Colostomy and Ileostomy

Treatment of Crohn's disease, ulcerative colitis, polyps, and colorectal cancer sometimes requires removal of all or part of the large intestine. Depending on how much tissue must be removed, the surgeon may need to create a new path for stool to pass from the body. Surgery to create a new opening (called a stoma) through the abdominal wall when the rectum is removed is called a colostomy; if both the rectum and the colon must be removed, the procedure is known as an ileostomy.

The stoma is about the size of a quarter. A pouch is worn over the opening to collect waste and it must be emptied periodically. In some cases the surgeon can create an internal pouch made from a portion of the ileum, which the person periodically empties by inserting a tube through a tiny opening in the abdominal wall.

For some people a colostomy is temporary, and the surgeon performs a second operation to reconnect the healthy sections of the colon after the lower colon and the rectum have healed.

Ileoanal reservoir surgery is an alternative procedure that involves two separate operations. In the first operation, the colon and rectum are removed, and a temporary ileostomy is created. In the second operation, the ileostomy is closed, and part of the ileum is used to create an internal pouch to hold stool. This pouch is attached to the anus. The muscle of the rectum is left in place, so the stool in the pouch does not leak out. People who have this surgery are able to control their bowel movements, although the bowel movements may be more frequent and may be watery.

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