Ileostomy

What this procedure is

An ileostomy is a surgery that changes the way waste leaves your body. During the procedure, a surgeon creates an opening in the wall of your abdomen, or belly area.

The surgeon brings the end of your small intestine—called the ileum—through this opening. This new opening is called a stoma. Instead of waste passing through the colon and rectum, it exits through the stoma and is collected in a small, secure pouch worn on the outside of your body.

Depending on your health needs, an ileostomy may be temporary or permanent. A temporary ileostomy allows the lower part of your digestive system time to rest and heal after another surgery or illness. A permanent ileostomy may be needed if the lower part of the bowel must be removed or can no longer function.

What it treats or fixes

This procedure is often used when the large intestine (colon) or rectum is damaged, diseased, or needs to be bypassed. By redirecting waste, the body can continue to function while the affected areas are treated or removed.

Your clinician may recommend an ileostomy to manage conditions such as:

• Inflammatory bowel diseases, including ulcerative colitis or Crohn’s disease.
• Certain types of cancer, such as colorectal cancer.
• Birth defects or injuries to the intestinal tract.
• Severe blockages or infections in the colon.

In some cases, the procedure is part of a larger treatment plan to help the body recover from a different surgery on the bowel. It provides a way for the digestive system to continue working while other parts heal.

How common it is & where it's done

Ileostomy is a well-established and common surgical procedure. Thousands of people undergo this surgery every year to improve their quality of life and manage chronic health issues.

The surgery is performed in a hospital setting by a surgeon who specializes in the digestive system. You will typically stay in the hospital for a few days afterward so your care team can monitor your recovery and teach you how to care for the stoma.

While it is a major surgery, many people find that they can return to their normal activities, including work, exercise, and travel, once they have fully healed. Specialized nurses, often called ostomy nurses, are usually available to help you adjust to the changes.

Recovery: What to Expect

After surgery, you will likely stay in the hospital for a few days. During this time, your care team will help you learn how to manage your stoma (the small part of the intestine that is visible on the outside of your abdomen). It is normal for the stoma to look red, moist, and slightly swollen at first.

Your clinician may suggest a slow return to your regular diet. You might start with clear liquids and soft foods that are easy to digest. Over time, you can usually begin adding more variety back into your meals as your body adjusts to the change.

Risks & Possible Complications

While many people recover without major issues, some complications can occur. The most common concern is skin irritation around the stoma. Your clinician may recommend specific powders or wipes to protect your skin and keep it healthy.

Because the large intestine is no longer processing waste, your body may not absorb water as effectively. This can lead to dehydration. It is important to drink plenty of fluids and watch for signs like dark urine or feeling dizzy. Occasionally, certain foods can cause a blockage in the small intestine.

You should contact your clinician if you experience any of the following:

• No waste output in your pouch for several hours.
• Severe cramping or persistent nausea.
• Skin sores or a rash that does not go away.
• A significant change in the size or color of your stoma.

Outcomes & Long-Term Results

Most people find they can return to their usual activities, including work, travel, and exercise. Modern pouching systems are designed to be discreet and fit flat against the body, so they are often not noticeable under regular clothing.

If your ileostomy is temporary, your clinician may talk to you about a reversal surgery in the future. This procedure reconnects the ends of the intestine so you can pass waste normally again. If your ileostomy is permanent, your care team will help you find the best supplies for your long-term comfort and lifestyle.

Emotional Support & Reassurance

Adjusting to life with an ileostomy is a journey that involves both physical and emotional changes. It is very common to feel overwhelmed or anxious in the beginning. Many people find that their confidence grows as they become more familiar with their daily routine.

You do not have to go through this alone. Your clinician may refer you to an ostomy nurse or a local support group where you can connect with others who have had similar experiences. With time and support, most people lead full, active, and healthy lives.

Why doctors recommend it

An ileostomy is a surgery that creates an opening in the belly, called a stoma, to allow waste to leave the body. Your clinician may recommend this procedure if your large intestine (colon) or rectum is damaged, diseased, or needs time to heal after another surgery. By bypassing the lower part of the digestive tract, the body can still process food and remove waste safely.

