Closure of loop ileostomy surgery

Your treatment journey with Circle Health Group will usually begin with an initial consultation with your chosen specialist. This is where they start to get to know you, and as well as taking a detailed medical history they will want to know about your personal circumstances and why you want to have surgery, as well as the outcomes you are hoping for. They will need to know everything about any previous treatment you have had including why you had the ileostomy.

You might have a short physical examination and they may send you for scans or tests to check you are fit and healthy enough for surgery, that your digestive system has healed enough for the loop closure, and to assess how your colon is working. These might include X-rays, CT scans, blood tests and more. You won't be able to have the closure until they are satisfied that you've recovered properly and swelling has gone down, which is typically at least 12 weeks after the ileostomy procedure but can be much later. In some cases reversal is done more than 12 months after the original surgery.

Once your consultant has the results of these tests and has made their diagnosis, they will be able to talk you through the available treatment options, including ileostomy closure of loop if appropriate. Together, you'll make a decision on what's best in your individual circumstances.

An operation to close a loop ileostomy is typically performed under general anaesthetic and takes around an hour. It is a relatively simple operation with a high success rate.

Your surgeon will begin by making a cut into your skin around the ileostomy. They will free up the 'loop' of small bowel that was used to create the stoma and joint the two ends back together. The reconnected portion of bowel will be placed back inside your abdominal cavity.

The incision is then closed using either surgical staples or stitches.

You should be able to go home after one to three days in hospital, and you should feel strong enough to return to normal activities within a few weeks of going home. Additionally, exercise should help you to return to normal activities as soon as possible. Before you start exercising, ask the healthcare team or your GP for advice.

Most people make a good recovery and are able to return to emptying their bowels as usual.

Like all surgical procedures, ileostomy closure of loop carries certain risks. Your consultant surgeon will talk you through all of these in detail ahead of time so that you can make an informed decision. They should be able to put your mind at ease about any worries you are having.

General complications of any operation include:

• Pain
• Bleeding
• Developing a hernia in the scar
• Infection of the surgical site (wound)
• Unsightly scarring of your skin
• Chest infection
• Blood clots

Specific complications of this operation

• Anastomotic leak
• Bowel obstruction
• Continued bowel paralysis
• Diarrhoea
• Developing an abnormal connection (fistula) between your bowel and your skin

Is a loop ileostomy permanent?

At Circle Health Group, we often explain to our patients that a loop ileostomy is usually designed to be temporary. However, in some cases, it may become permanent:

• Loop ileostomies are usually created with the intention of reversal
• Most patients have their loop ileostomy reversed within 3-12 months
• Sometimes, medical conditions or complications may require a permanent ileostomy

Our consultants will discuss your individual circumstances and the potential for reversal during your initial consultation. We aim to restore normal bowel function whenever possible, but your health and safety are our top priorities.

How long does loop ileostomy surgery take?

The initial loop ileostomy surgery at Circle Health Group is typically a straightforward procedure:

• It usually takes about one hour to perform
• The exact duration can vary depending on individual circumstances and any additional procedures required
• It's generally performed under general anaesthesia

Your consultant will provide more specific information about the expected duration of your surgery during your pre-operative consultation, considering your individual medical history and needs.

How long does an ileostomy loop reversal take?

We perform ileostomy loop reversals with efficiency and care. Here's what you can expect:

• The surgery typically takes about one hour
• It's usually performed under general anaesthesia
• You'll likely stay in hospital for one to three days after the procedure

Remember, the exact duration can vary based on individual circumstances. Your consultant will provide a more precise estimate based on your specific situation during your pre-surgery consultation.

What is the difference between an ileostomy and a loop ileostomy?

We often explain these differences to our patients at Circle Health Group:

Ileostomy:

• Can be permanent or temporary
• The end of the small intestine (ileum) is brought through the abdominal wall
• Waste exits through a single opening in the stoma

Loop Ileostomy:

• Usually temporary
• A loop of the small intestine is brought through the abdominal wall
• The stoma has two openings: one for waste and one connecting to the inactive part of the bowel

Loop ileostomies are often preferred when reversal is planned, as they're typically easier to close. Your consultant will discuss which type is most appropriate for your specific situation.

Can you have output from J-Pouch with a loop ileostomy?

At Circle Health Group, we understand that this can be a concern for patients with both a J-pouch (ileo-anal pouch) and a loop ileostomy:

• Typically, there should be minimal output from the J-pouch when a functioning loop ileostomy is in place
• However, some patients may experience small amounts of mucus or discharge from the anus
• If you notice significant output from your J-pouch, it's important to inform your healthcare team as this could indicate a problem

We encourage our patients to discuss any unusual symptoms or concerns with their consultant, who can provide you with personalised advice and care.

What does a loop ileostomy look like?

