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Ileostomy Patient Care

Patient Care: A Quick Look at Ileostomy

Ileostomy is the surgical removal of the large intestine from the ileum (the lowest portion of the small instestine) and an opening is created in the abdomen. The ileum is brought into the abdomen to make a stoma which is commonly at the lower right side.  The stoma is the lining of the intestine which is more likely the same as the lining in the cheek. It is pink to red, moist and shiny.  In time, it will shrink after surgery. It may be round or oval. The large instestine and the rectum is surgically removed and because it is not functioning normally.  This means that the person who has undergone ileostomy no longer passes bowel through the rectum but through the stoma and drained in a pouch which is emptied 5-8 times a day.

When you have undergone an ileostomy procedure, you can either have this as a permanent or only on a temporary basis. This depend on what caused your surgery in the first place. If you had a permanent ileostomy, the large instestines and rectum are either removed or bypassed.  If you  had a temporary ileostomy, the large intestine or the colon is either partially or entirely removed but not the rectum.

Who needs an Ileostomy?

This kind of surgery is done when you have been afflicted with diseases in the colon wherein other methods of medication is no longer working. It is necessary to perform this surgery to protect and rest the intestine.  Inflammatory bowel disease such as Crohn’s disease and ulcerative colitis are the common reasons in performing ileostomy.  Sometimes, they are created due to defects from birth, polyposis, and cancer.

How do you manage your Ileostomy?

In managing ileostomies, choosing a pouching system is a must. The pouch should be leakproof that could last for at least a week, odor resistant, inconspicuos, easy to remove and apply and it must protect the skin.  Changing the pouch may be best after breakfast or an hour after a meal.

The skin should be protected at all times most especially the skin around the stoma.  The output from the stoma can irritate the skin.  The skin around the stoma should look the same as the rest of the skin in the abdomen.  By using the right size pouch and skin barrier, you can avoid skin irritation.  If is is too small, it can injure the stoma.  When it is too large, it can irritate the skin.  When there is itching or burning sensations, the pouch must be changed.  Regularly changing will avoid leakage.  Clean the skin surface with water and a mild soap.  It should be rinsed thoroughly and dried well.  Sensitivity to the tapes, skin barriers, or from the materials from the pouch can occur so it is best to monitor the skin all the time.

A gas or flatulence will pass through the stoma.  It is normal but it can be embarassing.  A regular  eating habit will avoid excessive gas.  This means that meals should not be skipped and should always be on time.  Eating small frequent meals, about 4-6 times a day would be best.  Foods as eggs, cabbage, onions, fish, beans, dairy products, and alcohol causes the formation of gas in the intestines.  Doctors will order the patient to avoid foods that are difficult to digest such as raw foods and vegetables during the first week after the surgery.  All kinds of foods can be eaten unless told by the doctor.  Plenty of fluids is recommended to avoid dehydration and increased fluid intake is advised in hot climates.

The odor of the gas caused by foods and normal bacteria in the intestine are normal.  The odor between those with ileostomies will vary.  To control the odor, the person with ileostomy must use an odor resistant pouch.  The skin barrier should be sealed securely to the skin.  The pouch must be emptied frequently. There are special deodorants in the form of liquids and tablets available.  Never used talc powders because this may destroy the normal mucosa or the lining of the stoma. There are also oral products available for eliminating odor such as chlorophyll tablets, bismuth subgallate and bismuth subcarbonate. There are also air deodorizers that is used when pouch is emptied.


Medications that are in coated tablets will be of no use to the patient.  The tablet will come out whole in the pouch.  The physician will order you take liquid or liquid gel medications for a faster and effective absorption of the medication.

When to call the doctor?

When cramps occurs and last for more than 2 to 3 hours without an output for about 5 hours, it is time to call the doctor or your healthcare provvider.  Other symptoms that requires calling the health care provider are nausea and vomiting, an infection indicated by an odor lasting for more than 7 days, skin irritation, continous bleeding in the stoma opening, and a change in the color and size of the stoma.

How do you go on with life after an Ileostomy?

Living with an ileostomy may seem to be very difficult at first.  Because there is a change in the normal appearance and function in the body, it does not mean that a person who underwent an ileostomy can no longer live normally the way they used to be.  Social events, travelling, and sports are not to be avoided most especially if this are done before.  By letting others know that the person has underwent an ileostomy will be easier to be understood by those taking care of them.

In terms of clothing, there are no such thing as clothes exclusively for those with stomas.  The pouches are flat and can hardly be seen.  However, using cotton and stretchable underpants provides support.  For women, using a pantyhose will also be comfortable.

Participating in sports is not something to be avoided when the person underwent an ostomy.  However, weight lifting and contact sports should be avoided to refrain from protrusion and injury to the stoma.  Some of these sports are basketball, football, boxing, or soccer.  If these sports cannot be avoided, a consult with the doctor is needed.  There may be special protection gears available to eliminate injury problems.

Written by,

Ronald Uy, RN

© 2009 Hemorhoid Information Center


Ileostomy. Retrieved Sept 4, 2009 from Wikepedia: http://en.wikipedia.org

Bowel Diversion Surgeries. Retrieved Sept 4, 2009 from NDDIC:  http://digestive.niddk.nih.gov

Ileostomy. Retrieved Sept 5, 2009 from NHS Choices: http://www.nhs.uk

Ileostomy. Retrieved Sept 5, 2009 from Medline Plus: http://www.nlm.nih.gov

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