Kate Middleton and ileostomy, which diseases make the “bag” necessary

Kate Middleton and ileostomy, which diseases make the “bag” necessary


Among the rumors circulating about the health conditions of Kate Middleton, the rumor is gaining ground that the princess has undergone an ileostomy. A delicate intervention, which could justify the confidentiality shown by the Palace and the entire Royal Family regarding the health of the future Queen of England. But what is it?

What is ileostomy

An ileostomy is a surgical operation in which an external diversion of the final part of the small intestine is created: an opening in the abdomen that allows the drainage of intestinal material into a pouch, as the stoma does not have the muscles to retain the feces, but allows them to flow freely. A solution that can be temporary and reversible, in cases where recovery of intestinal function is expected, or permanent. There are approximately 2 million people in the world who live with an intestinal stoma, of which 70 thousand in Italy.

When an ileostomy is necessary

There are several medical conditions that may require the creation of an ileal stoma, including inflammatory bowel diseases, such as Crohn’s disease, ulcerative colitis or diverticulitis, which can lead to serious complications such as perforations or fistulas, making it necessary a stoma to divert fecal flow. Then there is congenital Hirschsprung disease, in which some parts of the small intestine lack nerve cells needed to control bowel movements.

Tumor hypothesis

Another reason is cancer that affects the small intestine and requires its removal: in this case the ileostomy can be performed in association with colon or rectal resection surgery, to divert the flow of the stool and “protect ” the anastomosis, or intestinal conjunction, until healing. But the choice to resort to this type of operation depends on the size and location of the section of colon removed.

Severe injuries to the small intestine following trauma or surgery may also require a temporary or permanent ileal stoma to allow the intestine to heal, as may intestinal obstructions, which may be caused by scarring, tumors, or other conditions , making it impossible for the normal passage of feces through the lower intestinal tract, making a diversion of the flow necessary. A flow that is liquid or semi-liquid, as being still in the ileum the feces have not had the opportunity to solidify due to the lack of reabsorption of some substances which occurs further downstream, and which can be collected by an adhesive stoma bag, which has filters inside that absorb odors.

What does the intervention consist of?

Although the bags today are less impactful than in the past, they are still visible under clothes: there are abdominal bands specifically designed to hide them. Living with a stoma requires special attention which can lead to embarrassment, especially if you lead a life perpetually in the spotlight: recovery can take up to 12 weeks and in case of reversibility, the patient must undergo a second surgery in total anesthesia. The one generally performed as a temporary solution is the lateral loop ileostomy, in which a loop of intestine is brought out of the abdomen and sutured to the skin. The definitive terminal ileostomy, however, involves two incisions: one for the separation of the ileum and the other for the creation of the stoma for stool drainage.

As they explain from the Gemelli Polyclinic, “the hospital stay is usually 3 to 5 days, depending on the severity of the problem that led to the operation”, so in reality many less than the 13 nights Kate spent at the London Clinic, which is internationally renowned for regarding colorectal surgery. But the recovery times coincide: “For at least 3 months it will be necessary to avoid any type of effort, in order to avoid complications, such as para-stomal hernias and promote complete recovery from the operation”.


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