An ileostomy can be performed in several different ways depending on the underlying condition.
An end ileostomy involves removing the whole of the colon. The end of the ileum (small intestine) is brought out of the abdomen via a permanent stoma (opening) and stitched into place.
Waste material comes out into a stoma bag that is worn under your clothes. The stoma bag is made of an adhesive material that sticks to your skin and needs to be emptied regularly. It is recommended that it is emptied when it is one-third full, to prevent it from bulging and possibly leaking.
An ileo-anal pouch (also known as a J pouch) is sometimes used as an alternative to an external stoma pouch.
An ileo-anal pouch is created from the ileum (the end of the small intestine) and joined to the anus so your bowel actions can be controlled in the normal way. The pouch stores the waste material until it is excreted (expelled) when you go the toilet.
The area around the pouch usually needs to heal before it is used, so a temporary loop ileostomy (see below) above the pouch will be created. A second, smaller operation is usually carried out a few months later to close the loop ileostomy.
Sometimes the operation can be performed without creating a temporary ileostomy.
A loop ileostomy is a procedure that involves creating a stoma at the loop of the ileum, usually on the right-hand side of the abdomen. The colon and rectum are left in place.
The loop is created to direct the waste material from the ileum. This may be necessary to assist with healing after an injury to the colon or following the removal of a diseased section of colon. It may also help to relieve a blockage.
The loop ileostomy is usually temporary and the stoma may be closed during a second operation.
A continent ileostomy involves removing the colon (large intestine). The end of the ileum is bent back inwards, to create a pouch that is stapled into place against the side of the abdomen.
A smaller section of the ileum is used to create a valve, which is pulled through a stoma in the abdomen and then stitched into place. The internal pouch can then be emptied by draining it with a catheter (thin tube).
The continent ileostomy is an option for people who cannot have an ileo-anal pouch due to health or technical reasons, or when an ileo-anal pouch stops working and needs to be removed.