Common reasons for this surgery include:

• Inflammatory Bowel Disease (IBD): Conditions like Crohn’s disease or ulcerative colitis that cause severe swelling and sores in the digestive tract.
• Colorectal Cancer: When a tumor needs to be removed from the colon or rectum.
• Birth defects: Issues with how the bowels formed before birth.
• Injury: Physical damage to the intestines that requires the area to be bypassed.

Urgent vs planned treatment

In many cases, an ileostomy is a planned procedure. This usually happens after you and your care team have tried other treatments, such as medications or diet changes, that did not provide enough relief. A planned surgery gives you time to talk with specialists, such as a wound, ostomy, and continence (WOC) nurse, to prepare for the changes ahead.

Sometimes, the surgery must be performed urgently. This may happen if there is a sudden blockage in the bowel, a serious infection, or a hole (perforation) in the intestinal wall. In these emergency situations, the surgery is done quickly to protect your health and allow the body to begin the recovery process.

Goals of treatment

The primary goal of an ileostomy is to provide a new path for waste when the natural path is no longer working correctly. For some patients, the surgery is temporary. This is often called a "resting" ileostomy, as it allows a lower part of the bowel to heal after a different surgery. Once healing is complete, your clinician may perform a second procedure to close the stoma and reconnect the bowel.

For others, the ileostomy may be permanent. This is typically the case if the lower part of the colon or the rectum has been removed or is too damaged to function again. The ultimate goal of treatment is to improve your quality of life by reducing pain, preventing serious complications, and helping you return to your daily activities with more comfort and control.

Who may benefit

An ileostomy is a surgery that creates an opening in the abdomen (called a stoma) to allow waste to leave the body. This procedure may be helpful for people whose colon (large intestine) or rectum is damaged, diseased, or needs time to heal. Your clinician may suggest this if you have inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis.

It is also a common option for those dealing with colorectal cancer, certain types of polyps, or an injury to the digestive tract. In some cases, the surgery is temporary. This allows the lower part of your bowel to rest and heal after a different operation before the ileostomy is reversed later on.

When it may not be the right option

An ileostomy might not be the best choice if your condition can be managed effectively with medications or other less invasive treatments. Your care team will look at your overall health to see if you are strong enough for the procedure and the recovery process.

If there is not enough healthy small intestine to create a stoma, or if a patient has other serious health issues that make surgery very risky, a clinician may explore different options. The decision often depends on whether the benefits of the surgery outweigh the risks for your specific situation and lifestyle.

Questions to ask your care team

• Is this ileostomy likely to be temporary or permanent?
• How will having a stoma affect my daily life, diet, and physical activities?
• What kind of support is available to help me learn how to care for the pouching system?
• Are there other treatments we should try before deciding on surgery?
• What are the signs of healing I should look for after the procedure?

In the procedure room

When you are brought into the procedure room, you will see a team of healthcare professionals, including your surgeon, nurses, and an anesthesiologist. The room contains specialized monitors and equipment designed to keep you safe and comfortable. You will be positioned on a padded table, and the team will perform final safety checks before the procedure begins.

High-level steps

The surgeon begins by making an opening in the wall of your abdomen (belly). A section of your small intestine, called the ileum, is gently brought through this opening to the surface of your skin. This new opening is called a stoma.

The surgeon then folds the end of the intestine over itself and stitches the edges to your skin. This creates a small, rounded nub. This process allows waste to bypass the lower part of your digestive tract and exit your body through the stoma into a secure, external pouching system.

Anesthesia and pain control

To ensure you are comfortable, you will typically receive general anesthesia. This means you will be in a deep sleep and will not feel any pain during the surgery. Your clinician may also use local numbing medications at the site of the opening to help with comfort immediately after you wake up.

After the procedure, your care team will use various medications to manage any soreness or pressure you may feel. It is common to feel some numbness or a dull ache in the abdominal area as you begin to heal.

