Guide to care for your Ileostomy
CARING FOR YOUR ILEOSTOMY
An ileostomy is a surgically created opening in the abdomen through which the end of the ileum (small intestine) is brought up to the surface of the skin. This new opening, called a stoma, allows body waste to pass directly out of the body to be collected in a plastic bag. The waste contains large amounts of salts and digestive enzymes.
With an ileostomy you will no longer have voluntary control over bowel movements. Therefore the discharge of body waste will be fairly constant throughout the day. It may occur several times a day, especially after meals.
Immediately after surgery, the stoma will be swollen. The swelling will go down over the next few weeks. During this time, it is necessary to continue to measure your stoma, making sure the pouching system fits correctly.
A stoma does not have nerve endings; therefore, it should not hurt. It is, however, rich in blood vessels and may bleed slightly if irritated or rubbed. This is normal, but if bleeding is prolonged or if the discharge from the stoma is bloody, please contact our office.
The skin surrounding the stoma, called the peristomal skin, must be protected from direct contact with body waste. This discharge can be irritating since it contains a large number of digestive enzymes. The peristomal skin should be gently cleaned with water and soap and then dried thoroughly.
After your recovery from surgery, you can gradually resume eating a balanced healthy diet. However, you may wish to avoid certain foods that can cause blockages, odor, or gas.
High-fiber foods can cause blockages in the ileum, which has a relatively narrow diameter. Chewing food well helps break down the fiber into smaller pieces that are less likely to cause a blockage. Drinking plenty of fluids also helps to flush the system.
HIGH-FIBER FOODS THAT MAY CAUSE BLOCKAGES
• apple skins
• Chinese vegetables
• dried fruit
• grapefruit • meats with casings
(sausage, hot dogs, bologna)
• orange rinds
• potato skins
GAS & ODOR
You may want to avoid gas or odor-producing foods and liquids.
FOODS AND BEVERAGES THAT CAN PRODUCE GAS
• carbonated beverages
• dairy products
• cabbage family vegetables: broccoli, Brussels sprouts, cabbage, cauliflower
Diarrhea can be caused by viruses, antibiotics, medications or food allergies. To reduce diarrhea, omit fiber and bulk from your meals and avoid excessive caffeine, chocolate, sweeteners or large meals. You may also eat foods that thicken your stools, such as white rice, applesauce, bananas, creamy peanut butter, yogurt, pasta, and bread. Continued diarrhea can cause dehydration, so increase the amount of fluids and salts in your diet.
After an ileostomy, you no longer have a working colon. The function of the colon is to absorb water. This may cause you to lose water and electrolytes. It is necessary for you to drink at least 8 to 10 glasses of water or juice each day to prevent dehydration.
CHANGING YOUR BAG
•Empty your bag before it becomes too full by removing the clip at the end of the plastic bag and let the contents run into a sink.
•Try to leave the wafer on for as long as it will stay. Ideally, water should be changed every 4-5 days. Gently remove your wafer and then get into a shower. Let the warm water run over your stoma. Soap and water will not hurt the stoma.
•Use an adhesive remover to wash away adhesive residue from peristomal skin, without traumatizing sensitive skin. Then dry the skin thoroughly.
•Cut the wafer exactly to the size of the ostomy and use a small mirror to apply it over the ostomy.
Skin irritations, including rashes or breakdown of the skin around the stoma, may be caused by leakage from around the skin barrier or pouch or by irritation from an improperly fitting pouching system and occasionally by fungal infection.
Cutting the wafer to the correct size, correctly applying your pouch, and carefully cleaning and drying the skin around the stoma with every pouch change are the best ways of preventing skin irritation.
Modern ileostomy pouches are inconspicuous under almost any kind of clothing. Ostomy pouches can be worn inside or outside underwear—whatever feels most comfortable.
If your stoma is at or near the waistline, be sure to avoid pressure from tight-waisted pants or belts.
Carry your ostomy supplies in your hand luggage, in case your suitcases are lost or stolen. Always carry a few extra bags with you
Fasten your seatbelt below or well above your stoma.
Store your supplies in a cool place. Heat can melt the adhesive on your pouch.
The ostomy should not cause any restrictions in your activities. Whether you play tennis or golf or enjoy jogging, swimming, water- or snow-skiing, you can still keep fit. With your doctor’s permission, after you’re feeling stronger you can go back to the same sports and activities you engaged in before your surgery.
However, you should avoid heavy lifting and refrain from rough contact sports such as boxing, wrestling or football.
Khawaja Azimuddin M.D. & Tal Raphaeli M.D. & Jean Knapps M.D.
1125 Cypress Station Dr, Suite G, Houston TX 77090
Tel: 281-583 1300 Fax: 281-583 1303
YOU DON’T HAVE TO SUFFER: CALL TODAY FOR AN APPOINTMENT