What Is an Ileostomy?

An ileostomy and a colostomy sound alike, and both involve a bag worn on the abdomen — but they start from different parts of the bowel, and that difference shapes almost everything about living with one. An ileostomy is an opening in the abdominal wall made during surgery. The end of the ileum, the lowest part of the small intestine, is brought through that opening to form a stoma, usually on the lower right side of the belly. Waste then leaves the body through the stoma into a pouch, bypassing the colon. The short explainer above, "What is an Ileostomy?", walks through that anatomy in just over four minutes.

Small intestine versus large intestine

Here is the contrast that matters. A colostomy is formed from the colon — the large intestine — as our guide to what a colostomy is explains. An ileostomy sits one step earlier in the digestive journey, in the small intestine. Because the colon's main job is absorbing water, output that leaves before reaching it tends to be looser and more frequent, and the pouch usually needs emptying more often during the day. That is not a complication; it is simply what the anatomy predicts, and it is why ileostomy care puts extra emphasis on fluids and on protecting the skin around the stoma.

Why a surgeon creates one

Sometimes the bowel below needs complete rest to heal — after part of the colon is removed, for example — and diverting the stream further up gives it that rest. In other cases the colon itself has been removed, and the ileostomy becomes the permanent route out. An ileostomy can therefore be temporary or permanent, and your surgical team will be clear about which plan applies to you. When a temporary ileostomy has done its job, a later, usually smaller operation can close it and reconnect the bowel; the site's "Ileostomy Closure" video, just under three minutes long, shows that reversal procedure.

Living with the pouch, day to day

The stoma itself has no nerve endings, so it does not hurt to touch, though it can bleed a little if rubbed — that is normal for such well-supplied tissue. Most people settle into a routine: empty the pouch when it is about a third full, change the skin barrier on a regular schedule, and check the surrounding skin each time, because output from the small intestine is more irritating to skin than formed stool. Eating usually returns to near normal once your team advises it, with attention to drinking enough fluid. If output becomes very high, the skin breaks down, or you feel dizzy or unusually thirsty, contact your stoma or surgical team promptly rather than waiting for a routine visit.

Frequently Asked Questions

Is an ileostomy permanent?
Not always. Some ileostomies are temporary, created to let the bowel below heal, and are later closed in a reversal operation. Others are permanent when the colon has been removed. Your surgeon will tell you which applies in your case.

Does a stoma hurt?
The stoma has no nerve endings, so it does not hurt to touch. The skin around it can become sore if output leaks onto it, which is why a well-fitting barrier and prompt attention to leaks matter.

What can I eat with an ileostomy?
Most people return to a broadly normal diet once their team advises it. Drinking enough fluid is especially important because more water leaves in the output. Your team may suggest introducing certain foods gradually at first.

How is an ileostomy different from a colostomy?
An ileostomy is made from the small intestine and sits usually on the lower right abdomen, with looser, more frequent output. A colostomy is made from the colon, so its output is usually firmer and less frequent.

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Educational only — this article is general information about ileostomy, not medical advice and not a diagnosis. If you have an ileostomy or have been told you need one, talk to your surgical or stoma care team, who know your situation.