Monitoring and safety steps

Throughout the entire procedure, the surgical team uses monitors to track your heart rate, blood pressure, and oxygen levels. These safety steps help the team react quickly to your body's needs while you are asleep.

The surgeon also carefully checks the stoma to ensure it has a healthy, reddish color, which shows it has a good blood supply. This monitoring continues into the recovery period to make sure the new opening is functioning as expected.

Immediately after the procedure

You will wake up in a recovery area where nurses will watch you closely as the anesthesia wears off. You will notice a small, moist, pinkish-red stoma on your abdomen. A clear plastic pouch will already be attached to your skin to collect waste and allow the team to monitor the stoma's output.

It is normal to feel groggy, thirsty, or slightly sore. Your clinician may check the stoma frequently to ensure it remains healthy. You will also begin learning how the pouching system works with the help of a specialized nurse.

Typical procedure length

The time spent in surgery can vary depending on your overall health and the specific reason for the ileostomy. In most cases, the procedure takes a few hours to complete. Your surgical team will provide your family or support person with updates during this time.

Common approaches (open vs minimally invasive)

Surgeons can perform ileostomy surgery using different techniques to access the intestine. The choice often depends on your overall health and the reason for the surgery.

• Open surgery: The doctor makes a single, long cut in the abdomen to view and reach the organs directly.
• Minimally invasive (laparoscopic) surgery: The doctor makes several small cuts. They insert a tiny camera and special tools to guide the procedure.

Laparoscopic surgery may offer a shorter recovery time for some patients, but it is not always applicable. For example, if you have scar tissue from past surgeries or if it is an emergency, your clinician may recommend open surgery as the safer option.

Partial vs total

While an ileostomy always involves the small intestine, the approach changes based on how much of the lower bowel is removed or needs to rest.

• End ileostomy: The surgeon brings the end of the small intestine through the abdominal wall. This is often done when the colon and rectum are removed or permanently disconnected.
• Loop ileostomy: The surgeon lifts a loop of the small intestine through the skin. This is often used as a temporary measure to divert waste, allowing the colon or a new surgical connection further down to heal.

Your doctor will explain which type is necessary for your specific condition.

Revision or repeat procedures

Many ileostomies are temporary. Once the bowel has healed, your doctor may perform a "reversal" surgery. During this procedure, the surgeon closes the stoma and reconnects the ends of the intestine so you can pass stool normally again.

Reversal is not guaranteed for everyone. If the rectum was removed, the ileostomy might be permanent. In some cases, surgeons can create an internal pouch (called a J-pouch) from the small intestine that connects to the anus. This avoids the need for a permanent external bag, but it typically requires more than one surgery to complete.

Tests and imaging that may be done

Before your surgery, your healthcare team will check your overall health to ensure you are ready for the procedure. This often involves a physical exam and a review of your medical history. You may also need standard blood tests to check your blood counts and organ function.

Your doctor may order imaging tests, such as X-rays or computerized tomography (CT) scans. These pictures help the surgeon view your digestive tract. You might also meet with a specialized nurse who cares for people with ostomies. They will look at your abdomen to find the best flat area for the stoma opening, marking a spot that avoids skin folds and fits comfortably with your clothing.

Medication adjustments

It is important to give your clinician a full list of everything you take. This includes prescription medicines, over-the-counter drugs, vitamins, and herbal supplements. Some substances can increase the risk of bleeding or interfere with anesthesia.

Your doctor will tell you which medicines to continue and which ones to stop. Common adjustments may involve:

• Blood thinners: Medicines that affect blood clotting often need to be paused before surgery.
• Supplements: Certain herbal products may need to be stopped.

Note: Only stop taking your medicines if your clinician specifically instructs you to do so.

Day-before and day-of instructions

Your care team will give you specific rules to follow in the 24 hours leading up to your ileostomy. You may need to clear out your digestive tract so the surgery can be done safely. This process, often called "bowel prep," usually involves taking laxatives or using enemas.

