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The temporary ileostomy after rectal surgery | CION Cancer Clinics
A temporary ileostomy is a loop of small bowel brought out on the right side of the tummy so that stool leaves into a bag before it reaches the new join lower down. It is made to protect the join while it heals, and closed in a second, smaller operation once the join is sound. This page explains why it is made, what daily life with it involves, and what cannot wait. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- Why do I need a temporary ileostomy after rectal surgery?
- What happens from the operation to the closure
- What looking after an ileostomy involves
- Words you will hear, in plain language
- Four things families tell us, and what is actually true
- What this page cannot tell you
- Common questions about the temporary ileostomy
The short answer
Why do I need a temporary ileostomy after rectal surgery?
A temporary ileostomy is a loop of small bowel brought out through the skin on the right side of the tummy, so that stool leaves the body into a bag before it reaches the new join lower down. It is made to protect the join while it heals, and it is closed in a second, smaller operation once the join is sound.
Why the join needs protecting
After a low anterior resection, the colon is joined to the rectum or anus deep in the pelvis. That join is the weakest point in the whole operation. If it leaks, bowel contents escape into the pelvis and cause a serious infection. Diverting stool away makes a leak far less dangerous if one happens.
Who usually gets one
Most people with a join low in the pelvis, anyone who had radiation before surgery, and people whose general health would make a leak harder to survive. For a join high in the rectum it is often not needed.
"Temporary" means planned for closure. A small number of people never have it closed, usually because of other illness or because the join does not heal.Start to finish
What happens from the operation to the closure
Marked before surgery
A stoma nurse marks the site on your skin while you stand, sit and bend, so the bag will sit flat and away from folds and the waistband.
Made at the end of the operation
Once the join is complete, a loop of small bowel is brought out through a small opening and stitched to the skin. It is pink and moist, like the inside of the mouth, and has no feeling.
Learning the bag in hospital
The stoma nurse teaches you or a family member to empty and change the bag before you go home.
Living with it at home
The bag is emptied several times a day. You eat, work and go out normally. Fluids and salt need attention because the large bowel, which normally absorbs them, is being bypassed.
Checking the join and closing
Some months on, a scan or dye test confirms the join has healed. The stoma is then closed through the same small opening, and stool passes the normal way again.
Not sure whether this applies to you?
Ask an oncologistDay to day
What looking after an ileostomy involves
Most people are managing on their own within a few weeks. These are the four things the stoma nurse will go through.
The bag and the skin
The bag sticks to the skin around the stoma with a flat ring. The ring is cut or moulded to fit the stoma exactly, because output from small bowel is irritating if it touches skin.
Tell the nurse if
- The skin under the ring is red, raw or weeping
- The bag keeps lifting or leaking
Output
Ileostomy output is liquid to porridge-like and comes throughout the day, more after meals. Watery output that is filling the bag far more often than usual is the thing to watch, because it drains fluid and salt from the body fast.
Food and drink
Chew well, eat regularly, and add salt to food. Some foods thicken output; some make it watery or cause wind. A dietitian can help you find what suits you. Plain water alone, drunk in large amounts, can make watery output worse.
Medicines
Some tablets, especially slow-release ones, may pass through without being absorbed. Show every medicine you take to your surgeon and pharmacist, and never stop or change one on your own.
!
One thing that cannot wait
Very watery output that keeps filling the bag, together with thirst, dizziness on standing, cramps, a dry mouth or passing very little dark urine, means the body is losing fluid and salt faster than it can replace them. This can lead to kidney damage within a day or two. Call the helpline or go to the nearest emergency department the same day and say you have an ileostomy. Do not simply drink more plain water and wait.
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On your report
Words you will hear, in plain language
- Loop ileostomy
- The usual temporary type. A loop of small bowel is brought out with both ends open, which makes it easier to close later.
- Defunctioning or diverting
- Other words for the same thing: the stoma takes the join out of use while it heals.
- Appliance
- The bag and its adhesive ring. Comes as one piece, or two pieces where the ring stays on and only the bag is changed.
- High output
- More watery output than the body can keep up with. Needs treatment, not just more drinking.
- Reversal or closure
- The second operation that rejoins the loop and closes the opening in the skin, so stool passes through the anus again.
Commonly believed
Four things families tell us, and what is actually true
"The bag means the surgeon could not join the bowel."
The join has been made. The ileostomy sits above it, protecting it while it heals. It is planned before the operation for most low joins.
