A Quick Guide to the structure of the intestines; or "Do you know your arse from your ileum?"

 I had a conversation the other day with someone who didn’t know the difference between the commonly understood colostomy and the less well known ileostomy. Why should you know unless the red hand of fate intervenes in your life and hits you with something like colitis or Crohn’s?

I’d never heard of it before it came my way.

So here’s a quick run down of the guttering. . . . (Click on the image below to enlarge)

Gut Map - Roger Knott-Fayle

Mouth: Where you put it all in

Esophogus: Pipe down to the stomach

Stomach: Cement mixer and vat that breaks down the food

Pyloric sphincter: Stops food that has not been properly processed by the stomach from moving on. When it’s “done” it’s called “Chyme” and this is allowed through the spincter to be further processed in the . . .

Small intestine

Duodenum which further digests food and extracts nutrients. The duodenum is the first part of the small intestine.

The jejunum – part two of the small intestine – absorbs carbs and proteins.

The Ileum – the last part of the small intestine where fats are absorbed into the blood stream

The small intestine finishes with a valve called the ileocecal valve. This stops anything coming back up from the large intestine.

The large intestine – the colon- is about 5 foot long and starts with the cecum which is a large pouch which receives the gunge that emerges from the small intestine.

The colon has four parts the ascending colon, the transverse colon, the descending colon and the sigmoid colon this 5ft of gut is mainly concerned with absorbing any water back into the body, and acting as a packing and warehousing unit before expulsion at your soonest convenience.

It is this last 5ft where your ulcerative colitis lurks.

So depending on the severity you might face either an ilesotomy, or colostomy.

If, like me, your last 5ft is so completely kaput, the whole 5ft comes out and the hole – or “stoma”(Latin for opening I think)- is formed at the end of your ileum. Ileum stoma  which contracted down becomes ileostomy. This is where everything exits me.

If your last 5ft is not so completely kaput, for example if the colitis is only in the sigmoid section of the colon, you get to keep the rest. In this case the hole is made on the colon; colon stoma shortened to colostomy.

In the case of Chron's I believe, please correct me if I'm wrong, the problem can occur anywhere along the small intestine or the long intestine. In the case of ulcerative colitis it occurs only in the colon.