ileostomy


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Related to ileostomy: continent ileostomy

ileostomy

 [il″e-os´tah-me]
an artificial opening (stoma) created in the ileum and brought to the surface of the abdomen for the purpose of evacuating feces. This may be done in the treatment of ulcerative colitis, crohn's disease, congenital defects of the bowel, cancer, trauma, and other conditions requiring bypass of the colon.

An ileostomy may be temporary or permanent. When the ileostomy is done in conjunction with partial or complete removal of the colon and anus, it is always permanent. The stoma created by ileostomy usually is located in the right lower quadrant of the abdomen.
Patient Care. Patients with an ileostomy require physical care similar to that given patients with a colostomy. The major difference is that the fecal material from an ileostomy will be more liquid and the passage of feces through the stoma less predictable than in a colostomy. The farther along the intestinal tract a stoma is located, the firmer the stool.

The psychosocial impact of surgery for either urinary or fecal diversion is a major concern of patients and their professional caregivers, families, and significant others. The problems related to this kind of surgery and the changes it brings in self-concept and fulfillment of roles are shared by all patients who must live with a stoma. Hence the emotional and psychological care of these patients is presented under stoma.

The appliance for collection of feces is worn continuously and emptied every 4 to 5 hours. There is a continuous flow of liquid feces through an ileostomy. There should be no problem with persistent odor if the appliance is well made, worn correctly, and washed and rinsed frequently. Manufacturers of collection devices provide detailed information about cleaning and storage of their products.

Obstruction and diarrhea are common problems to be avoided. In regard to obstruction, the major offenders are foods that absorb water, for example, hard nuts, dried fruits, corn (including popcorn), and foods high in fiber. Particles from these foods are not small enough to pass through the ileostomy stoma; hence they inhibit the passage of feces and produce abdominal cramping and vomiting. Relief of blockage requires oral administration of enzymes to promote digestion, gentle lavage, and massage of the abdomen to encourage passage of the obstructing material. As a last resort, surgery may be necessary to remove the obstruction. Laxatives are never given; they will only aggravate the problem. Patients are taught the symptoms of obstruction and the necessity of consulting a health care professional should they occur and self-care measures not be effective.

Diarrhea is a more frequent problem in patients with an ileostomy than in patients with other types of fecal diversion and it is more likely to result in fluid and electrolyte imbalance than it would in a person who defecates normally. Although the fecal material passing through an ileostomy is already semi-liquid, patients can learn the difference between what is normal for them and what is indicative of diarrhea.

Dietary restrictions, other than the foods that could cause an obstruction, are not severe. The ostomate usually begins with a bland diet and gradually adds foods one at a time, noting whether a particular food causes problems of flatus, abdominal cramps, or diarrhea. Patients are warned that eating too quickly, not chewing food thoroughly, and swallowing air while eating can contribute to the problem of flatulence.
continent ileostomy an ileostomy that maintains continence of feces, usually through construction of a continent ileal reservoir; the ileostomy must be drained by the patient several times a day. See also kock pouch.
Continent ileostomy (Kock pouch) with Maclet ring device. 1, Loop of terminal ileum is sutured together and cut open. Using forceps, surgeon intussescepts distal ileum to form nipple valve. 2, Free edges sutured together to form reservoir; stoma sutured flush with skin, and pouch sutured to abdominal wall. 3, Magnetic ring is implanted in subcutaneous layer and stoma closed with magnetic cap. From Polaski and Tatro, 1996.
urinary ileostomy ileal conduit.

il·e·os·to·my

(il'ē-os'tŏ-mē),
Establishment of a fistula through which the ileum discharges directly to the outside of the body.
[ileo- + G. stoma, mouth]

ileostomy

/il·e·os·to·my/ (il″e-os´tah-me) surgical creation of an opening into the ileum, with a stoma on the abdominal wall.

ileostomy

(ĭl′ē-ŏs′tə-mē)
n. pl. ileosto·mies
1. Surgical construction of an artificial excretory opening through the abdominal wall into the ileum.
2. The opening created by such a surgical procedure.

