Loop ileostomy is a reversible type of ileostomy that diverts the contents of the intestines to allow certain parts of the body to heal due to complications or after medical procedures.
A surgeon will carry out a loop ileostomy by creating an opening, or a stoma, in the abdomen. This procedure is usually temporary, but it can be a big change in a person’s life, and preparation is key.
This article explores loop ileostomy, including why surgeons perform it, how to prepare for it, what to expect during and after the procedure, and when to call a doctor.
Loop ileostomy is one of two types of ileostomy, a surgical procedure where the small intestine is diverted through an opening in the stomach.
Surgeons pull a loop of the small intestine out through an incision, open it up, and stitch it to the skin to create a stoma, or an opening. This stoma is a temporary pathway for waste to exit the body when the natural route is blocked or compromised.
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Doctors often recommend this procedure to temporarily redirect stool away from a specific area of the intestines. For example, they may perform loop ileostomy after distal anastomosis, which is a surgery that joins two parts of the colon together.
Other reasons a doctor may carry out loop ileostomy include to:
- remove stool from the body after removing the entire colon, such as in colorectal cancer or familial adenomatous polyposis
- relieve bowel obstruction
- provide temporary relief to allow a segment of the bowel to rest and heal in cases of inflammatory bowel disease (IBD)
- manage intestinal obstruction from tumors or adhesions
- allow the healing of
anastomotic leaks or fistulas in the intestines - prepare for further surgical interventions, such as bowel resection
Preparation before undergoing a loop ileostomy may include:
imaging studies - blood tests
- other assessments to help identify any potential risks
- adjusting diet and medications to minimize the risk of complications during and after the procedure
Loop ileostomy can be a big change in a person’s life, and they will need to learn how to care for their stoma.
A doctor or stoma nurse can help guide individuals through the process. They will usually:
- provide information about the operation and answer any questions
- show different types of stoma bags and explain how to use them
- inform individuals on how to prepare for the operation
- help find the best position for the stoma
A surgeon typically performs loop ileostomy while the patient is under general anesthesia to ensure their comfort and safety.
The stages of loop ileostomy surgery include:
- A surgeon makes a small cut, usually on the right-hand side of the abdomen, and creates an opening for the small bowel to pass through.
- Then, the surgeon carefully brings a loop of small bowel through the opening and holds it in place.
- Finally, the surgeon will cut the loop open and stitch it to the skin, making two stoma openings that are joined together at the base. One stoma is “active” and leads to the small bowel, where stool leaves the body. The other stoma is “inactive” and leads to the large bowel.
- Waste can now pass through into a collection pouch.
A loop ileostomy is usually temporary. The surgeon does not remove the colon during this procedure.
Following loop ileostomy, patients may experience some discomfort or pain at the
The recovery timeline varies for each person but may involve:
- staying in the hospital between 3 and 10 days to monitor for any complications and ensure adequate healing
- using a catheter in the bladder to drain away urine
- using an IV drip in the arm to provide fluid and medications
- gradually returning to usual activities
- receiving regular monitoring until waste starts to come out of the stoma and people feel confident taking care of it themselves
- attending follow-up appointments with the surgeon to monitor stoma function, address any concerns, and plan for potential reversal surgery
Patients will also receive instructions on caring for their stoma, including how to change the pouching system and maintain proper hygiene.
Also, the patient works with the healthcare professional to make dietary changes following the procedure.
Learn more about what to eat after an ileostomy.
Recovery time
The stoma will usually be swollen, and it might bleed at first. This is normal, and swelling should decrease in the next 2 to 3 months.
While loop ileostomy is generally safe, it can potentially lead to complications. These
- skin irritation or damage
- leakage
- stoma prolapse
- postoperative infection at the surgical site
- dehydration or electrolyte imbalance due to fluid and electrolyte loss through the stoma
- bowel obstruction
- hernia formation around the stoma site
Patients must promptly contact their healthcare professional with any unusual symptoms or concerns to prevent complications from worsening.
In some cases, loop ileostomy may be temporary, and individuals might consider reversal surgery once the underlying condition has improved or healed. Reversals usually happen for loop ileostomies that have been done in an emergency.
The decision to undergo reversal surgery depends on various factors, including:
- the patient’s overall health
- the severity of the underlying condition
- the risk of complications
During the reversal procedure, a doctor surgically closes the stoma and reconnects the intestines to restore regular bowel function. After a reversal, individuals will no longer need a stoma bag, as toilet function returns to normal.
Learn more about ileostomy reversal.
Patients should contact their healthcare professional if they experience any of the following symptoms after loop ileostomy surgery:
- persistent abdominal pain or cramps
- fever or chills
- nausea and vomiting
- excessive bleeding or drainage from the stoma
- signs of dehydration, such as dizziness or weakness
- dark urine
- frequent diarrhea
- loss of appetite
- changes in stoma appearance or function, such as discoloration or a reduction of output
- difficulty breathing
A loop ileostomy is a surgical procedure that diverts intestinal contents away from a damaged or healing segment of the intestines through a stoma. People with inflammatory bowel disease, intestinal obstruction, or a fistula may require it.
With proper care and management, individuals who undergo loop ileostomy can improve their overall health and quality of life.