Common instructions often include:

• Fasting: You will likely be told not to eat or drink anything for a certain time before surgery, usually starting the night before.
• Hygiene: You may need to shower with a special antibacterial soap to reduce the risk of infection.
• Morning medications: If you are allowed to take specific pills on the morning of surgery, take them with only a small sip of water.

General surgical risks

Like any major operation, ileostomy surgery carries some general risks. These are not specific to the stoma but can happen with many abdominal procedures. Your surgical team takes many steps to lower these risks before, during, and after the operation.

• Infection: This can happen at the incision site or inside the abdomen.
• Bleeding: Some bleeding may occur during surgery or afterward.
• Blood clots: Being inactive after surgery can increase the risk of clots forming in the legs or lungs.
• Reaction to anesthesia: Some people may have side effects from the medication used to put them to sleep.

Procedure-specific complications

There are also side effects related specifically to having an ileostomy. Because the large intestine (colon) is no longer processing waste, your body handles digestion differently.

• Dehydration and electrolyte imbalance: The large intestine usually absorbs water and minerals. Without it, you may lose more fluids than usual.
• Blockage: Scar tissue or undigested food can sometimes block the small intestine.
• Stoma issues: The stoma might pull inward (retraction), stick out too far (prolapse), or develop a hernia (bulging skin around the stoma). Skin irritation around the stoma is also common.
• Phantom rectum: You might feel an urge to have a bowel movement, even if your rectum was removed or disconnected.

How complications are treated

Most complications can be managed with medication, diet changes, or supplies. Your care team will teach you how to spot signs of trouble early.

• For dehydration: Drinking plenty of water and electrolyte drinks usually helps. In severe cases, fluids may be given through a vein (IV) in the hospital.
• For skin irritation: Changing how you fit your ostomy bag or using special powders and barrier creams can heal the skin.
• For blockages: Doctors may recommend resting the bowel by not eating for a short time and drinking fluids. Surgery is rarely needed unless the blockage does not clear up on its own.
• For infection: Antibiotics are typically prescribed to treat bacterial infections.

Pain control medicines

After an ileostomy, your care team will help you manage any discomfort. They often use a combination of medicines to keep you comfortable while you heal. This might include over-the-counter options like acetaminophen or prescription-strength pain relievers. Your clinician will tailor this plan to your specific needs and health history.

It is important to tell your team about any allergies or other medicines you take to avoid interactions. Using pain medicine as directed helps you stay mobile, which is an important part of recovery.

Antibiotics

Antibiotics are medicines used to prevent or treat infections that can happen after surgery. You might receive them through an IV (a small tube in your vein) during your hospital stay or as pills to take at home. Your clinician may prescribe a specific type based on your procedure and your risk for infection.

Always follow the instructions provided and finish the entire course, even if you feel better. This helps ensure the medicine works correctly. If you notice signs of an allergic reaction, such as a rash or itching, contact your care team right away.

Blood thinners and clot prevention

Because you may be less active right after surgery, your clinician may use medicines to help prevent blood clots. These are often called blood thinners or anticoagulants. They help keep your blood flowing smoothly while you are resting and recovering.

Your care team will decide which medicine is best for you based on your health history. While taking these, it is important to watch for any unusual bruising or bleeding and report it to your healthcare provider immediately. Staying hydrated and moving as much as your team recommends also helps prevent clots.

Emergency warning signs

While recovering, it is important to recognize symptoms that require immediate help. You should seek emergency care if you experience severe pain in your abdomen that does not get better with medication. Vomiting or being unable to pass gas or stool can be signs of a blockage in your intestine.

Pay close attention to the appearance of your stoma. If it turns pale, purple, dark, or black, it may indicate that the tissue is not getting enough blood. Severe signs of dehydration—such as confusion, extreme thirst, or passing very little urine—are also reasons to seek immediate medical attention.

Call your surgeon or clinic if…

Contact your healthcare provider if you notice signs of an infection. This may include a fever, chills, or new redness and warmth around the incision or stoma. You should also call if you see unusual drainage or pus coming from the surgical area.

