Achieving ileostomy continence with an indwelling stomal device.

To determine whether intermittent occlusion of a Brooke ileostomy could be tolerated and achieve continence without impairing intestinal function, we constructed such ileostomies in seven dogs. After initial assessment of ileal diameter, compliance, transit, and absorption, four dogs underwent progressively lengthening periods of ileostomy occlusion, with the use of an indwelling intraluminal device. Three dogs served as unobstructed control subjects. All dogs were restudied after 20 weeks. Both occluded and control animals remained healthy, regaining and maintaining their preoperative weights. Complete continence for gas and stool was achieved without distress during periods of occlusion up to 6 hours twice a day. After the device was removed, the ileum emptied promptly. Occluded dogs developed amore dilated, compliant distal ileum with slower transit than did the control dogs. However, ileal absorption of water, glucose, sodium, and chloride, ileal secretion of potassium, and enteric absorption of fat were not impaired by occlusion; these indices did not change during 20 weeks in occluded or control animals. We concluded that chronic intermittent ileostomy occlusion in dogs was well tolerated, achieved fecal continence, slowed ileal transit, and resulted in the formation of a functional ileal reservoir without impairing enteric absorption.