Ileostomy to colostomy

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Lookin4ward
Posts: 251
Joined: 2014-07-12 19:56:00

Ileostomy to colostomy

Post by Lookin4ward »

Has any one gone from having an ileostomy to getting a colostomy?? Did you have a significant reduction in stool amount? I am 5 years with a high output (4-5 liters a day) ileostomy. My GI doc referred me to a colorectal surgeon, which happens to be my ileostomy surgeon, to see if switching my stoma placement would reduce my output if the benefits do not out weigh the liabilities I will leave well enough alone. TIA.
Diagnosed with Crohns in 2002. Ileostomy (7-24-14)
sassie
Posts: 164
Joined: 2018-10-19 19:22:16

Re: Ileostomy to colostomy

Post by sassie »

Lookin4ward , I personal do not know but a lady where i bank her hubby just did what your going to do and she said He is so happy, his output is more firm and he also has the choice to irrigate now, she said he says for the first time he feels some control over things...Yes he had reduction as well..

Best of luck, sassie
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steiconi
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Joined: 2015-05-18 03:12:03

Re: Ileostomy to colostomy

Post by steiconi »

I had a temporary ileostomy, and years later a permanent colostomy.
I MUCH prefer the colostomy.

The large intestine removes much of the water from the faeces, so less output winds up in the pouch, and it's more solid.

That can mean less skin irritation, fewer trips to the bathroom, and fewer leaks. I irrigate, which reduces all that even more.

You should definitely consider the switch.
Lee

I am not my disease.
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Diane C
Posts: 1006
Joined: 2005-10-02 08:30:29

Re: Ileostomy to colostomy

Post by Diane C »

Lookin4ward,

I did the reverse after surgeons recommended this for over a decade. If your transit time is effective, you've experienced no blockages, you have no functional GI disorders as I do -- my puberactalis muscle and accompanying anal and rectal muscles have been dysfunctional from birth (genetic) resulting in severe constipation and distention (see iffgd.org for more info on functional GI disorders), you've had no cancer, and doctors think it'd help -- it's probably an advantage. You also can irrigate which results in less gas and often a sense of more freedom. See the Irrigators Forum for very helpful tips -- I did irrigate -- but still developed a sigmoid abscess, required a mesh to be installed in 2015, felt internal pressure to irrigate more than daily, and more. Yes, I do think a colostomy would be far easier to handle for most folks but it depends on the individual and your condition.

I'm getting used to the very frequent flow from the ileo -- and no, I don't constantly eat. Other toxins are released from the liver and other organs -- -- not just undigested food -- and yes, the output can sting the skin if there's leakage. I'm taking Immodium liquid which I can titrate and it's helped very much. :)

Good luck with your decision. Seek out good surgeons for advice and talk to others. Wishing you health!

Diane C
2000 MACE procedure for non-relaxing puberactalis
2002 Colostomy
2018 Ileostomy and Removal of Colostomy, Hernia, Mesh -- and More
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Bob Webtech
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Joined: 2005-09-29 11:17:09

Re: Ileostomy to colostomy

Post by Bob Webtech »

Hi Lookin4ward,

I looked up your early posts because, as you surely know with your nursing background, most people with a (permanent) ileostomy have had their entire colon removed, which would make a colostomy impossible. In your case, based on your comments on Aug 2, 2014, a large amount of small intestine and some of your large intestine were removed. Your resulting ileostomy is a high-output one because, due to the large amount of small intestine removed, it's located high in the ileum. Most of your colon was left in place, along with your rectum and anus, so I assume the retained colon continues to generate some mucus which drains out your bottom.

In order to convert to colostomy, your small and large intestines would need to be reconnected. The difficulty of that process would depend on the distance that portions of your remaining small and/or large intestine would need to be moved in order to rejoin them. If nothing else is done, aside from reconnecting your small and large intestine, you'd be pooping through your bottom again. I know you don't want that because, based on your comments on July 16, 2014, you had a fistula in the anal area which left you with very little control there. Therefore, a colostomy would be necessary to provide bowel control.

While making the colostomy, the question would arise what to do with your rectum and anus. The simpler option would be to leave a rectal stump. And, assuming the drainage from your colon during the past 5 years hasn't given you too much trouble, you'd probably have even less trouble with the drainage from a rectal stump. The other option would be to remove the rectum and anus entirely. This would be a bigger operation, possibly with a long recovery period, but would completely eliminate drainage out your bottom.

As for the output from the colostomy: Since a colon normally absorbs liquid from the material passing through it, the output would probably be less liquidy and less voluminous than from your current ileostomy. It may nevertheless be somewhat more continuous, and somewhat higher volume, than is true for many permanent colostomies, because of the amount of intestine that's been removed and because (I assume) your ileocecal valve was removed. So it may not be a good candidate for irrigation, but would probably be easier to deal with than your current high-output ileostomy.

I hope I've given you some questions to discuss with your surgeon in deciding whether to go through with such a surgery.
Bob Baumel, UOAA discussion board administrator
Lookin4ward
Posts: 251
Joined: 2014-07-12 19:56:00

Re: Ileostomy to colostomy

Post by Lookin4ward »

Thank you all for your response! I’m still not settled on having this done. For many years prior to my ileostomy my stools were always watery. Never a formed stool. My question to the surgeon is why would a colostomy change that when I have less functioning intestine now than I did then? In theory it sounds kinda good but I’m very skeptical.
Diagnosed with Crohns in 2002. Ileostomy (7-24-14)
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Bob Webtech
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Re: Ileostomy to colostomy

Post by Bob Webtech »

Hi Lookin4ward,

During those "many years" before ileostomy when your stools were always watery, did you already have Crohn's disease? That disease tends to cause watery diarrhea because the diseased portions of intestine don't absorb liquid as they should, and can even secrete extra liquid.

Key questions now are whether your 2014 surgery removed all the diseased intestine and, especially, whether your remaining large intestine (which has been bypassed for 5 years but will become functional again if you get this surgery) is sufficiently free of disease that it will function as normal colon and will absorb liquid from the material passing through it.

It's my guess that if you get this surgery, the resulting colostomy may not be suitable for irrigation, but may be easier to handle than your current high-output ileostomy. But you need to discuss this with your surgeon.
Bob Baumel, UOAA discussion board administrator
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