ileostomy /il′ē·os″təmē/ [L, ileum + Gk, stoma, mouth, temnein, to cut] , surgical formation of an opening of the ileum onto the surface of the abdomen, through which fecal matter is emptied. The operation is performed in advanced or recurrent ulcerative colitis, Crohn’s disease, or cancer of the large bowel. A low-residue diet is given before surgery and is reduced to fluids 24 hours before surgery to decrease intestinal residue. Intestinal antibiotics are given to decrease the bacterial count. A nasogastric or intestinal tube is passed. The diseased portion of the large bowel is removed in a permanent ileostomy. Occasionally, the distal and proximal segments of bowel may be reconnected after ulcerated areas have healed. A loop of the proximal ileum is then drawn out onto the abdomen and sutured in place, and a stoma is formed. A pouch may be made with part of the terminal ileum, in which the open end is woven through the rectus muscles to form a valve and then opens onto the abdomen. After surgery the patient wears a disposable bag to collect the semiliquid fecal matter, which begins to drain once peristalsis is restored and the nasogastric tube is removed. Because the secretions contain digestive enzymes that can ulcerate the skin around the stoma, the nurse ensures that nothing leaks from the bag. The nurse instructs the patient in how to apply and care for the stoma and the ileostomy bag. If a pouch is present, it is drained three or four times a day through a small irrigating catheter through the valve. Compare colostomy. See also enterostomy, ostomy irrigation, stoma.
