Colostomy and ileostomy are surgical procedures that create a drainage point for stool when the patient’s intestinal tract is not functioning normally. Colostomy uses the colon, while ileostomy uses the end of the small intestine. Both procedures are potentially reversible and have alternatives. Patients should discuss all options with their surgeon and prepare for lifestyle adjustments.
Both colostomy and ileostomy involve bringing a section of intestine to the surface of the abdomen to create a drainage point for stool when the patient’s intestinal tract is not functioning normally. In the case of a colostomy, the affected section of intestine is part of the large intestine, also known as the colon. In contrast, an ileostomy uses the ileum, the end of the small intestine, bypassing the colon altogether. Both procedures are used in a number of different settings, and some alternatives to colostomy and ileostomy have been developed to give patients more options.
In both procedures, the patient is placed under general anesthesia to allow the surgeon to perform abdominal surgery. Some indications for an ostomy procedure may include bowel cancer, bowl injuries that take time to heal, bowel perforations, and severe bowel damage caused by inflammation. The surgeon takes a section of the intestine above the affected area and creates an outlet through the abdomen. The outlet attaches to a bag to collect feces.
Both procedures are potentially reversible, and the surgeries can be used as a temporary measure while a patient’s bowel is recovering from a medical problem, such as injuries that take time to heal. The injured bowl section can be bypassed with the ostomy procedure to allow it to heal, then the surgeon can return to reverse the surgery once the bowel is healthy again. Success rates with colostomy and ileostomy reversal vary depending on factors such as the patient’s general health level and the skills and experience of the surgeon.
These procedures are associated in the popular imagination with the dreaded ostomy bag, an external pouch used to collect stool. Handling an ostomy pouch takes some training and practice, but once patients get used to it, they can engage in a wide variety of activities including sports and strenuous exercise following a colostomy or ileostomy. Some surgeons have also developed alternatives such as procedures with an internal collection bag or procedures in which the opening is plugged and the intestine is periodically washed to drain as needed. Patients may wish to discuss all available options before agreeing to a procedure.
When colostomy and ileostomy are recommended, it is usually because a surgeon believes these are the best treatment options. The procedures are invasive and require lifestyle adjustments for the patient and are not recommended lightly. Patients should ask their surgeons about aftercare and other issues when preparing for surgery so they know what to expect.
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