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A continent ileostomy device.

J H Pemberton, J A van Heerden, R W Beart

    Annals of Surgery
    |May 1, 1983
    PubMed
    Summary
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    Mechanical occlusion of end-ileostomies with an indwelling device can achieve fecal continence. This method improved ileal reservoir capacity without negatively impacting intestinal function or nutrient absorption in patients with Brooke ileostomies.

    Area of Science:

    • Gastroenterology
    • Surgical Innovation
    • Stoma Management

    Background:

    • End-ileostomy, specifically Brooke ileostomies, often presents challenges with fecal continence.
    • Managing fecal output and maintaining hygiene are significant concerns for individuals with ileostomies.

    Purpose of the Study:

    • To investigate the feasibility of achieving fecal continence through mechanical occlusion of an end-ileostomy.
    • To evaluate the impact of an indwelling occluding device on ileostomy function and patient outcomes.

    Main Methods:

    • Four healthy patients with Brooke ileostomies underwent progressive stomal occlusion using an indwelling device.
    • Pre- and post-occlusion assessments included clinical and physiological tests: fat balance, intestinal transit time, ileal motility, absorption studies, ileal compliance, radiography, and ileoscopy.

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    Main Results:

    • Patients rapidly mastered the use of the occluding device, achieving reliable stomal continence.
    • Intermittent occlusion led to a significant increase in ileal reservoir capacity.
    • Ileal absorption of nutrients (glucose, electrolytes, vitamin B-12, fat) and intestinal transit time remained unchanged. Ileal mucosa integrity was maintained.

    Conclusions:

    • Chronic intermittent occlusion of Brooke ileostomies with an indwelling device is a feasible method for achieving enteric continence.
    • This approach successfully restores fecal continence without compromising essential intestinal functions or mucosal integrity.