Enterostomy
Definition
Enterostomy is surgery to create an opening into the intestine through the abdominal wall. It allows the intestine contents to drain. It may also be used to insert a feeding tube.
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Reasons for Procedure
This surgery is done when a new opening is needed to empty the bowels.
It may also be needed when food can no longer enter the mouth or stomach normally. A feeding tube is inserted in the opening to provide nutrients.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Blood clots
- Damage to other organs or structures
- Infection or skin irritation around the stoma
- Diarrhea
- Intestinal blockage
- Hernia at the incision site
- Feeding tube blockages or leaks
Things that may raise the risk of problems are:
What to Expect
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging
- Cleaning out the colon
Anesthesia
The doctor will give general anesthesia. You will be asleep.
Description of the Procedure
An incision will be made in the abdomen. Next, the doctor will use one of these methods for the procedure:
In one method, an intestinal sac is made inside the abdomen. The sac is to collect stool. It will lead to a hole (stoma) in the outer abdomen called a stoma. From the stoma, the sac will be emptied through a tube.
In another method, the intestine is attached to a stoma in the outer abdomen. The stoma allows stool to leave the intestine. It collects in a pouch called an ostomy bag.
If the surgery is done to place a feeding tube, the doctor will make an opening in the small intestine. The tube will be placed through this opening. It will be held in place with stitches. The tube will then be brought through the outer abdomen. It will also be held in place with stitches.
These procedures may be done as an:
- Open procedure—using a large incision
- Laparoscopic procedure—using several small incisions
How Long Will It Take?
30 to 45 minutes. It may take longer if other repairs need to be made.
Will It Hurt?
Pain and swelling are common in the first week. Medicine and home care help.
Average Hospital Stay
The usual length of stay is 2 to 4 days. If you have any problems, you may need to stay longer.
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Give you medicines to control pain or nausea
- Teach you stoma and ostomy care
During your stay, the hospital staff will take steps to lower your risk 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 and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Recovery may take 1 to 2 months. Physical activity will be limited during this time.
Call Your Doctor
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever or chills
- Redness, swelling, excess bleeding, or discharge from the incision or stoma
- Lasting nausea or vomiting
- Pain that you cannot control with medicine
- Pain or swelling in the feet, calves, or legs
- Problems passing urine or stool, including bleeding
If you think you have an emergency, call for medical help right away.
RESOURCES:
Family Doctor—American Academy of Family Physicians
https://familydoctor.org
National Institute of Diabetes and Digestive and Kidney Diseases
https://www.niddk.nih.gov
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
https://www.cag-acg.org
Canadian Digestive Health Foundation
http://www.cdhf.ca
REFERENCES:
Colorectal surgery considerations. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/colorectal-surgery-considerations. Accessed January 13, 2021.
Tube enterostomy. Encyclopedia of Surgery website. Available at: http://www.surgeryencyclopedia.com/St-Wr/Tube-Enterostomy.html. Accessed January 13, 2021.
What is an ileostomy? American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/ostomies/ileostomy/what-is-ileostomy.html. Accessed January 13, 2021.
Xian H, Zhang Y. A descriptive, cross-sectional study among chinese patients to identify factors that affect psychosocial adjustment to an enterostomy. Ostomy Wound Manage. 2018 Jul;64(7):8-17.
Last reviewed February 2020 by EBSCO Medical Review Board Marcin Chwistek, MD Last Updated: 1/13/2021