Your clinician may also want to hear from you if:

• Your stoma bleeds more than usual or the bleeding comes from inside the opening.
• The stoma changes shape significantly, such as pulling back into the skin or bulging out.
• You have severe diarrhea or very high output that makes it difficult to stay hydrated.

Expected vs concerning symptoms

It helps to know what is normal as your body heals. Most people will have a stoma that looks pink or red and moist, similar to the lining of a cheek. It is also expected to see a small spot of blood on a tissue when you gently clean the stoma.

In contrast, concerning symptoms include a stoma that looks dry or changes color drastically. While some cramping is common as your bowel starts working again, severe cramps that last for several hours are not expected. If your output stops completely for a long period and you feel nauseous, contact your care team.

Non-surgical treatments

Before suggesting an ileostomy, your clinician may recommend other ways to manage your condition. For many people with inflammatory bowel disease (IBD), medications are the first step. These may include steroids to lower swelling or biologics, which are specialized drugs that help the immune system stop attacking the bowel.

Dietary changes can also play a role. A dietitian might help you find foods that are easier on your digestive system. These treatments aim to control symptoms like pain and frequent bathroom trips without the need for an operation.

Watchful waiting

Watchful waiting is a period where you and your care team monitor your health closely. This approach is often used if your symptoms are mild or if your condition is not currently getting worse. During this time, you may have regular check-ups, blood tests, or imaging to see how your bowel is doing.

This approach allows you to delay surgery as long as it is safe to do so. It gives other treatments more time to work. However, if your symptoms start to interfere with your daily life or if tests show more damage, your clinician may suggest moving toward a surgical plan.

When surgery becomes the best option

Surgery often becomes the best choice when other treatments no longer provide relief. If medications fail to control inflammation or if you experience a blockage in your intestines, an ileostomy may be necessary. This procedure creates an opening in the belly to allow waste to leave the body, bypassing the damaged parts of the bowel.

Your clinician may recommend an ileostomy to:

• Allow a diseased or injured part of the colon (large intestine) to rest and heal.
• Remove parts of the bowel affected by cancer or severe damage.
• Prevent serious complications like a rupture in the intestinal wall.

While the idea of surgery can be stressful, many patients find that an ileostomy helps them return to activities they enjoy by removing the source of their pain and illness. In some cases, the ileostomy is temporary and can be reversed once the bowel has healed.

Hospital services that commonly perform this surgery

An ileostomy is a surgery where a piece of the small intestine is brought through an opening in the abdominal wall to create a stoma (an opening for waste to leave the body). This procedure is typically performed in hospitals that have specialized departments for General Surgery or Colorectal Surgery. These units focus on the digestive system and have the equipment needed for abdominal procedures.

Your clinician may suggest a hospital that features a dedicated gastrointestinal (GI) floor. These areas are staffed by healthcare providers who are familiar with the specific recovery needs of patients having bowel surgery. Large medical centers or teaching hospitals often have specialized teams that perform these surgeries frequently.

Patient resources and support services

Recovery involves learning new ways to manage body waste, and many hospitals provide specialized support to help. A key resource is a Wound, Ostomy, and Continence (WOC) nurse. These are specialized health professionals who teach you how to care for the stoma and how to use the pouching system (the bag that collects waste).

• Support Groups: Many facilities offer access to peer support groups where you can talk with others who have had similar surgeries.
• Dietary Services: Because an ileostomy changes how your body processes food and water, a dietitian may help you create a plan to avoid dehydration and ensure you get enough nutrients.
• Educational Materials: Most hospitals provide guides, videos, or hands-on training sessions before you go home to ensure you feel comfortable with your care routine.

Questions for choosing where to have surgery

When deciding where to have your procedure, it can be helpful to look for a facility that offers comprehensive care from start to finish. You may want to use this checklist when speaking with your surgical team:

• Does the hospital have certified ostomy nurses on staff to help me before and after surgery?
• Is there a dedicated program to help coordinate my supplies and insurance coverage after I am discharged?
• How often does the surgical team perform ileostomy procedures?
• Does the facility offer 24-hour support or a helpline if I have questions about my stoma once I am home?
• Are there outpatient clinics nearby where I can go for follow-up skin care or pouching adjustments?