We always ensure our patients are well-informed about what to expect. A loop ileostomy typically appears as:

• A small, pinkish-red protrusion on the abdomen, usually on the right side
• About 2.5-4 cm in diameter
• Moist and shiny in appearance
• Often described as looking like the inside of your cheek
• It may have two visible openings, though these can sometimes be difficult to distinguish

Remember, everyone's stoma looks slightly different. Your stoma care nurse will help you become comfortable with the appearance and care of your stoma.

Why does a loop ileostomy have two holes?

The two openings in a loop ileostomy serve distinct purposes:

• The active opening: This is where waste exits the body
• The inactive opening: This leads to the inactive part of your bowel, which will be reconnected during reversal surgery

Having two openings makes the eventual reversal procedure easier and safer. It's important to note that these openings may not always be clearly visible, and your stoma care nurse will guide you on how to manage your specific stoma.

What does an ileostomy loop mean for digestion?

Here’s how a loop ileostomy affects your digestion:

• It diverts waste away from the large intestine, so it exits the body before complete water absorption
• This results in more frequent and looser stools
• Nutrient absorption is largely unaffected as most occur in the small intestine
• You may need to increase fluid and salt intake to compensate for losses
• Some dietary adjustments may be necessary to manage output

Our dietitians and stoma care nurses work closely with you to ensure optimal nutrition and hydration while you have your loop ileostomy.

Can you still poop with a loop ileostomy?

We explain to our patients with a loop ileostomy:

• Waste will exit through the stoma into an external bag, not through the anus
• You may experience some mucus discharge from the anus, which is normal
• In rare cases, if the ileostomy isn't functioning properly, some waste might pass to the colon and exit through the anus

If you experience any unexpected output from your anus, it's important to inform your healthcare team promptly. We're always here to address any concerns and ensure your ileostomy is functioning correctly.

Can you still fart with an ileostomy?

This is a common question at Circle Health Group, and we explain to our patients that:

• With an ileostomy, gas will typically exit through the stoma into the ileostomy bag
• You won't be able to control this gas as you would normally
• You won't typically pass gas from your rectum, though some patients may experience occasional rectal gas
• Modern ileostomy bags have filters to help control odour from gas

Our stoma care nurses can provide advice on managing gas and odour, ensuring you feel comfortable and confident with your ileostomy.

Why is an ileostomy worse than a colostomy?

At Circle Health Group, we avoid characterising one type of stoma as ‘worse’ than another. Both ileostomies and colostomies have their own characteristics:

Ileostomy:

• Output is more frequent and liquid
• May require more careful management of fluids and electrolytes
• Can sometimes cause skin irritation due to the liquid output

Colostomy:

• Output is usually more formed and less frequent
• Generally easier to manage in terms of skincare
• May be easier to regulate with diet

The choice between an ileostomy and colostomy depends on the specific medical condition and individual patient factors. Our consultants will recommend the most appropriate option for your unique situation.

Is having a colostomy bag classed as a disability?

The Equality Act 2010's disability legislation protects people from unfair discrimination and ensures they have the same opportunities as others.

• In the UK, having a stoma (including a colostomy or ileostomy) is considered a disability under the Equality Act 2010.
• This classification provides legal protection against discrimination in employment, such as in application forms, interviews, job offers, and terms of employment.
• This means that employers may need to make reasonable changes or concessions to accommodate your needs.
• The Equality Act also protects you if your stoma has a long-term negative effect on your ability to perform daily activities, such as using the toilet.
• However, many people with stomas lead full, active working lives without considering themselves as ‘disabled’.

The impact of a stoma varies from person to person. Our team, including stoma care nurses and counsellors, is here to support you in adapting to life with a stoma and addressing any challenges you may face going forward. 

At Circle Health Group, we have the experience and expertise to ensure the best possible care and outcome for our patients. As a patient with Circle Health Group, you can expect the highest standards of care including:

• Flexible appointment times and locations that are convenient for you
• The freedom to choose which hospital and consultant suit your needs
• Personalised, consultant-led treatment plans tailored to your individual needs
• Comfortable and safe private facilities maintained by expert multidisciplinary teams
• Private ensuite rooms as standard
• A range of delicious healthy meals
• Affordable, fixed-price packages with aftercare included
• Flexible payment options to help you spread the cost of your care

If you would like to see a consultant to learn more about ileostomy reversal, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in May 2023. Next review due May 2026.

1. Ileostomy, NHS
2. Colostomy, NHS
3. Closure of loop ileostomy, Health Direct
4. Loop ileostomy. Techniques and indications, PubMed
5. Stoma reversal, Colostomy UK
6. Ileostomy, Cleveland Clinic 
7. Ostomy reversal, Cleveland Clinic 
8. FAQs, Ileostomy and Internal Pouch Association