A conventional ileostomy means the end of the small intestine comes out an opening in the abdominal wall and a bag (appliance) is worn over it at all times to collect intestinal waste and gas. The waste passes through without being under the control of the individual. The bag must always and continuously be worn to prevent waste from getting onto the skin and causing a burn.
A continent ileostomy is very different. It allows the patient to be in control over their body and the discharge of their intestinal waste, rather than their body controlling them. A continent ileostomy involves the surgical creation of an internal pouch with a nipple valve. Both the pouch and the valve are made from the patient’s own intestine. The valve is not a device or a foreign object of any kind. The valve prevents waste and gas escaping or water going into the pouch in swimming or other water activities including bathing. The only way digestive waste and gas can come out of the intestinal tract is by painlessly inserting a tube (catheter) through the stoma opening and into the internal pouch. The waste flows through the tube which is directed into the toilet receptacle. Special catheters are available for continent ileostomy patients. The catheters are silicone and 30French in size. A catheter will last for many months until it gets discolored or stiffens. Most people sit on the toilet to empty their pouch. This is done from 2-6 times a day, depending on your individual system. You will get a sensation of fullness (similar in concept to the urinary bladder) which gradually increases. The longer you delay or defer “intubation” (the insertion of the drainage catheter) the more crampy your abdomen will feel. Still, no waste or gas will come out until you insert the tube. If you were to go a very long time you might become nauseated or vomit, but the internal pouch will stay continent and will not rupture internally.