Loop Ileostomy

Loop ileostomy is performed by cutting a few part of the small intestine and pulling it up on the abdominal surface that creates a protrusion which looks like a loop. A hole is then created called a stoma. Loop ileostomy is a type of ileostomy that can be reversed and because of this, it is the most common procedure done for future operation purposes. In loop ileostomy, a rod that is made of plastic is placed under the loop to prevent the protruding part to slip back. After securing the loop, selected intestinal walls are cut which creates two openings or stoma. A stoma is on the upper part of the digestive tract and is attached to a loop ileostomy bag in wherein wastes are stored and emptied. Another stoma is on the part of the colon and its function is to excrete mucus coming from the bowel. The affected intestine is not entirely separated which ensures easier access for loop ileostomy reversal or other surgeries necessary. Loop ileostomy is also called brooke ileostomy. The end part of the ileum is placed through the abdominal wall to the surface of the abdomen. The opening is anatomically found in the lower right side of the abdomen. Patients with loop ileostomy can not control bowel movement and should wear a loop ileostomy pouch for collection.The feces excreted by the loop ileostomy is rich in digestive enzymes that can be very irritating to the skin. Peristomal care is necessary to avoid skin erosion. Common loop ileostomy problems 1. Skin irritation may happen especially when the seal is not tight enough in the peristomal area. Digestive enzymes and feces touch the skin which creates a reaction. Skin redness and inflammation are signs of skin irritation. Keeping the peristomal area clean and dry will prevent this problem from happening to a loop ileostomy. 2. Food blockage may be experienced because of ingested foods such as legumes, fruits and vegetable peelings. It can either be partial or complete obstruction. Complete obstruction is emergent and it is the absence of wastes passing through the stoma for six hours or more. Symptoms such as nausea, vomiting and cramps may be experienced due to this loop ileostomy problem. 3. Dehydration can also be a loop ileostomy problem. This happens when too much fluid are eliminated in the body. Passing out of much loose stools and vomiting may precipitate this. With dehydration comes electrolyte imbalance which adds insult to injury. Drinking a lot of water or eight to ten glasses of water per day helps this from not happening and also treating the underlying cause of diarrhea and vomiting helps. Fluid and electrolyte replacement are done when dehydration occurs. 4. Retraction of stoma, this is experienced when the height of the stoma is below the level of the skin. This may happen very soon after surgery as the small bowel is inactive for hours after a loop ileostomy. Gaining weight may also cause stomal retraction. 5. Peristomal hernia is when a part of colon enlarges around the opening. This usually happens when abdominal pressure is high. This is evident during straining, sitting and coughing. Splinting helps to prevent this from happening. 6. Prolapse is when the bowel is stretched and bulges out from the stoma, on top of the abdominal surface. This loop ileostomy problem is again caused by high abdominal pressure.