Ileostomy Care

WHAT YOU SHOULD KNOW:

Ileostomy care is done to keep your ileostomy and the skin around it clean. This helps prevent skin problems. An ileostomy specialist will show you how to care for your ileostomy. Follow up with your primary healthcare provider (PHP) or ileostomy specialist as directed.

AFTER YOU LEAVE:

Products used with an ileostomy:

  • Pouches are used to collect bowel content that drains from the stoma. The pouch has a spout at the bottom to empty contents. Pouches come in a variety of sizes and styles. Most are lightweight and prevent odor. Some also have filters that release gas slowly and help decrease odor. Use a pouch that has an opening 1/8 inch larger than your stoma on each side. Your ileostomy specialist can help you decide which type of pouch is best for you.

  • Skin protection may help keep your skin from getting irritated. It includes films, paste, strips, or rings.

How to empty your pouch:

Empty your pouch about every 4 to 6 hours. Always empty the pouch when it becomes 1/3 full. Do not let the pouch fill completely. A full pouch puts pressure on the seal and may cause a leak. The pouch may also detach, causing bowel contents to spill.

  • Hold the end of the pouch up. Remove the clamp.

  • Roll up the ends of the pouch. This helps keep the ends clean.

  • Place toilet paper into the toilet to reduce splash back. Then empty the pouch into the toilet.

  • Unroll the ends of the pouch. Clean the ends with toilet paper or a moist paper towel.

  • Replace the clamp or close the end of the pouch as directed.

How to change your pouch:

Your ileostomy specialist will tell you how often to change your pouch and will show you how. Always change it if is leaking. The following is general information about how to change your pouch:

  • Empty the contents of the pouch into the toilet.

  • Gently remove the pouch. Push your skin down and away from the adhesive skin barrier with one hand. With the other hand, pull the pouch up and away from your stoma.

  • Clean the skin around the stoma with warm water. You may use soap. Do not use soaps that contain oil or perfumes. Pat your skin dry.

  • Use skin protection products as directed if you have irritated skin around the stoma.

  • Center the new pouch over the stoma and press it firmly into place on clean, dry skin. It may be helpful to hold your hand over the newly applied pouch for 30 seconds. The warmth of your hand can help to mold the adhesive skin barrier into place.

  • Discard or clean the old pouch. Place the old pouch in another plastic bag and throw it away if the pouch is disposable. If you use a reusable pouch, ask how to clean the reusable pouch.

Nutrition changes to reduce symptoms:

  • Do not eat foods that are hard to digest for 6 to 8 weeks after your surgery. Examples are tough meat, nuts, seeds, and raw fruits and vegetables. After 6 to 8 weeks, you can start eating your regular foods. You may still have to limit some foods that are hard to digest, such as corn, nuts, seeds, and celery.

  • Do not eat foods that cause cramps or diarrhea. When you start eating these foods again, eat small portions first and then gradually increase how much you eat.

  • Reduce gas and odor. Do not use a straw to drink liquids. Eat slowly. Some foods, such as broccoli, cabbage, beans, eggs, and fish may increase gas. Fresh parsley, yogurt, and buttermilk may help to reduce odor and gas.

  • Drink liquids as directed. You may need to drink about 1 to 2 extra glasses of liquid each day to prevent dehydration. Ask how much liquid you should drink each day.

How an ileostomy fits into your lifestyle:

  • Return to work when your PHP says it is okay. You may need support to prevent a hernia if you lift heavy items or perform heavy labor. You may need an ostomy belt over the pouch to keep it in place if you are active.

  • Stay active and exercise as directed. Ask your PHP about the best exercise plan for you. Wear your pouch when you swim. Use waterproof tape over the edges of your skin barrier to keep your pouch from leaking. Empty your pouch before you exercise or have sex.

  • Carry extra supplies with you in case your bag leaks. Supplies include extra pouches, skin protection products, and a change of clothing.

Contact your PHP or ileostomy specialist if:

  • You have a fever.

  • Your stoma changes in size or appearance.

  • You see pills (medicine) in your bowel contents.

  • Your incision wound or stoma is red or swollen, or you have a rash.

  • You have diarrhea or very watery bowel movements for more than 6 hours.

  • You have an unusual odor that lasts longer than a week.

  • Your bowel contents are black or bloody.

  • You have more bowel contents draining from your stoma than is normal for you.

  • You have nausea or are vomiting.

  • Your stoma becomes narrow, comes out too far, or sinks inside your abdomen.

  • You have questions or concerns about your condition or care.

Seek care immediately or call 911 if:

  • You cannot stop the bleeding from your stoma.

  • You are so weak that you cannot stand.

  • You have severe abdominal pain.

  • Bowel contents will not drain through your stoma.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Ileostomy Care (Discharge Care)

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