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loop ileostomy? huh?

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Posted 1/4/2008 11:43 PM (GMT 0)
Ok everyone,

I went to the dr. yesterday, and told them i decided to have the surgery :O/. I'm waiting for them to call me with my date. Well, when i went they said i would be getting a loop ileostomy. Whats the difference between this and a regular ileostomy? I looked it up, but it sounds so technical i dont get it. N e answers would b appreciated. Thanks you guys...this is becoming more and more real :o(
Posted 1/5/2008 12:14 AM (GMT 0)
Here is a description that I found on the web.  I hope it helps.

Types of ileostomy

There are two types of ileostomy - an end ileostomy and a loop ileostomy.

In an end ileostomy, the colon and rectum are removed and the end of the ileum is bought out through the stoma.

In a loop ileostomy, a loop of the small intestine is bought out through the stoma, but the colon and rectum are not removed. This is usually carried out as a temporary procedure, when it is necessary to remove only a part of the colon. Once the remaining colon has healed, it can be reconnected to the small intestine, and the stoma can then be closed.

Posted 1/5/2008 12:27 AM (GMT 0)
Since I am not in the medical field... I have sent an email to another member of this forum who has much more medical background than I do. Hopefully she will be able to give you the answers you need.
Posted 1/5/2008 12:54 AM (GMT 0)
thanks peggy, that was actually one of the sites that i found, i was just wondering if anyone here was actually told that that's what they have, and if its any different than what others have.

Ash, thats what i mean, you would think that when you got your surgery if there was a big difference they would have said, "Ash you are getting a ____ ileostomy, which is different from a regular ileostomy because_______" lol i dont know. im so lost now
Posted 1/5/2008 1:35 AM (GMT 0)
I always, without fail, get a copy of my post op report for my records for any surgery or even procedure (ie EGD, etc.) . You would be surprised how much you learn from that report and it is all in black and white! No gray areas.... You might need a medical dictionary to get thru it all but you will know exactly what was done.
Posted 1/5/2008 3:43 AM (GMT 0)
i didnt' really understand that either, but i would think that if you have UC they wouldnt' leave any of your colon in "to heal" cause it will just get affected too. But since you have chrons, maybe they are hoping it won't attack what is left.
Posted 1/5/2008 6:39 AM (GMT 0)
If your ileostomy is only going to be temporary, they tend to give you a loop ileo. To visualise this, imagine your colon is a piece of hose. Now imagine that piece of hose is almost cut in two but not quite so it's still joined together at some point. The is the part of the bowel they use for a stoma so that in actual fact there's two openings. One the working stoma (which comes from the digestive system) and the other stoma (called a mucous fistula) which joins on to the rectum and anus. At first you will find, there is usually a rod underneath the 'loop' of bowel between the two stomas, to keep it from gravitating back into your body while it heals.When the time comes for the ileostomy to be reversed, all the surgeon has to do is rejoin the two bits together properly and 'voila' you have a complete bowel again. See http://www.ostomates.org/ostomies.html#temp

 for pictures to explain it

Another type of temporary ileostomy is called a Hartmann's pouch. With this they completely cut the colon in two and leave the non-working end inside you (or some bring it out elsewhere to make a separate stoma) and when the time comes the two ends are just joined up again.

In an end ileostomy, they just cut the rest of the intestine off completely so you only have one stoma which leads to the digestive system. They may or may not leave you with a rectal stump in this surgery. Obviously, since the rest of the colon is gone, this type of ileostomy is considered permanent.

Clear as mud? :)

Posted 1/5/2008 12:48 PM (GMT 0)
Thanks shaz,

So I asked my doc would I have 2 stomas and they said no. What's that about? I really don't want two, does stuf come out of both?
Posted 1/5/2008 2:40 PM (GMT 0)
Thanks Shaz!!!!

Posted 1/5/2008 7:44 PM (GMT 0)
Shaz,

This is like Ostomy 101 for Dummies...THANK YOU very much for the explaination!
Posted 1/5/2008 7:50 PM (GMT 0)

Thanks Shaz! Sign me up for the next semester!

