Reasons for Procedure

Possible Complications

What to Expect

Call Your Doctor

En Español

Enterostomy

Pronounced: en-tuh-ROS-stuh-mee

by Diana Kohnle

Definition

This is surgery of the abdominal wall and intestines. An opening is made into the intestines to drain the contents out or put in a feeding tube.

The Stomach and Intestinal Tract

Reasons for Procedure TOP

This surgery is done when a new exit for intestinal or fecal matter is needed. It may be needed when feces can no longer travel through the bowels and out the anus.

An enterostomy may also be needed when food can no longer enter the mouth or stomach normally. In this case, a feeding tube will be placed to help food enter the intestines.

Possible Complications TOP

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

Bleeding
Blood clots
Infection
Skin irritation around the stoma from leaking digestive fluids
Diarrhea
Intestinal obstruction
Hernia the at surgical site
Blockage or leakage of the tube, requiring replacement
Adverse reaction to the anesthesia

Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:

Smoking
Drinking
Chronic diseases, such as diabetes or obesity

What to Expect TOP

Prior to Procedure

Talk to your doctor about your medications. You may be asked to stop taking some medications up to one week before the procedure.
Your intestines will be cleaned with a special solution.
Your doctor will talk to you about the physical and emotional difficulties that you will face after this surgery.

Anesthesia

General anesthesia will be used. It will block any pain and keep you asleep through the surgery. It is given through an IV in your hand or arm.

Description of the Procedure TOP

There are different ways this surgery can be done. In one technique, an intestinal sac for collecting fecal waste is created inside of the abdomen. This sac will include a hole called a stoma in the abdominal wall. The stoma allows access to the sac so that it can be emptied through a tube. In another technique, the intestine is directly attached to the abdominal wall so that an external bag can be attached to collect fecal waste.

If the surgery is done to place a feeding tube, an incision will be made in your abdominal wall. The doctor will grasp a section of your small intestine. A small opening will be made. The tube will be placed through this opening and secured in place with sutures. The tube will then be brought through your abdominal wall. It will be secured with sutures.

These procedures may be done by an:

Open procedure, which uses an abdominal incision
Laparoscopic procedure, which uses several small incisions

How Long Will It Take? TOP

30-45 minutes to insert the tube
2-4 hours if sections of the intestine need to be removed

How Much Will It Hurt? TOP

Anesthesia will prevent pain during surgery. Pain and discomfort after the procedure can be managed with medications.

Average Hospital Stay TOP

This procedure is done in a hospital setting. The usual length of stay is 2-4 days. Your doctor may choose to keep you longer if complications occur.

Post-procedure Care TOP

At the Hospital

You may need antibiotics. You may also need medicine for nausea and pain.
If you had an enterostomy to help fecal matter exit the bowels, you may have a pouch on the outside of your body. Waste material will be collected in it. You will receive instructions about diet and activity. During the first few days after surgery, you may be restricted from eating.
The staff will monitor your fluid intake and output to help you avoid dehydration.
You will wear boots or special socks to help prevent blood clots.
You will be asked to walk often after surgery.
You may be asked to use an incentive spirometer, to breathe deeply, and to cough frequently. This will improve lung function.
Your incision will be examined often for signs of infection.

Preventing Infection

During your stay, the hospital staff will take steps to reduce your chance of infection, such as:

Washing their hands
Wearing gloves or masks
Keeping your incisions covered

There are also steps you can take to reduce your chance of infection, such as:

Washing your hands often and reminding your healthcare providers to do the same
Reminding your healthcare providers to wear gloves or masks
Not allowing others to touch your incision

At Home

You will need to reduce activity during your recovery. It may take 1-2 months to completely heal. Other instructions may include:

Practicing good skin care of the area around the stoma. This will help to prevent infection.
Caring for the stoma site and changing the ostomy bag if you have one.
Keeping the area dry until you have permission from your doctor to shower or bathe.

Call Your Doctor TOP

Contact your doctor if your recovery is not progressing as expected or you develop complications, such as:

Redness, swelling, increasing pain, excessive bleeding, or any discharge from the stoma site
Pus or yellow/green discharge from the incision
Persistent nausea and/or vomiting
Signs of infection, including fever and chills
Severe abdominal pain
Cough, shortness of breath, or chest pain
Pain and/or swelling in your feet, calves, or legs
Pain, burning, urgency, frequency of urination, or blood in the urine
Blood in your stool, or black, tarry stools
Diarrhea
If you had a feeding tube placed, food cannot pass through the tube
The tube comes out or leaks
If you had an ostomy bag placed, and there is no stool collecting in the bag.

If you think you have an emergency, call for emergency medical services right away.

RESOURCES:

Family Doctor—American Academy of Family Physicians
http://familydoctor.org

National Institute of Diabetes and Digestive and Kidney Diseases
http://www.niddk.nih.gov

CANADIAN RESOURCES:

Canadian Association of Gastroenterology
https://www.cag-acg.org

Canadian Digestive Health Foundation
http://www.cdhf.ca

References:

Shellito PC, Malt RA. Tube gastrostomy. Techniques and complications. Ann Surg. 1985;201(2):180-185.

Torosian MH, Rombeau JL. Feeding by tube enterostomy. Surg Gynecol Obstet. 1980;150(6):918-927.

6/3/2011 DynaMed's Systematic Literature Surveillance
...(Click grey area to select URL)
Mills E, Eyawo O, Lockhart I, et al. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.

Last reviewed March 2016 by Daus Mahnke, MD
Last Updated: 5/7/2014

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