What is an ileostomy

What an ileostomy is

An ileostomy is an opening in your belly, called a stoma, made from the end of your small bowel. That last part of the small bowel is the ileum, which gives the ileostomy its name.

The NHS puts it simply: the end of your small bowel is brought out through an opening in your belly. You no longer poop from your bottom. Instead, stool comes out of the stoma into a pouch that sticks to your belly. The surgeon usually makes the opening on the right-hand side.

Why ileostomy output is more liquid

With an ileostomy, stool leaves your body from the small bowel, before it ever reaches the large bowel (colon). That's why the NHS describes the output as liquid or soft, like porridge. You can still get constipated or have diarrhea.

Fluids matter more than before. The NHS says an ileostomy makes it harder to stay hydrated. Tiredness, a dry mouth or a lot of output from the stoma can be signs of dehydration, so speak to your stoma nurse if you notice them. Our guide to high-output ileostomy explains what very heavy output means and what helps.

Ileostomy or colostomy: the short version

Both are stomas. The difference is which part of the bowel is brought out: an ileostomy uses the small bowel, a colostomy uses the large bowel.

Figures from the NHS ileostomy and colostomy pages listed in the sources below. For how output, pouches and food compare day to day, read our ileostomy vs colostomy guide. If the words are still new, what is an ostomy explains the whole family, including urostomy.

Why an ileostomy is done

An ileostomy is usually done when your large bowel needs to be removed, or rested after treatment or surgery. Reasons the NHS lists include:

• bowel cancer, or bowel polyps that might turn into cancer over time;
• inflammation, such as inflammatory bowel disease, or an infection, such as an abscess;
• not enough blood reaching the colon;
• a bowel obstruction, when the colon is blocked;
• megacolon, when part of the colon becomes very stretched and swollen;
• a spinal cord injury that means you can't control when you poop;
• nerve problems in the colon (Hirschsprung's disease), or conditions of the brain and spinal cord, such as multiple sclerosis, that affect the bowel;
• severe constipation that doesn't get better with treatment.

Depending on the reason, an ileostomy can be temporary and reversed later, or permanent. Sometimes another operation is possible instead of a permanent ileostomy. One example is an internal J-pouch for ulcerative colitis, which lets you poop from your bottom. Your surgeon will explain which options fit you.

Loop ileostomy and end ileostomy

1. Loop ileostomy

   A loop of small bowel is pulled through the opening, cut open and stitched to the skin. This makes two openings joined at the base. One is active and passes stool. The other leads to the resting colon. A loop ileostomy is usually temporary, and the colon usually stays.

2. End ileostomy

   The small bowel is separated from the colon, and its end is brought out and stitched to the skin. An end ileostomy can be temporary or permanent, and some or all of the colon may be removed.

With either type, a sticky white or yellow mucus may come out of your bottom now and then. The NHS says this is normal.

What is ileostomy surgery like?

Ileostomy surgery is done under general anesthetic, so you're asleep. According to the NHS, it can be keyhole surgery, through a few small cuts, or open surgery, through one larger cut. If some or all of the colon comes out in the same operation, the surgeon usually makes a long cut down the middle of your belly.

• When you wake up

  You'll already have a pouch on. The stoma is swollen and may ooze a little blood at first. The NHS says it shrinks over the next 2 to 3 months.

• In hospital

  Most people stay 3 to 10 days, or until stool starts coming out of the stoma and they feel confident looking after it. Your stoma nurse makes sure you're comfortable wearing and changing the pouch before you go home.

• At home

  The NHS says recovery usually takes 6 to 8 weeks. Avoid strenuous activity and heavy lifting for 3 months while your belly muscles heal, and wait until you've recovered to drive, usually at least 6 weeks.

• If it's temporary

  A reversal closes the openings and puts the bowel back inside, so you poop from your bottom again. It is done at least 6 weeks after the ileostomy, and it isn't always possible. Read more about ileostomy reversal surgery.

Day to day with an ileostomy

The NHS says an ileostomy shouldn't stop you living a full and active life. Once you've recovered, most people can eat their usual foods. You should be able to go back to work and wear your usual clothes. A few habits make the biggest difference:

• Eat low-fiber for about 6 weeks while your bowel heals, then bring foods back gradually. Eating regularly and chewing well help stop the stoma getting blocked. Our ileostomy diet guide has the food lists.
• Drink plenty of fluids to avoid dehydration.
• Ask your doctor about your medicines. Slow-release tablets may come straight out into the pouch before they work. Don't stop a prescribed medicine without talking to your doctor.
• Wear what you like. High-waisted underwear with an inner pocket keeps the pouch flat under everyday clothes.

Under everyday clothesSIIL Ostomy UnderwearHigh-waisted and soft, with an inner pocket that holds the pouch flat under jeans, dresses and leggings.See ostomy underwear →

For the full picture, from sleep and sport to travel and relationships, read our guide to living with an ileostomy.

When to get help

The NHS lists these as possible signs of an infection or a serious bowel blockage. Call your surgical team, stoma nurse or doctor the same day, and call 911 in an emergency. For problems that aren't urgent, like sore skin around the stoma, contact your stoma nurse. Learn the early signs of a stoma blockage.

What is an ileostomy: common questions