ileostomy

[il′ē·os′təmē]
Etymology: L, ileum + Gk, stoma, mouth, temnein, to cut
surgical formation of an opening of the ileum onto the surface of the abdomen, through which fecal matter is emptied. The operation is performed in advanced or recurrent ulcerative colitis, Crohn's disease, or cancer of the large bowel. A low-residue diet is given before surgery and is reduced to fluids 24 hours before surgery to decrease intestinal residue. Intestinal antibiotics are given to decrease the bacterial count. A nasogastric or intestinal tube is passed. The diseased portion of the large bowel is removed in a permanent ileostomy. Occasionally, the distal and proximal segments of bowel may be reconnected after ulcerated areas have healed. A loop of the proximal ileum is then drawn out onto the abdomen and sutured in place, and a stoma is formed. A pouch may be made with part of the terminal ileum, in which the open end is woven through the rectus muscles to form a valve and then opens onto the abdomen. After surgery the patient wears a disposable bag to collect the semiliquid fecal matter, which begins to drain once peristalsis is restored and the nasogastric tube is removed. Because the secretions contain digestive enzymes that can ulcerate the skin around the stoma, the nurse ensures that nothing leaks from the bag. The nurse instructs the patient in how to apply and care for the stoma and the ileostomy bag. If a pouch is present, it is drained three or four times a day through a small irrigating catheter through the valve. Compare colostomy. See also enterostomy, ostomy irrigation, stoma.
enlarge picture
Ileostomy construction

ileostomy

GI disease An opening from the ileum to outside the body, which provides an exit for feces when the entire colon has been removed Indications Active ulcerative colitis with dysplasia or cancer, familial polyposis, Crohn's disease, injury–eg, shotgun blast to abdomen. See Colostomy.

il·e·os·to·my

(il'ē-os'tŏ-mē)
1. Establishment of a fistula through which the ileum discharges the bowel's contents directly to the outside of the body.
2. A type of fecal diversion.
[ileo- + G. stoma, mouth]

ileostomy

A surgical operation in which the lower part of the small intestine (the ileum) is cut and the upper end brought out through the front wall of the abdomen so that the bowel contents can discharge externally into a bag. Ileostomy is necessary when there is bowel obstruction, or when the lower bowel requires to be rested to recover from disease, injury or surgical operation.

ileostomy

an artificial opening (stoma) created in the small intestine (ileum) and brought to the surface of the abdomen for the purpose of evacuating feces.

urinary ileostomy
use of a segment of the ileum as a stoma for the diversion of urinary flow from the ureters. See also ileal conduit.
References in periodicals archive ?
Becca Foskuhl Becca was diagnosed with Crohn's disease at age 16 and has experienced a ruptured appendix, peritonitis, a perforated colon, fistulas, abscesses, strictures, and five total hospital stays, including three abdominal surgeries on her path to an ileostomy just over a year ago.
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Three patients were treated with fistula division, debridement and diverting loop ileostomy.
Rosado, a Worcester mechanic, was in intensive care with a breathing tube, underwent an ileostomy, and had an open abdominal wound for more than a month, said Mr.
The doctors removed her entire colon as well as a part of her small intestine, leaving her to function with an ileostomy bag on her abdomen.
CNS stomal therapy nurse from Palmerston North, Lawrence Mutale, presented a case study on managing a patient with a recessed ileostomy and an overactive enterocutaneous fistula.
They took the colon out and now I have a permanent ileostomy (a procedure where waste is collected outside the body).
Patients with ileostomy typically have recurrent renal stones and produce low-volume, acidic, sodium-poor urine because of abnormally large enteric losses of water and sodium bicarbonate.
IFR scientists developed the model over a 12-year period, working with ileostomy patients, using aspirates and the like.
I consider myself "blessed" with an ileostomy (it saved my life), but that blessing comes with body image issues (you know, I wear a bag).
This report demonstrates the progression of a defunctioned colon in a patient with ulcerative colitis (UC), 20 years after ileostomy without colectomy.