Pros and Cons of Changing from Colostomy to Ileostomy

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michelecjam

So I am presented with changing my colostomy to ileostomy due to chronic constipation and obstruction issues from that. What are the pros and cons to having an ileostomy over just a revision to colostomy.

AlexT

Just from what I've read on here, I'd much rather keep a colostomy rather than have to empty so many more times a day and deal with watery output on a regular basis. &zwj

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Justbreathe
Reply to AlexT

I sport an ileostomy and I would contribute the following:


Depends (I do like my puns intended)....I only empty about 4 times a day...and according to my surgeon the consistency should be like oatmeal - sorry for you oatmeal lovers out there reading this sh*t on this sight. So a lot DEPENDS on the individual and what you are eating and drinking - don't like oatmeal so much anymore. Jb

P.S. I rarely take a trip to the loo in the night

AlexT
Reply to Justbreathe

So much oatmeal hate.

AlexT
Reply to Justbreathe

Just asking here, how much do you change your diet up? As in, eat a variety of different foods and at different times? Or, do you stick to a pretty set schedule on when you eat and what you eat?

 
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Ben38

I've only ever had an ileostomy. Some people with colostomies seem to think of those of us with ileostomies as their poor relations and as if we're disabled.

Far from it, I've had my ileostomy for over 30 years, been there, done it all, and still learning new things every day. As I always say, the first 10 years are the hardest. You think you know it all, then you realize how little you really know, and you never stop learning.

I used to empty my bag about 2 times a day for 20 years and had very solid output. Never having a colostomy, I can only imagine it was of similar consistency. I did have a large piece of my small bowel removed a few years ago. Since then, I have to empty my bag more often and have looser output. I eat anything anytime, time of day or night I feel like it and can't honestly remember the last time I needed to empty my bag in the night. The other end, my water works, is another story, but that's just down to old age and enlarged prostate!

TerryLT

Hi Michele, it sounds like you and I have something in common, and I hope I can put your mind at rest. I started out with a colostomy, due to a perforated bowel. I had suffered from chronic constipation for years, and the colostomy did nothing to remedy this. My large intestine just didn't work properly, and I ended up with multiple blockages and hospitalizations. It was awful. My surgeon recommended an ileostomy, and I went for it. It has worked out wonderfully for me, and I am grateful every day that I had that option. For me, the pros outweigh the cons in spades. Yes, I have to empty a little more often, but it's no big deal. I usually empty a couple of times during the night, but it's quick and I am back to sleep with no problem. If you don't want that, there are adjustments to your eating time that you can make, i.e., not eating after dinner. As far as output goes, everyone is different and, ileostomates do tend to have looser stool, but not always and certainly not in my case. If I didn't drink tons of water and other liquids throughout the day, my stool would be very hard and compact. I really need to consume a lot of liquid to make it looser, and I prefer it that way. It's way easier to empty loose output, than thick, hard stuff. Another pro is that my stoma is smaller (more dainty!) than my colostomy stoma, and lower profile, just because the ileum is a smaller organ than the large bowel. Some people with ileos have to avoid certain foods that can cause blockages, but they are usually those who have scarring from disease (Crohn's, Colitis) or multiple surgeries. Your profile doesn't indicate you have had any of those issues. I can eat anything, and only have to remember to keep well hydrated and chew my food well. Because of the caustic nature of the ileostomy output, skin problems can occur, and full disclosure, I've been having some irritated skin issues myself recently, but it's the first time I've had any problems since getting my ileostomy nearly two years ago, and it is getting better. There are always solutions. In most ways, having a colostomy or an ileostomy are pretty much the same. We both poop into pouches! I wouldn't even consider going back. Hope this helps.

Terry

TerryLT

Me again, just noticed, you mentioned the possibility of just having a revision done to your ostomy. I'm not sure how that would change anything if you are having constipation and obstruction issues? This is exactly what was happening to me, and removing my large bowel was the only way to solve that.

Terry

Justbreathe
Reply to AlexT

So far, (2-1/2 years) I haven't had any issues with any food (knock on wood). I have only given up my rum and Coke every evening at happy hour - but not because of ostomy but more for liver and kidney health, and I somehow lost my love for it. I rarely eat lettuce because no matter how much I chew it, it comes out in shreds clinging to the inside of the clear bag like Frankenstein fingers until the next bag change. I eat whenever and whatever I want. jb

michelecjam
Reply to AlexT

I stick to a schedule. My main issue is that I have a partial paralytic colon and I am so constipated, and my colostomy is pretty much stopped. I can't take any laxative or stool softener because they do not agree with me at all. I have been in and out of the hospital so much and now developing pancreas problems because of all this. So to me, it would be freedom - well more than the colostomy. Thank you so much for your feedback.

michelecjam

But I don't change if I need to bulk it or make it softer too and adjust accordingly.

michelecjam
Reply to TerryLT

Thank you so much!! I totally agree. Thank you! Appreciate your feedback.

michelecjam
Reply to TerryLT

Wow!!! Very helpful indeed. Very helpful, thank you so much. I am definitely getting it done because I'm tired of being a frequent flyer of obstructions and hospital stays and pain because I can't go, and when it does, it's so hard or thick. Thanks so much, and now I am at the point it's almost stopping altogether. So thank you, this was helpful indeed.

michelecjam
Reply to Ben38

Thank you so much

Very helpful to me and encouraging

michelecjam
Reply to Justbreathe

LOL. I get that even with a colostomy. The funniest is a partially eaten caramel. Eww but funny too.

Thank you for your response. Helpful and made me laugh.

michelecjam
Reply to Justbreathe

Thank you. Very helpful indeed.

TerryLT
Reply to michelecjam

I am so glad you found this helpful. I was thinking of something you might want to discuss with your surgeon. I didn't just go from a colostomy to an ileostomy in one fell swoop. I was not on board with the whole idea of an ileostomy, even with how bad things were for me, simply because of all the negative stuff I'd heard, so what my surgeon suggested is that he give me a temporary 'loop ileostomy', leaving my large bowel intact, along with the colostomy stoma. That way, we could see how well I functioned with the ileostomy, and always reverse it if it didn't work out. So, that's what we did, and I lived for approximately eight months with two stomas, the old colostomy stoma no longer worked, it was just there on the other side of my abdomen and I wore a little stoma cover over it. The ileostomy functioned perfectly and I was very happy with it, no more pain and discomfort, and I haven't taken a laxative in nearly two years! The second surgery was to remove my large bowel, with the old stoma. He could have changed the loop into an 'end' ileostomy, but I said why fix what ain't broke, and he agreed. Maybe discuss with your surgeon. It does mean having two surgeries, but at least then you know for sure, and can always reverse things.

Terry

michelecjam
Reply to TerryLT

Great idea. I will suggest that. Thank you.