Ileostomy surgery in Turkey: types, procedure and recovery

What is an ileostomy?

An ileostomy is a surgical procedure that diverts a portion of the small intestine to an opening created in the abdominal wall. This opening becomes the new exit point for stool, temporarily or permanently replacing the natural passage through the rectum.

After the operation, a pouch is attached to the skin at the site of the stoma to collect stool. Since the stoma has no sphincter muscle, bowel movements are continuous and cannot be voluntarily controlled. This is why an external collection system is essential.

This procedure is often recommended for patients suffering from:

• Chronic inflammatory bowel diseases (such as Crohn's disease or ulcerative colitis)

• Colorectal cancer

• Following complex digestive surgeries

What to expect after surgery

Immediately after the operation, the stoma appears red and moist, as it is made of intestinal mucosa. It may bleed slightly to the touch. Over the following weeks, its shape and size stabilize. The stitches that secure the stoma dissolve on their own.

The stoma usually starts to work within the first days after surgery, once eating resumes and gas begins to pass, a sign that the intestine is active again.

A stoma that turns dark, purple or black, or stops working with vomiting and a swollen belly, needs urgent medical attention.

Comprehensive preparation with Turquie Santé

Before the operation, an essential step is to choose the position of the stoma. It depends on your anatomy, your lifestyle, the suppleness of your skin and the way you hold yourself or dress, and is marked with the stoma nurse.

Turquie Santé coordinates this preparation with the hospital: review of your reports by a specialist, a detailed quote, the planned stay, airport pickup, transfers, an interpreter and 7-day-a-week assistance.

Different types of ileostomy

An ileostomy can be performed in different ways depending on the patient's condition, the extent of intestinal damage, and the goal of the surgery. There are two main types: end ileostomy and loop ileostomy.

End Ileostomy

This is the most commonly performed type. It involves bringing the end of the small intestine (called the ileum) to the surface of the abdomen, where it is sutured to the skin to create a visible opening called a stoma.

This type of ileostomy can be either temporary or permanent. In its temporary form, it is typically used when the diseased part of the intestine has been removed and the remaining bowel needs time to heal before a potential reconnection of the digestive tract. On the other hand, if reconnection is impossible or too risky, the stoma becomes permanent.

Loop Ileostomy

In a loop ileostomy, a loop of the small intestine is brought through an opening in the abdominal wall without being completely severed. This creates two openings side by side: one for the discharge of stool and the other for the possible passage of gas or secretions.

This type of ileostomy is most often temporary. It is used to protect a digestive anastomosis (such as after bowel resection) or to temporarily relieve the intestine. Once healing is achieved, intestinal continuity is usually restored and the stoma is closed in a second surgery.

Use of a drainable pouch

After an ileostomy procedure, using a drainable pouch is essential for collecting stool. There are two types of systems available:

• One-piece system: The skin barrier and the pouch are attached together and are changed as a single unit.
• Two-piece system: The skin barrier can remain in place for up to 3 days, while the pouch is changed daily.

How to change and empty your pouch?

Changing the pouch becomes a routine with practice. The pouch is emptied several times a day, depending on your output, and replaced as taught by your stoma nurse. With a two-piece system, the adhesive barrier is usually changed every 2 to 3 days.

To empty the pouch, open the clamp over the toilet, let the contents drain out, then clean the opening with toilet paper and close the clamp.

It may seem complicated at first, and your medical team and stoma nurse support you until it becomes easy.

Surgery process in Turkey

Before an ileostomy, your doctor advises you to limit or stop tobacco and alcohol and to follow the fasting instructions, since they can interfere with healing. Never stop a prescribed medication on your own: the prescribing doctor decides.

The operation is performed by laparoscopy when the case allows it, or by open surgery. With laparoscopy, instruments and a camera are inserted through small openings instead of one large incision, which often shortens recovery.

Nutrition and postoperative precautions

After the surgery, you will be hospitalized for monitoring and care. Painkillers and antibiotics may be administered to manage pain and prevent infection. During your recovery, it is recommended to drink plenty of fluids to avoid dehydration.

During the first weeks, certain foods such as raw fruits and vegetables, grains, nuts, and corn may need to be avoided, as they can irritate or block the stoma; your team will tell you how long this applies in your case.

It is also advised to limit intense physical activity for several weeks, as directed by your surgeon, to allow your body to recover.