Small bowel resection is performed while the patient is under general anesthesia (unconscious and pain-free). An incision is made in the abdomen. The diseased part of the small intestine (ileum) is removed and the two healthy ends are sewn back together (resected). The abdominal incision is closed.
If it is necessary to spare the small intestine from normal digestive work while it heals, a procedure called an ostomy may be used. An opening called a stoma is made from the intestine through the abdominal wall. The proximal (nearer to the stomach) end of the healthy bowel tissue is then passed through the abdominal wall, and the edges are stitched to the skin of the abdominal wall. An adhesive drainage bag (stoma appliance) is placed around the opening.
In most cases, depending on the disease process being treated, small bowel stomas are temporary and can be closed with another operation at a later date. If a large portion of the bowel is removed, the ostomy may be permanent.
The ileum absorbs much of the fluid from foods. When the large intestine is bypassed by an ileostomy, the patient should expect liquid stool (feces) from the ostomy bag. The constant or frequent drainage of liquid stool can cause the skin around the ostomy to become inflamed. Careful skin care and a well-fitting stoma appliance can reduce this irritation.
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