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End Ileostomy vs Loop Ileostomy

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Posted 3/4/2014 8:33 PM (GMT -5)
From what I have learned and heard about the two, why change from the end to the loop?

I mean I'd the end is already in place, why not just wait to reconnect after the j-pouch heals?

I heard the loop has higher risk of blockage. Also with the part that leads to the J-pouch being open in the loop, how does stuff from the bag not go down that?

I know every dr is different and have different reasons.

So for those of you that had the J-pouch done, did they give you a loop or just keep the end?

Scared of the second step now idea
Posted 3/4/2014 8:48 PM (GMT -5)
The j-pouch is made out of the end of the ileum -- you can't keep the end ileo because they need to pull the end of the ileum down into the pelvis to make the j-pouch!

The "distal opening" of the loop ileo (the part that goes down into the j-pouch) is smaller and not as "open" as the opening your waste comes out of. A lot of the time on a loop ileo you won't even be able to see the distal end. Sometimes a small amount of waste can bypass the loop ileo and go into the j-pouch, but it's pretty unusual. It never happened to me.
Posted 3/4/2014 8:57 PM (GMT -5)
Thank you Pluto. You just answered all my questions and made me feel better. It totally makes sense now.
Posted 3/4/2014 8:58 PM (GMT -5)
Yep, what Pluot said! Nobody "wants" to change from the end to the loop to get a J Pouch, there is just no way to make a J Pouch without taking the end away.
Posted 3/4/2014 9:02 PM (GMT -5)
Try not to worry about the loop too much. I have nothing to compare it to since I only had a loop (I had a two step procedure not three). I had it for 4 months and I survived. Just remember...it's only temporary. :)
Posted 3/4/2014 9:50 PM (GMT -5)
Most people do not experience a blockage with a loop. The bigger issue is to stay hydrated.

Loop ostomies may also be used to let a lower portion of the bowel heal from resections. I had a loop jejunostomy as my ileum needed to heal after a portion was removed and the rest was joined back together. Jejunum = middle part of the intestine. Ileum = last third of the intestine. It was a loop because they pulled a middle portion so that there was some intestine above and some intestine connected below the ostomy. If I had had my ileum removed and the "end" portion of my jejunum poked out of my belly, then I would still have had a jejunostomy, but it would have been an end jejunostomy.
Posted 3/5/2014 1:26 PM (GMT -5)
Hi Halo

I had a loop with my 2 step jpouch, and have an end ileo now (I had my jpouch removed) and to be honest, for me, there isn't that much of a difference between the two. I found the biggest thing with the loop was cutting the wafer correctly to properly account for the smaller distal loop - I wanted to make sure my flange was cut big enough for both loops but small enough that too much skin wasn't exposed. Add a bit of barrier (paste or ring) and I was good to go! I didn't have any obstructions with my loop, and I can't say my output was any more liquid than it is now - but then again this end is located higher up in my system.
Posted 3/5/2014 7:44 PM (GMT -5)
Thanks guys
Posted 3/6/2014 1:40 PM (GMT -5)
I had a lot of hydration and leakage issues with the loop - it was just a tempermental little bugger. But it's short lived, so you will get through it. And it was still a cakewalk compared to UC!
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