"Nothing should come out of the anus while the stoma is there."
A little mucus or discharge from the back passage is normal, because the bowel below the stoma still makes it. Sitting on the toilet to pass it now and then is expected. Blood or pus, or pain, is different and should be reported.
"Drinking lots of water will keep me hydrated."
With an ileostomy, large amounts of plain water can actually pull salt out and make output more watery. Fluids with salt and sugar, and salt on food, do more. If output is high, this needs medical treatment, not more water.
"Closing the stoma is a small thing; life goes straight back to normal."
The closure is smaller than the first operation, but it is still an operation with a hospital stay. And once stool passes the join again, bowel habit is often unsettled for months. Plan for that.
Being straight with you
What this page cannot tell you
It cannot tell you whether you will have a temporary stoma, or for how long. That depends on how low your join is, whether you had radiation, your general health, and whether chemotherapy is planned after surgery, which usually delays the closure until it is finished.
When it may not be closed
If the join does not heal well, if a leak has caused scarring, or if your health has changed so that a further operation is unwise, the stoma may stay. Some people decide, after living with a stoma, that they would rather keep it. None of this is failure. It is a decision to make with your surgeon when the time comes.
What to ask before the first operation
Ask whether an ileostomy is planned, and where it will be sited. Ask when the closure is likely and what has to happen first. Ask who to call about the bag once you are home, and whether the stoma nurse will see you again after discharge. Ask about the cost of supplies.
If you already have an ileostomy and something about it worries you, call the helpline. A stoma nurse or surgical oncologist will talk it through.Questions we are asked
Common questions about the temporary ileostomy
How long will I have the ileostomy?
Usually some months. The join must be checked and shown to have healed, and if chemotherapy is planned after surgery the closure usually waits until it is complete. Your surgeon and oncologist set the timing together.
Will it hurt? Can I feel it?
The stoma itself has no nerves for pain, so touching it or changing the bag does not hurt. The skin around it can become sore if output touches it, which is why the ring must fit well. Pain in the stoma or the tummy around it should be reported.
Can I eat rice, dal and normal home food?
Yes, and most people are back on ordinary food within weeks. Chew well, eat regular meals and add salt. Very fibrous foods such as raw vegetables, nuts and corn can block the stoma if eaten in large amounts early on, so introduce them slowly. A dietitian can help.
How often will I empty the bag?
Several times a day, usually when it is around a third full, and once at night for some people. Output is higher after meals. If you find yourself emptying far more often than usual and the output is like water, that is high output and needs the same-day advice above.
Can I bathe, pray and go to work with it?
Yes to all three. The bag is waterproof, sits flat under clothing, and is not visible. Many people return to work within weeks of going home, depending on the job. Heavy lifting waits until your surgeon says so.
What does the closure operation involve?
The surgeon frees the loop of bowel through the same small opening, rejoins it, and closes the skin. It is a shorter operation and stay than the first, but still needs a general anaesthetic. Bowel habit is often loose and frequent afterwards while the join gets used to stool again.
What if the stoma changes colour or bulges?
A healthy stoma is pink or red and moist. Dark purple, grey or black colour needs urgent review the same day. A bulge around it, or the stoma sitting further out than before, is usually less urgent but should be shown to the stoma nurse at the next visit.
Are the bags and the closure covered by Aarogyasri or insurance?
The operations are often covered when they are part of an approved cancer treatment plan. Aarogyasri, CGHS, ECHS and EHS are accepted, and most cashless insurers are empanelled. Stoma supplies are treated differently by each scheme. Call the helpline with your card details and we will check.
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Sources
- NHS — Ileostomy
- American Cancer Society — Ostomies
- Cancer Research UK — Surgery for bowel cancer
- National Cancer Institute — Rectal Cancer Treatment (PDQ) - Patient Version
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
Keep reading
Related pages
High Output From an IleostomyThe problem behind the red flag on this pageDehydration and Salt With an IleostomyWhy plain water is not enoughIleostomy Reversal: Timing and What to ExpectThe closure operation in detailLife With an Ileostomy: How It Differs From a ColostomyThe two kinds of stoma, comparedLow Anterior Resection ExplainedThe operation the ileostomy protects
Talk to us
Have an ileostomy, or been told you will need one?
Call the helpline or send us your discharge summary. A stoma nurse or surgical oncologist will talk through what to expect and when closure is likely. One helpline serves every CION centre.