Richard

Posted 1/5/2008 7:56 PM (GMT 0)
I havea loop colostomy I had a severe obstruction in the descending colon and the surgeon just made the loop above the obstruction.  I had had no part of the colon removed.  Everything has worked out well except for a humongous stoma.  It is nearly the size of two doubled fists together.  The st oma works wellhowever, except that in the last few days I have had a pain similar to that just before sugery.  Like I have severe constipation.  I have also had some ugers (Not successful) to have an ordinary BMI am concerned that perhaps some of my waste producst are doing into the colon through the back door and leaving me with the same condition i had before surgery  Any Ideas?

 

p.s. Amy  I feel so gad fdor you   .  I pray that you will soon fi nd the cause and relief from your problem.  Booze and Coffee won't cut it  Your LDS friend Ralph nono nono nono

Posted 1/6/2008 4:07 AM (GMT 0)

Praying4healing said...
So I asked my doc would I have 2 stomas and they said no. What's that about? I really don't want two, does stuf come out of both?

A lot of surgeons don't acknowledge the smaller second opening as a stoma, which is why it's called a mucous fistula I guess lol  But there will be two openings (from the same spot in the loop of bowel which is brought to the surface). A lot of people don't even realise there is a second opening because sometimes it is really tiny and they don't even notice it.

Only the working stoma that is connected to your upper digestive system will work. The other one will just sit there waiting to be connected up again when the time comes.

You may, however, find that with a loop ileostomy, you have a bowel movement via your anus. It's something the doc's forget to warn you about. Because the two openings are housed in the one bag, sometimes stool can work it's way into the mucous fistula and out via your rectum and anus. It's nothing to worry about, just scary cos you're not warned it can happen (it doesn't seem to happen too often to people though).

Posted 1/6/2008 5:03 PM (GMT 0)

Shaz:

Thanks again for all the great information. I guess I like to conteplate on my stoma (instead of my navel), and I think I can see the mucous fistula. I always thought it was some surgical remnant. Also, my surgeon once told me when I was in the hospital that my stoma was "communicating" with my large intestine and he seemed bewidered as to how this could happen. I think you answered it! I also have mucous discharge from my rear on occasion.

Do you think having the mucous fistula so close makes a laproscopic reconnection more feasible?

I feel like I should give you my insurance so you can submit a bill for consultation!

Richard

Posted 1/7/2008 3:46 AM (GMT 0)
Hey Richard,

"Do you think having the mucous fistula so close makes a laproscopic reconnection more feasible?"

Unfortunately, that's a question only your surgeon can answer. Certainly, I have heard of others having their loop ileo reconnected via laproscopy but again it's a question for your surgeon.

The mucous discharging from your rear end is normal and healthy and will happen whatever type of ostomy you have as long as your rectum and anus are still in place. When you were 'bowel intact' they would secrete mucous to help the stool slide along. Now the mucous is superfluous but still there because the rectum and anus are still doing what they're meant to do. It's annoying but a good sign :)

Btw, I'm an Aussie and as much as I try to, I will NEVER understand the US health insurance system so consider this a freebie lol
Posted 1/7/2008 4:03 PM (GMT 0)
Praying,
My first surgery was to remove the colon and leave the rectum, at this point I have an end ileostomy. The output is thicker than the loop because it's the lower end of the small intestine. I've been told that you really have to drink a lot with the loop because your chances of getting dehydrated is much higher than with the end. With the loop having more watery consistency, it's more of a challenge to change the appliance. My second surgery will be on the 14th where he will form the j-pouch and I could possibly have the loop (if all goes well, they will try to complete everything, but usually my surgeon does 3 surgeries) I've had the bloody mucus discharge which was nothing in the beginnng, but my rectum is still inflamed and I've had horrible rectal spasms and pain that pain killers can't touch. When they form the pouch, they remove the rectum and I will be so happy to be rid of it! Are you a canditate for this j-pouch with Crohn's? Are they telling you if this is temporary or permanent? I would think that if it's permanent, you would have the end. I hope you are less frightened about this surgery after reading the posts here and I even keep telling myself that the surgery pain will get better with time, instead of the pain of UC which doesn't. Good Luck to you!
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