I am looking at a third temp ileo after a crohns diagnosis and recurring fistulas. I have a j-pouch currently as they thought I originally had UC.

If I have a temp done now...because I am pregnant and a removal and perm. ileo would be too risky right now...is it possible I can't get an end ileo. done later because of length of bowel or because of lack of a good stoma site?

Can you re-use a stoma site from before?

Thanks

The number of stoma surgeries would probably be mainly be limited by the length of bowel you have left (you don't want to get short bowel syndrome).

However, there are other factors to take into consideration:

a) Every stoma surgery further weakens the stomach muscles because they must be cut to create the stoma. This will increase your susceptibility to hernias.

b) Every surgery creates adhesions (scar tissue). 90% of stoma blockages are caused by adhesions - only 10% are caused by food blockages. Surgery to get rid of adhesions is risky because, by definition, that surgery itself creates more adhesions

c)if you do develop short bowel syndrome, there is a good chance you may need to be on tube feedings for the rest of your life since your body won't absorb the food it needs (you really don't want to do anything that increases this risk).

However, having said that, you surgeon is probably the best person to say whether such a surgery would be too risky for you or not. He/She will also be able to say whether the previous stoma site is fine for them to reuse.

Good luck.

Shaz
http://www.ostomates.org

Marcene,

I agree with Shaz's comments above. Also, you will have to keep in mind that you cannot use the same site for a new stoma in the future. Once your old stoma site heals, the surgeon most likely will not use that site again. So, if you have a good spot for your stoma now, the new one might have to be moved over to the side or above/below. Hope this helps,

Matt

Matt, I actually have my perm ileo in the site of my original temp ileo...the issue is the quality of the scar...if it heals well and the area is soft, the same site can be used again.

Marcene, when I had my pouch disconnected, the surgeon did an end ileo that could become "permanent" in the future. When I had my pouch out in 2003, my ostomy was working fine, so they left it - in the pouch removal surgery, all they did was remove the pouch. So my stoma is from 2001. Perhaps you can get the surgeon to do something similar so you won't need to have a new stoma if at some point the pouch comes out.

Is a perm ileo surgery more involved than a loop? Meaning, can I have a perm. done laproscopically in the same way a loop might be done for my pregnancy?
It would make sense to have the end ileostomy done instead of the loop if I know that is what I want eventually even if I can't get the pouch removed right away.

Jill-

When they leave the pouch disconnected do they sew up your bum or do you have to wait until it is removed and still deal with the mucus output?

With disconnect the anal area is left open. The closure of the anal area is a big part of the pouch removal and very complicated so I would imagine they won't want to do that while you are pregnant.

THe end ileo shouldn't be any more complicated than a loop.

Jill,

How did you have an end ileo and still have the pouch left in? I have decided to have my pouch removed and the surgeon gave me a loop ileo because he said he couldn't do an end ileo with the pouch still left in. I couldn't have the pouch taken out because of some problems and he didn't think it would heal properly until everything settled down.

Jim

Jim,

Not sure how it was done, but I know my ileo was an end from the beginning (that sounds odd ) WHen I had my pouch removed, my ileo wasn't touched...

I suspect the surgeon left a small tail of bowel on the pouch to allow for reconnection at a future date had I chosen that path.