Complications Of Ileostomy

Post-operative complications

As with any surgery, complications can develop during, or soon after, having an ileostomy. Possible complications include:

excessive bleeding – which can be treated with blood transfusions
post-operative infections – which can be treated with antibiotics
accidental damage or perforation to nearby tissues or organs – which may require further surgery to repair

There is a risk that an ileostomy will cause serious complications, such as a heart attack, or stroke, which could potentially be fatal.

It is difficult to estimate the exact rate of death because estimates can vary depending on the type of ileostomy surgery being performed, and the general health of the person who is having the surgery. Generally, the risk is thought to be small, at less than 1 in 100.

Obstruction

Sometimes, the ileostomy does not function for short periods of time. This is not usually a problem. However, if your stoma is not active for more than six hours, and you experience cramps or nausea, you may have an obstruction. In this situation, you should contact your doctor or stoma nurse.

A warm bath may help to relax your abdominal muscles. Do not take a laxative. Foods such as nuts, pineapple, coconut, and corn, are more likely to cause an obstruction.

Pouchitis

Pouchitis is when an internal pouch becomes inflamed and is a common complication in people with an ileo-anal, or continent, ileostomy. It is estimated that around 1 in 3 people with an internal pouch will experience at least once episode of pouchitis.

The symptoms of pouchitis are similar to digestive conditions such as Crohn’s disease, or ulcerative colitis, and include:

diarrhoea, which is often bloody
abdominal pains
stomach cramps
dehydration
high temperature (fever) of or above 38C (100.4F)

Pouchitis can usually be successfully treated with a two-week course of antibiotics.

Stoma problems

Some people with an end, loop, or a continent, ileostomy, experience problems related to their stoma. These can include:

irritation and inflammation of the skin around the stoma – this can make it difficult to hold the pouch in position
narrowing of the stoma (stoma stricture) – which can make it difficult to fit the pouch into the stoma
widening of the stoma (stoma prolapse) – again, making it difficult to hold the pouch in place

If you experience any of these problems, you should contact your doctor or stoma nurse for advice. Skin irritation can usually be treated with topical treatments, such as a spray, to reduce skin inflammation and irritation.

A stoma stricture or prolapse may require minor surgery to correct the stoma.

Valve malfunction

A common complication of a continent ileostomy is that the valve that is connected to the internal pouch can malfunction due to the valve narrowing, or being pulled out of position. In this circumstance, minor surgery is required to either repair or replace the valve.

Phantom rectum

Phantom rectum is a complication that can affect people with ileostomies. The condition is similar to a ‘phantom limb’, where people who have had a limb amputated feel that it is still there.

People with phantom rectum feel like they need to go to toilet even though they do not have a working colon. This feeling can continue to occur many years after surgery. Some people have found that sitting on a toilet can help relieve the feeling.

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