Why an ileostomy may be needed 

An ileostomy may be needed if the colon is damaged, inflamed or doesn't work properly.

Some of the most common reasons why surgery to form an ileostomy is carried out are described below.

Crohn's disease

Crohn's disease is a long-term condition where the digestive system becomes inflamed. Common symptoms include:

Crohn's disease can usually be controlled with medication, but surgery to create an ileostomy may sometimes be recommended to temporarily divert digestive waste away from the inflamed section of the digestive system to give it a chance to heal.

Ulcerative colitis

Ulcerative colitis is a long-term condition where the lining of the large intestine or large bowel (colon or rectum) becomes inflamed. Common symptoms include:

  • bloody diarrhoea
  • abdominal pain
  • a frequent need to pass stools

In most cases symptoms can be controlled with medication. However, surgery to remove the colon and form an ileostomy or ileo-anal pouch an internal pouch to store stools created using the end of the small intestine  may be recommended if the condition is particularly severe or doesn't respond to medication.

Bowel cancer

Bowel cancer is a type of cancer that develops inside the colon or rectum. Chemotherapy or radiotherapy, or a combination of both, may be used to shrink the cancer first, before the affected section of bowel is removed.

Depending on the size and position of the removed section of bowel, a temporary ileostomy, permanent ileostomy, or an ileo-anal pouch may be formed during the operation.

In some cases, a section of your colon may need to be diverted out of your tummy (abdomen). This is known as a colostomy, rather than an ileostomy.

Less common uses

Some of the less common reasons why surgery to form an ileostomy is needed are described below.

Familial adenomatous polyposis

Familial adenomatous polyposis (FAP) is a rare condition that triggers the growth of non-cancerous lumps of tissue inside the colon.

Although the lumps are non-cancerous to begin with, there's a very high risk that, over time, at least one will turn cancerous. More than 99% of people with FAP have bowel cancer by the time they're 50 years old.

Because of the high risk of developing cancerous lumps, it's usually recommended that a person diagnosed with FAP has their colon removed. It's usually replaced with an ileo-anal pouch, or occasionally a permanent ileostomy.

Bowel obstruction

A bowel obstruction occurs when part of the digestive system becomes blocked by food, fluids, or waste products. This can happen if part of the person's digestive system is scarred or inflamed, or if their digestive system is unusually narrow.

If the colon becomes completely blocked, it's usually necessary to remove the colon and form an ileostomy. This can be temporary or permanent, depending on the underlying cause of the obstruction.

Injury

A significant injury to the colon, such as a puncture or impact injury, can result in the colon becoming permanently damaged.

In these cases, it may be necessary to remove the colon and form an ileostomy. Whether this is a temporary or permanent ileostomy depends on the type and extent of the injury.

Page last reviewed: 29/03/2016

Next review due: 31/10/2018