IBD Surgery - Ileostomy and Colostomy

One form of surgery for IBD is an ostomy — either an ileostomy or a colostomy. Ostomy is the generic term for a procedure that brings an opening in the intestine out through the layers of the abdominal wall and the skin. This is sometimes referred to as a stoma.

 

If the last part of the small intestine (ileum) is brought out to the skin, this procedure is specifically called an ileostomy, and if the large intestine (colon) is brought out to the skin, it is called a colostomy. In both procedures, either a cut end of the intestine or a loop of intestine is brought through the skin. Where a loop is brought out, it is usually a temporary ostomy with the intention to close it or, if necessary, convert it to a permanent end ostomy. With the end ostomy, the wall of the intestine is turned out after it is brought out through the abdominal wall and its edge is sewn to the surrounding skin.

 

A colostomy is usually flat or flush with the surrounding skin, while an ileostomy usually sticks out several centimeters above the level of the skin.

 

Because the stoma consists of the inner lining of the intestine, it is normally pink or red and may look painful or sore. However, the stoma has no pain detecting nerve fibers and, as a result, is not actually painful to touch.

 

Because stomas do not have a valve or sphincter, there is no way to control if and when stool or gas is excreted from the stoma. As a result, a stoma requires an appliance or bag that fits over it to collect the stool and prevent soiling.