Ileostomy Creation

WHAT YOU SHOULD KNOW:

An ileostomy is an opening created to connect your ileum to the surface of your abdomen. Your ileum is the upper part of your intestine. The opening, called a stoma, will be connected to a pouch that collects bowel contents. Your ileostomy may be temporary or permanent.


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:

  • Surgery may cause bleeding or damage to nearby organs. A fistula (abnormal tissue connection) may form between your intestines and another organ. Your intestines may stop working for a period of time after surgery. You may get a blood clot in your leg or arm. This may become life-threatening.

  • Your stoma or part of your intestines may become narrow or blocked. The stitches securing your ileostomy may come loose. Your stoma may slip back into your body, or come out too far on your abdomen. The rod holding your stoma in place may create a hole in your skin. You may get an infection in your intestines, reservoir pouch, urinary tract, or the skin around your stoma. The skin and intestine that forms your stoma may die. You could get a hernia (intestine that pushes through a weakened abdominal muscle wall). An ileostomy may increase your risk for dehydration.

  • Without an ileostomy after colon surgery, bowel contents may leak into your abdomen and cause an infection. This may become life-threatening. If you are paralyzed, you may not be able to control your bowel movements.

WHILE YOU ARE HERE:

Before your surgery:

  • Informed consent is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

  • Pneumatic boots are inflatable boots put on your legs. The boots are connected to an air pump. The pump tightens and loosens different areas of the boots. This helps improve blood flow to prevent clots.

  • Medicines may be given to prevent a bacterial infection or to prevent blood clots.

  • Anesthesia is medicine to make you comfortable during the surgery. Caregivers will work with you to decide which anesthesia is best for you.

    • General anesthesia will keep you asleep and free from pain during surgery. Anesthesia may be given through your IV. You may instead breathe it in through a mask or a tube placed down your throat. The tube may cause you to have a sore throat when you wake up.

    • Local anesthesia is a shot of medicine put into the skin of your abdomen. It is used to numb the area and dull the pain. You may still feel pressure or pushing during surgery.

  • A Foley catheter may be placed to drain your urine into a bag. You may need a Foley catheter both during and after your surgery.

  • A nasogastric tube may be placed into your stomach. The tube may be attached to suction (vacuum) to keep your stomach empty.

During your surgery:

  • Your surgeon will make an incision in your abdomen. He will separate your colon (lower part of your intestine) from your ileum and stitch your colon closed. He will bring the end of your ileum through the hole in your abdomen. Then he will fold it back and stitch it to the skin of your abdomen to create the stoma.

  • Your surgeon will create a loop ileostomy if it will be temporary. He will bring a small section of your ileum through the hole in your abdomen. He will make an incision through one side of the ileum. Then he will fold it back and stitch it to the skin on your abdomen to create the stoma. He may also place a small rod near your stoma to secure it to your abdomen.

  • Your surgeon may create a reservoir from a part of your ileum. It will be inside your body and will attach to the stoma on your abdomen. It will collect bowel contents and can be emptied with a tube as needed.

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 taken to your hospital room. You may need to wear compression stockings to prevent blood clots from forming. Your caregiver will decide when it is OK to remove your nasogastric tube.

  • You may need to walk around the same day of surgery, or the day after. Movement will help prevent blood clots. You may also be given exercises to do in bed. Do not get out of bed on your own until your caregiver says you can. Talk to caregivers before you get up the first time. They may need to help you stand up safely. When you are able to get up on your own, sit or lie down right away if you feel weak or dizzy. Then press the call light button to let caregivers know you need help.

  • You will be able to drink liquids and eat certain foods once your stomach function returns. You may be given ice chips at first. Then you will get liquids such as water, broth, juice, and clear soft drinks. If your stomach does not become upset, you may then be given soft foods, such as ice cream and applesauce. Once you can eat soft foods easily, you may slowly begin to eat solid foods.

  • A drain may be placed during surgery to remove extra fluid. This helps prevent infection.

  • Medicines:

    • Pain medicine may be given. Do not wait until the pain is severe before you ask for more medicine.

    • Bowel movement softeners are given to make it easier for you to have a bowel movement. You may need this medicine to treat or prevent constipation.

© 2014 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 Creation (Inpatient Care)

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