Ileostomy
What is Ileostomy ?
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Why do you need Ileostomy ?
An ileostomy may be temporary or permanent, depending on the underlying condition. It is indicated for:
- Inflammatory bowel disease (IBD): Severe ulcerative colitis or Crohn’s disease requiring colon removal or rest.
- Colorectal cancer: Tumors obstructing the colon or requiring rectal resection (e.g., in total proctocolectomy).
- Familial adenomatous polyposis (FAP): A genetic condition with multiple colon polyps, necessitating colon removal.
- Bowel obstruction or perforation: Due to tumors, volvulus, or trauma.
- Hirschsprung disease: In children, as part of staged surgery for congenital bowel motility issues.
- Severe infections or trauma: Diverticulitis, ischemic colitis, or abdominal injuries requiring fecal diversion.
The procedure aims to bypass a diseased or non-functional colon, manage complications, and improve quality of life.
Why Do Costs Vary in Philippines?
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Ileostomy Procedure
The procedure is tailored to the patient’s condition, the extent of disease, and whether the stoma is temporary or permanent:
- Before Surgery Evaluation:
- Diagnosis is confirmed via:
- Colonoscopy or imaging (CT/MRI): Assesses cancer, IBD, or obstruction.
- Blood tests: Evaluate infection, anemia, or organ function for surgical safety.
- Rectal biopsy (for Hirschsprung disease) or CEA levels (for cancer).
- Bowel preparation (laxatives, enemas) may be performed, though limited in emergencies.
- An enterostomal therapist marks the stoma site (usually on the right lower abdomen) to ensure accessibility and comfort.
- Patients receive counseling on ileostomy care and lifestyle adjustments.
- Diagnosis is confirmed via:
- Surgical Techniques:
- Open Ileostomy:
- Performed under general anesthesia, lasting 1–3 hours, often as part of a larger procedure (e.g., total proctocolectomy, colectomy).
- A midline abdominal incision provides access to the small intestine.
- The surgeon brings the ileum through the abdominal wall to form a stoma, which is sutured to the skin.
- Types of ileostomy include:
- End ileostomy: The ileum end forms the stoma, common in permanent cases (e.g., after total proctocolectomy).
- Loop ileostomy: A loop of ileum is brought out, typically temporary, with two openings (one for stool, one for mucus).
- A pouching system (ileostomy bag) is attached to collect liquid or semi-formed stool.
- Laparoscopic Ileostomy:
- A minimally invasive approach using 3–5 small incisions, a laparoscope (camera), and specialized instruments.
- Suitable for elective cases (e.g., IBD, early-stage cancer), offering less pain and faster recovery.
- Takes 1–2 hours, with conversion to open surgery possible if complications arise.
- Ileoanal Pouch (J-Pouch):
- In some cases (e.g., ulcerative colitis, FAP), an ileostomy is temporary, followed by creation of an internal pouch from the ileum, connected to the anus after colon removal.
- Requires multiple stages, with the ileostomy reversed once the pouch heals.
- Open Ileostomy:
- After Surgery:
- Patients are monitored in the ICU or high-dependency unit for 1–2 days to manage pain, fluids, and stoma function.
- Hospital stay lasts 3–7 days for open ileostomy or 2–5 days for laparoscopic ileostomy.
- An enterostomal therapist trains patients on pouch changes, skin care, and recognizing complications.
- Pathology reports (if cancer-related) guide further treatment (e.g., chemotherapy).
Recovery After Ileostomy
Recovery involves physical healing, adaptation to the stoma, and emotional adjustment:
- Hospital Stay:
- Open ileostomy requires 3–7 days, including 1–2 days in the ICU.
- Laparoscopic ileostomy involves 2–5 days, with 1 day in the ICU.
- Post-Surgery Care:
- Pain is managed with medications (e.g., epidural, opioids initially, then NSAIDs).
- The stoma begins functioning within 1–3 days, with output initially liquid due to small intestine contents, gradually thickening.
- Patients are trained on:
- Changing ileostomy bags (every 1–4 days, as output is more frequent and liquid than colostomy).
- Cleaning the stoma and surrounding skin to prevent irritation.
- Monitoring for dehydration, as ileostomies increase fluid loss.
- Antibiotics prevent infection; drains (if placed) are removed once output decreases.
- Activity and Diet:
- Light walking resumes within 1–2 days to prevent blood clots and promote bowel motility.
- Strenuous activities, heavy lifting, or driving are avoided for 4–6 weeks (open surgery) or 2–4 weeks (laparoscopic).
- A low-residue diet (e.g., white rice, bananas) is followed for 2–4 weeks to reduce output volume, avoiding high-fiber or gas-producing foods (e.g., beans, broccoli).
- Hydration (2–3 liters daily) and electrolyte supplements (e.g., oral rehydration salts) prevent dehydration, especially in hot climates like India.
