen, or sink inside your abdomen.

Getting Ready

Before your surgery:

  • Write down the correct date, time, and location of your surgery.

  • Ask your caregiver if you need to stop using aspirin or any other prescribed or over-the-counter medicine before your procedure or surgery.

  • Bring your medicine bottles or a list of your medicines when you see your caregiver. Tell your caregiver if you are allergic to any medicine. Tell your caregiver if you use any herbs, food supplements, or over-the-counter medicine.

  • You may need an enema (liquid put in your rectum) before your surgery. The enema has a dye in it that shows up on an x-ray. The enema and x-ray check for leaks in your colon where your past surgery was done. Your caregiver may also check your anal sphincter to make sure it is working properly. Ask your caregiver for more information about these and other tests you may need. Write down the date, time, and location of each test.

The night before your surgery:

  • You may need to drink a medicine the night before your surgery to help empty your intestines.

  • Ask caregivers about directions for eating and drinking.

The day of your surgery:

  • Ask your caregiver before you take any medicine on the day of your surgery. Bring a list of all the medicines you take, or your pill bottles, with you to the hospital. Caregivers will check that your medicines will not interact poorly with the medicine you need for surgery.

  • You or a close family member will be asked to sign a legal document called a consent form. It gives caregivers permission to do the procedure or surgery. It also explains the problems that may happen, and your choices. Make sure all your questions are answered before you sign this form.

  • Caregivers may insert an intravenous tube (IV) into your vein. A vein in the arm is usually chosen. Through the IV tube, you may be given liquids and medicine.

  • An anesthesiologist will talk to you before your surgery. You may need medicine to keep you asleep or numb an area of your body during surgery. Tell caregivers if you or anyone in your family has had a problem with anesthesia in the past.

Treatment

What will happen:

  • Your surgeon will make an incision around your stoma. He will bring the ends of your ileum and colon out of your abdomen. He will connect them with stitches or staples. He may inject salt water to check for leaks.

  • Your caregiver will place your reattached intestines back into your abdomen through the incision. He will close the opening on your abdomen with stitches. He may place a drain under your skin to remove extra fluid. He may also leave part or all of your skin open to heal on its own. Your wound may be covered with a bandage.

After your surgery:

You will be taken to a room to rest until you are fully awake. Caregivers will monitor you closely for any problems. Do not get out of bed until your caregiver says it is okay. When your caregiver sees that you are okay, you will be able to go home or be taken to your hospital room.

Contact a caregiver if

  • You cannot make it to your surgery.

  • The skin around your stoma is red, warm, and sore.

  • You have a fever.

  • You have an itchy skin rash around your stoma.

  • You have nausea or are vomiting.

  • You have abdominal pain or swelling.

Seek Care Immediately if

  • Bowel contents will not drain through your stoma.

  • You have pus draining from your stoma.

  • Your abdomen is swollen, hard, or painful, or you are vomiting.

  • Your stoma has sunk back into your abdomen.

  • Your stoma slips farther out of your abdomen than it should be.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Ileostomy Closure (Precare)

Hide
(web2)