Bowel Diversion Surgeries: Ileostomy, Colostomy, Ileoanal Reservoir, and Continent Ileostomy
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What is bowel diversion surgery?
Bowel diversion surgery allows stool to safely leave the body when—because of disease or injury—the large intestine is removed or needs time to heal. Bowel is a general term for any part of the small or large intestine.
Some bowel diversion surgeries—those called ostomy surgery—divert the bowel to an opening in the abdomen where a stoma is created. A surgeon forms a stoma by rolling the bowel’s end back on itself, like a shirt cuff, and stitching it to the abdominal wall. An ostomy pouch is attached to the stoma and worn outside the body to collect stool.
Other bowel diversion surgeries reconfigure the intestines after damaged portions are removed. For example, after removing the colon, a surgeon can create a colonlike pouch out of the last part of the small intestine, avoiding the need for an ostomy pouch.
Cancer, trauma, inflammatory bowel disease (IBD), bowel obstruction, and diverticulitis are all possible reasons for bowel diversion surgery.
Which parts of the gastrointestinal tract are affected by bowel diversion surgeries?
Bowel diversion surgeries affect the large intestine and often the small intestine.
The small intestine runs from the stomach to the large intestine and has three main sections: the duodenum, which is the first 10 inches; the jejunum, which is the middle 8 feet; and the ileum, which is the final 12 feet. Bowel diversion surgeries only affect the ileum.
The large intestine is about 5 feet long and runs from the small intestine to the anus. The colon and rectum are the two main sections of the large intestine. Semisolid digestive waste enters the colon from the small intestine. Gradually, the colon absorbs moisture and forms stool as digestive waste moves toward the rectum. The rectum is about 6 inches long and is located right before the anus. The rectum stores stool, which leaves the body through the anus. The rectum and anus control bowel movements.
What are the different types of bowel diversion surgery?
Several surgical options exist for bowel diversion.
Some people only need a temporary bowel diversion; others need permanent bowel diversion.
Which bowel diversion surgery is appropriate?
The type, degree, and location of bowel damage, and personal preference, are all factors in determining which surgery is most appropriate. For example, people whose disease affects the ileum are poor candidates for ileoanal reservoir surgery or continent ileostomy because of the increased risk of disease recurrence and the need for pouch removal.
Discussing treatment options with a doctor and seeking the advice of an ostomy nurse—a specialist who cares for people with bowel diversions—are highly recommended.
Bowel diversion surgeries. D
Concerns Related to Bowel Diversion
Although bowel diversion surgery can bring great relief, many people fear the practical, social, and psychological issues related to bowel diversion. An ostomy nurse is trained to help patients deal with these issues both before and after surgery. People living with an ostomy or who need bowel diversion surgery may also find useful advice and information through local or online support groups.
Points to Remember