Your doctor may choose to remove your colon and rectum as a part of the procedure to treat colon cancer or inflammatory bowel disease. It means that you will not be able to move your bowels the natural way after surgery. During surgery, the surgeon will bring a part of the small bowel out through an incision in the belly. He will then stitch the edges of the bowel with the abdominal skin to create a bud-like opening called a stoma. After surgery, you will be able to expel your bodily wastes through the stoma.
Wearing an ostomy pouch over the stoma is a necessary part of the ostomy or ileostomy care regimen. This plastic pouch comes with a flange or baseplate that goes against the abdominal skin. It has a hole in its center to allow the stoma to open into the ostomy pouch. The flange surface that adheres to the abdominal skin is laden with adhesive, meaning that the flange essentially sticks to the abdominal skin. The purpose of a flange is to prevent any leakage of the stomal output. Once the bag is in place, you are all set to move around and perform your routine activities without having to worry about leakage.
Depending on the underlying condition, your ileostomy can be permanent or temporary. If your surgeon finds out that your bowel only needs to rest for some time before it is fully ready to perform its usual function, he will give you a temporary ileostomy. If your bowel condition is so severe that there is no other way than removing your colon and/or rectum, you will get a permanent ileostomy.
An alternative to a permanent ileostomy is an ileoanal reservoir or j-pouch. To create this internal reservoir, the surgeon first removes the colon and rectum. He uses the end of the small intestine to create a pouch, which is then connected to the anal canal. This internal pouch stores waste materials; and your anal canal allows those waste contents to leave the body. A j-pouch eliminates the need to wear an ostomy pouch to collect wastes.
Whether you have an ileostomy or j-pouch, your body will need some time to adapt to it. Every bowel diversion surgery results in an increased vulnerability of the GI tract. During this condition, the patient has to stick to a restricted diet plan and a daily routine that involves minimal movement of the body. After six weeks or so, the patient may be able to eat anything he wants and engage in relatively intense physical activities.
An ileostomy requires a patient to be fully committed to a daily routine that allows a comfortable and long-lasting adherence to the ostomy pouch. It includes emptying and changing the pouch regularly and taking good care of the skin around the stoma. It is necessary to discuss everything with an ostomy care nurse or doctor.
Having a j-pouch frees a patient from typically ileostomy concerns but not from certain complications. For instance, the internal pouch can get inflamed or irritated. Antibiotic treatments may help resolve those issues. Again, speaking to your doctor is the best way to avoid or treat any issue that seems problematic.