- Follow-Up:
- Follow-up visits at 1–2 weeks and 4–6 weeks assess wound healing, stoma function, and adaptation.
- Cancer patients undergo CEA monitoring, CT scans, or colonoscopy every 3–6 months for 5 years.
- Temporary ileostomies (e.g., for IBD, Hirschsprung disease) may be reversed after 3–12 months, depending on healing or subsequent surgeries (e.g., J-pouch).
Most patients adapt to ileostomy within 4–8 weeks, resuming normal activities (work, school, travel) with proper stoma care. Quality of life improves significantly, with 80–90% of patients reporting good adjustment after training and counseling.
Risks and Complications
Ileostomy is a major surgery with potential risks:
- Surgical Risks:
- Bleeding, infection, or wound dehiscence at the incision or stoma site.
- Damage to nearby organs (e.g., bladder, small intestine) during surgery.
- Stoma-Related Complications:
- Stoma prolapse (protrusion), retraction (sinking), or blockage, requiring revision surgery.
- Parastomal hernia (bulge around the stoma, 10–20% risk).
- Skin irritation or breakdown due to frequent pouch changes or leakage.
- General Risks:
- Adverse reactions to anesthesia.
- Blood clots (deep vein thrombosis or pulmonary embolism), requiring anticoagulants.
- Ileostomy-Specific Risks:
- High-output ileostomy (>1.5–2 liters/day), causing dehydration or electrolyte imbalances, needing IV fluids or medications (e.g., loperamide).
- Nutritional deficiencies (e.g., vitamin B12, electrolytes) due to reduced small intestine absorption.
- Long-Term Issues:
- Chronic dehydration or kidney issues if fluid intake is inadequate.
- Psychological distress or body image concerns, manageable with counseling or support groups.
Prompt reporting of symptoms like no stoma output, severe skin irritation, or dehydration (e.g., dizziness, dark urine) ensures timely management.
Frequently Asked Questions (FAQs)
What causes the need for an ileostomy?
Common indications include ulcerative colitis, Crohn’s disease, colorectal cancer, FAP, Hirschsprung disease, or bowel obstruction/perforation.
Is an ileostomy always permanent?
Temporary ileostomies are created for reversible conditions (e.g., IBD, temporary obstruction) and may be reversed after 3–12 months. Permanent ileostomies are needed when the colon/rectum is removed (e.g., cancer, FAP).
How does an ileostomy differ from a colostomy?
An ileostomy involves the small intestine (ileum), producing liquid or semi-formed stool, while a colostomy involves the colon, producing more formed stool. Ileostomies require more frequent pouch changes and fluid monitoring.
How soon can I resume normal activities?
Laparoscopic ileostomy patients resume activities in 2–4 weeks; open surgery patients take 4–6 weeks.
Is ileostomy covered by insurance in India?
Most insurance plans cover ileostomy for cancer, IBD, or emergencies. Confirm with your provider.
What are the signs of complications post-ileostomy?
No stoma output, severe skin irritation, dehydration, or fever require immediate medical attention.
Can children undergo ileostomy?
Yes, children with conditions like Hirschsprung disease or IBD undergo ileostomy, managed by pediatric surgeons at centers like Apollo Children’s Hospital.
What lifestyle changes are needed post-ileostomy?
Maintain a balanced diet, stay hydrated (2–3 liters/day), practice diligent stoma care, avoid heavy lifting, and attend regular follow-ups, especially for cancer or IBD patients.
Conclusion
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Looking for Best Hospitals for Ileostomy
Note: we are not promoting any hospitals
We do not promote any hospitals. All details are sourced from Google and hospital websites. Please verify independently. Start with your surgery—here’s the list of government, budget, and superspecialty hospitals accredited by the Department of Health (DOH), Philippine Health Insurance Corporation (PhilHealth), and Joint Commission International (JCI)
- click on your city and schedule your surgery now done in good hands.
| City | Minimum Price (₱) | Maximum Price (₱) |
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Angeles City |
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Antipolo |
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Bacolod |
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Bacoor |
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Baguio |
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Butuan |
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Cagayan de Oro |
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Caloocan |
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Cebu City |
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Dasmariñas |
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Davao City |
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General Santos |
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General Trias |
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Iligan |
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Iloilo City |
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Las Piñas |
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Makati |
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Malolos |
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Manila |
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Muntinlupa |
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Parañaque |
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Pasay |
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Pasig |
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Puerto Princesa |
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Quezon City |
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San Fernando |
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San Jose del Monte |
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Taguig |
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Valenzuela |
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Zamboanga City |
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Disclaimer
This information is sourced from open platforms and is for general awareness only. Costs may vary based on individual cases. Please consult a qualified doctor for medical advice and explore options within your budget before deciding on the procedure.