Colostomy or Ileostomy?

[Jimena]

I have fistulas, perianal fistula and very possible recto-vaginal fistula. I have appointment to surgeon and OB/GYN in a next few weeks, to think about what is my tratment options. I have used Humira almoust 5 years now, and pasta year higher dosage, 80mg every two weeks. It doesn't help anymore ;( My rectum is badly inflamed.

I don't want surgery's down there, expesially in my vagina area :shifty: What kind of surgeries they can even do there? I haven't have a abscess down there, not that i have noticed.

I feel the "best" option may be temp stoma. I am kind of comfortable about that idea, coz pain after BM's and the leaking is nasty and i just can cope with those much longer.

My colon is fine, not nflamed of anything, only TI and rectum are inflamed. In that case, shouls they do colostomy or ileostomy? What are the difference of these, i know that how they are different but i would like to know from the patient perspective.

I am so sick of this Crohn right now..

 

[Susan2]

With an ileostomy, the stoma is made by cutting the ileum above where the problem is and bringing it out to the surface to form the stoma. With a colosomy they cut the colon, again above the problem area, and bring it out to the surface to form the stoma.

Both an ileostomy and a colostomy can be either temporary or permanent. A temporary stoma is usually formed to let the area below it have a chance to heal. If your colon is is in good shape they might give you a temporary colostomy fairly low down on your descending colon to let your rectum have a rest and heal. But if your terminal ileum is giving you a lot of trouble as well, they might want to give you a temporary ileostomy so that both areas will have a better chance of healing.

Does this help? If you have any other questions please ask. :hug:

 

[Jaano711]

Hi Jimena
I know how you feel. My Crohn's disease had 'invaded' my bottom end. I had severe perianal disease with fissures, abscesses and fistulas including a rectovaginal fistula. I had been on infliximab until I had an anaphylactic reaction to it, and since then, last 4 years I have been on humira instead. Neither of these biologically were able to slow the disease, nor were my other medications. I have recently (August) had surgery where they have removed my lower end, and now I have a colostomy. I have had 3 other bowel resections in the past and as a result now have short bowel issues. So even though I technically have a colostomy (colon Stoma) it behaves like an ilieostomy.

A colostomy will normally give you firmer more 'normal' output, where as an ilieostomy results in more liquid output, and more often.

Even now only 3 months post surgery I am relieved I don't have a red raw burnt leaky bottom. I have learnt to manage my Stoma and am getting more and more confident with all things Stoma related.

You really need to talk to your surgeons and ask what they suggest, and then see how you feel. I wish you well for the coming weeks and the decisions you have ahead of you.

Janette xx

 

[Jimena]

Thans for replies! Those helped a lot. Colostomy makes sence more, in my situation, coz my colon is clear. Though, if my TI is in bad shape i think ileostomy would make more sence so it can rest allso.

I haven't got my appointment time yet with the CR surgeon but i hope it will come soon.

I would like to live like a normal women, and not always feel dirty down there coz there is some leaking all the time :redface: I allso would like to have sex with my hubby again!!!! Haven't been able to do that for over year now I just don't feel like coz i am mess down there and because of the pain.

 

[Jaano711]

Hi Jimena
I know how you feel. Describes my situation pre surgery. Had leaking fistulas all over the place. Surgeon basically said rear end like a watering can. Hopefully when everything finishes healing we can have a sexual relationship as well..