Temporary vs. Permanent Ileostomy: Why Choose Permanent?

Just curious. Why do people get a permanent ileostomy? Why not keep your temporary one? I have a temporary one, but I'm scared to have any more surgeries! I'm not getting a reversal, but I'm also not having problems with my temporary ostomy. So, I don't understand what the purpose would be to undergo this surgery. Is there something I need to know???

Mostly depends on the reason someone has an ostomy in the first place. Several reasons why people have ostomies. I had a temporary ileostomy after a total colectomy over 20 years ago in between j-pouch surgeries, and then my j-pouch failed, so I now have a permanent ileostomy since it was safer for me to have everything after my small intestines removed and sewn up due to ulcerative colitis.

A temporary ostomy can be reversed; a permanent ostomy cannot.

Hi C

People don't choose these things; the doctor usually drives the process. Why they go to an end ileostomy, I don't know. Perhaps if there is nothing south of the ileostomy, it needs to be secured for some reason: blood supply, possible leak, who knows? I have a disconnected J-pouch, meaning sealed at the ileostomy but all still intact with a loop ileostomy with the second hole closed. I asked my surgeon why he did it this way. He said you never know what will happen in the future and that extra length on the end could be crucial one day. Works for me.

If you aren't getting a reversal, don't you have a permanent ileostomy? I have a permanent ileostomy because I can't get a reversal. I don't have enough large intestines left to reattach, so I have a permanent ileostomy.

Stories of Living Life to the Fullest from Ostomy Advocates I Hollister

On colorectal cancer forums, I often see people given a temporary ileostomy with the intention of reversal.

They do it for lots of reasons:

• When there's a danger of blockage and the tumor is too big for immediate surgery.
• To help someone tolerate radiation therapy that often causes diarrhea and incontinence.
• After surgery to allow a reconnected area to heal.
• Etc.

Sometimes people choose to keep the bag. I haven't heard of anyone getting their remaining colon removed, but I guess it probably happens. But I think it remains a "temporary" loop ileostomy unless they do get that closed up. In this case, it is kind of confusing to call it "temporary," but that's just how people talk about it.

Those with bowel diseases might go straight to a permanent ileostomy because the whole point was to get rid of the diseased organ.

Personally, I'd avoid the surgery unless there is a reason to remove the remaining colon.

So, my entire colon was removed and much of my small intestines, but I still have the option of reversal. I personally wouldn't do it because of all of the crazy side effects and incontinence problems. Right now, I can control things and I like it that way..lol. This is where my confusion is, I guess. What would they do differently if I get a permanent ileostomy? I understand about cancer. My entire colon was diseased, but not from cancer. I had IBD.

If you have a loop ileostomy, I guess they'd close the loop. This question is better directed to your surgeon. He or she should be able to explain exactly what they'd do as well as the advantages and disadvantages of doing it.

My ileo is permanent as UC had done a number on my large colon, plus a perforation a couple of years before where I had peritonitis and sepsis. I also had a burst appendix that caused damage. I was offered a temporary ileo to see if the UC flare-up would settle down, but I opted for it permanently because of how ill it was making me. Having the bag is the lesser of the two evils for me. Don't get me wrong, I wish to hell I didn't need it, but... such is life.

I'm sorry you had to go through this, but I'm happy you found another solution. I hope you are well now and living your best life. ❤️