A new ileostomy can be a life changing event. Below is information and general guidelines for your new ileostomy. Your ostomy nurse may individualize them for you as needed.
What is an Ileostomy?
An ileostomy is an opening in the ileum (small intestine). The opening is called a stoma and is made by pulling the intestine to the skin surface and stitching the edges of the intestine to the skin. The stoma surprisingly has no feeling. Your abdomen may be quite tender after surgery but the pain will go away over time.
What is a stoma?
The stoma is your intestine and it allows stool to exit your body. It is quite durable and with normal cleansing is not at risk for infection. It is red, moist, and may bleed easily; this is normal. A new stoma is usually swollen and will reduce in size over the first few weeks after surgery.
How often will stool pass though?
With an ileostomy stool will function (pass) from the stoma throughout the day. Normal output will be liquid about 1000 cc (1 liter) per day or about half of a 2 liter beverage container. During illness or chemotherapy the output could be much more. Notify your doctor if larger than normal stool output is occurring. You could be at risk for dehydration.
What does the stool empty into?
You will wear an ostomy appliance or pouch. Several types are available and your WOC Nurse will fit your ileostomy with the proper one. After leaving the hospital the contours of your abdomen and stoma may change. If you are having difficulty with your wafer/pouch fitting properly or not wearing well contact the WOC Nurse. Don’t live with an ill-fitting pouch.
Clean skin is an important part of your ileostomy care. With new stomas a small amount of blood may be noted on the cloth. This is normal due to the stoma having a rich blood supply. When cleansing the stoma, use oil/moisturizer free soap and a soft cloth. Rinse the soap off the skin and pat dry. This will assist in obtaining a good seal between the skin and wafer. Always look at the skin when cleansing it. The skin should be without redness or irritation. The surface around the stoma should be level/smooth. Dips and creases in the skin can develop after surgery, resulting in poor appliance wear time.
Burning or Itching Under Wafer
The stool from an ileostomy has digestive enzymes that can irritate the skin. Should you experience burning or itching underneath the wafer, change your ostomy appliance. Another cause of skin irritation is abdominal hair. Individuals with abdominal hair should use a safety razor and shave away from the stoma. This will prevent irritation to the hair follicles and provide you with a better appliance seal.
How often should I change the appliance?
Normally an ostomy appliance will be changed every 3-5 days. Showering and bathing can be done with your pouch on. If you are due to change your appliance, you may remove it to shower. Always select a time when your stoma is least active, before meals or first thing in the morning. After showering/bathing the tape may lift. Use a hair dryer on the cool setting and rub the tape down. This will allow the tape to re-adhere to the skin.
Minimize the amount of water that comes in contact with the inside of your appliance. You may feel a need to rinse the inside of your pouch. This activity is not necessary and can loosen the seal around your stoma. Some ostomates have reported removing the pouch (wafer stays on) during showering so they can “wash around the stoma”. This will also loosen the seal and decrease wafer wear time.
What if I have problems?
If you experience skin irritation or your ostomy appliance has to be changed more often than expected, notify your ostomy nurse.