We often hear phrases such as loop stomas and temporary stomas, but what exactly are they and how it will affect you having stoma surgery? Knowing more and understanding about this type of stoma can help during the recovery phase…
Will I have a permanent or temporary stoma?
This decision very much depends on your underlying condition and is usually discussed prior to your surgery. Your surgeon will tell you whether you are likely to have a stoma after your operation, and whether it will be temporary or permanent.
This decision is usually dependant on whether your bowels or bladder aren’t permanently damaged and just need a break, therefore giving you the opportunity for your stoma to be reversible.
The decision can be informed by your stoma care nurse, or for those who require emergency bowel surgery, this will be a decision made by your surgeon in a life saving scenario.
Can any type of stoma be temporary?
A urostomy is always a permanent stoma, but some colostomies and ileostomies may be temporary.
Types of temporary ileostomy
There are usually two different types of ileostomy surgery: a loop ileostomy and an end ileostomy.
A loop ileostomy is typically temporary. It is created when a loop of the small bowel is lifted above skin level during surgery, typically held in place with a stoma rod. A cut is then made on the exposed bowel loop, with the ends then rolled down and sewn onto the skin. The loop ileostomy consists of two stomas which are joined together.
An end ileostomy is created when part of your large bowel (colon) is removed or needs to rest. The end of your small bowel (ileum) is brought to the surface of your abdomen to form a stoma (ileostomy).
An end ileostomy can be either temporary or permanent. If the diseased part of the bowel has been removed, the remaining part needs to rest before the ends can be joined back together. If the surgeon deems it too risky, or not possible to join these two parts back together, then a permanent solution is chosen.
Why are temporary ileostomies formed?
An ileostomy is formed to treat several conditions. Some of these conditions involve surgery which can be reversed when you are fully recovered.
Conditions that might require surgery involving a temporary ileostomy:
- Colorectal cancer
- Diverticular disease
- Ulcerative Colitis
- Crohn’s disease
- Familial adenomatous polyposis surgery
- Congenital abnormalities
- Colo-vaginal/colo-vesicle fistula
Conditions that might require a permanent ileostomy:
- Crohn’s disease
- Colonic motility dysfunction
- Blocked, damaged, or ruptured large intestines
Types of temporary colostomies
There are also two types of colostomies: loop and end colostomy. As with temporary ileostomies, temporary colostomies very much depend on your circumstances. Only a small number of people with colon cancer need a permanent stoma.
A loop colostomy is often used in acute scenarios. If the colostomy is temporary, it is then easier to reverse further down the line.
A loop colostomy is a temporary intervention to redirect your colon to a stoma in your abdomen. Diverting your stool to a new route out of your body (stoma) allows your traumatised colon to rest and heal. This can be more easily reversed later by simply detaching the colon from the abdominal wall and closing the holes to re-establish the flow of stool through the colon.
An end colostomy can be reversed but is usually designed to be permanent due to your condition being irreversible. With an end colostomy, one end of the colon is pulled out through a cut in your tummy and stitched to the skin to create a stoma.
Conditions which might require a loop or end colostomy:
- Birth defect such as a blocked or missing anal opening, called an imperforate anus
- Serious infection, such as diverticulitis (inflammation of little sac in the colon)
- Inflammatory Bowel Disease (Crohn’s disease or ulcerative colitis)
- Injury to the colon or rectum
- Partial or colon cancer
- Wounds or fistulas in the perineum. (A fistula is an abnormal connection between internal parts of the body or between an internal organ and the skin)
Stoma reversal surgery
A temporary stoma can be reversed after several weeks to months once the bowel has had time to heal and recover.
Reversing a stoma involves re-joining the piece of bowel that is your stoma with either your rectum, colon or your small bowel and then closing the stoma site. If this is an option for you, it would be beneficial to talk things through with your Stoma Care Nurse as to what your expectation should be following reversal.
Not everyone decides to have their temporary stoma reversed, opting to remain with a stoma if they wish to do so.
Read more on stoma reversal surgery to learn about the options available.