Conditions commonly treated by this procedure

An ileostomy is a surgery that creates an opening in the abdomen (belly) to allow waste to leave the body. This procedure is often used when the large intestine (colon) or rectum is damaged, diseased, or needs time to heal. Your clinician may recommend this if you have certain digestive health conditions that prevent the lower part of the bowel from working correctly.

Common conditions that may lead to an ileostomy include:

• Inflammatory bowel disease (IBD): This includes conditions like ulcerative colitis or Crohn’s disease, which cause long-term swelling and sores in the digestive tract.
• Colorectal cancer: Surgery may be needed to remove cancerous parts of the colon or rectum.
• Familial adenomatous polyposis: This is a genetic condition where many small growths, called polyps, form in the colon and may become cancerous.
• Intestinal injuries or birth defects: Serious physical trauma to the bowels or conditions present at birth may require an ileostomy to bypass the damaged area.

Related symptoms people search for

People often look for information about an ileostomy when they experience long-term or severe digestive issues. These symptoms can be associated with the conditions mentioned above and may lead a healthcare team to suggest surgery as a treatment option. It is important to remember that these symptoms can have many causes and should be evaluated by a clinician.

Symptoms that people may search for include:

• Frequent or severe abdominal pain and cramping.
• Chronic diarrhea that does not improve with standard treatments.
• Rectal bleeding or noticing blood in the stool.
• Unexplained weight loss or feeling very tired (fatigue).
• Signs of a bowel obstruction, such as severe bloating or the inability to pass gas or stool.

An ileostomy may be temporary to allow the bowel to rest after a different surgery, or it may be permanent if the lower part of the digestive system must be removed. Your medical team will help determine the best path forward based on your specific health needs.

Evidence overview

Ileostomy is a well-established surgical procedure used to treat conditions that affect the large intestine or rectum. It is commonly performed for patients with ulcerative colitis, Crohn’s disease, familial adenomatous polyposis, or colorectal cancer. Medical experts consider it a standard and effective way to allow waste to leave the body when the colon cannot function properly or needs to be bypassed.

Depending on your specific medical needs, an ileostomy may be temporary or permanent. A temporary ileostomy is often used to allow the lower bowel to rest and heal after surgery. A permanent ileostomy is typically performed when the rectum or colon must be removed entirely. In both cases, the goal is to improve quality of life and manage serious digestive diseases.

Safety notes and individualized care

Like any major surgery, an ileostomy carries potential risks. Your care team will take steps to reduce the chance of complications such as bleeding, infection, or damage to nearby organs during the procedure. After surgery, the focus shifts to managing the stoma (the opening in the abdomen) and adapting to new bowel habits.

Living with an ileostomy requires specific daily care to stay healthy. Common safety considerations include:

• Dehydration: Because the large intestine usually absorbs water, people with an ileostomy lose more fluids. Drinking plenty of water and electrolytes is essential to prevent dehydration.
• Skin health: The skin around the stoma can become irritated by leakage. Using a properly fitted pouching system is critical for protecting the skin.
• Blockages: Scar tissue or certain foods can block the bowel. Clinicians often recommend chewing food thoroughly and avoiding hard-to-digest items.
• Hernia: A parastomal hernia (a bulge around the stoma) can develop if the abdominal muscles weaken.

If you have a temporary ileostomy, your doctor may discuss a reversal surgery after 3 to 12 months. This procedure reconnects the bowel so you can use the bathroom normally again. While generally successful, reversal has its own recovery period, and bowel function may take time to regulate.

Sources used

• Mayo Clinic. Ileostomy: About. https://www.mayoclinic.org/tests-procedures/ileostomy/about/pac-20582350
• WebMD. Colostomy and Ileostomy Reversal. https://www.webmd.com/colorectal-cancer/colostomy-ileostomy-reversal