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Ileostomy: What to Expect at Home

Your Recovery

Part of your intestine was removed or separated from the rest of the intestine. It's most often done because of a disease. During surgery, the surgeon made a hole in your belly and connected part of the small intestine to that opening in the skin. This opening is called the stoma.

A pouch is attached to the outside of the stoma. Stool collects in the pouch and must be removed several times each day. The stool will be looser or have more liquid than before surgery.

You're likely to have cramps that come and go for the next few days. You may also feel like you have influenza (flu). You may have a low fever and feel tired and sick to your stomach. This is common. You'll probably feel better in a week. A nurse or other health professional will show you how to care for your stoma and pouch after you go home.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia and constipation.
Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. When you are active again, a support belt can help secure the ileostomy pouch.
Ask your doctor when you can drive again.
You will probably need to take 4 to 6 weeks off from work. It depends on the type of work you do and how you feel.
Your doctor will tell you when you can shower after surgery. You can shower with or without the ileostomy pouch. You do not need to worry about getting soap or water inside the stoma.
Do not take a bath for the first 2 weeks, or until your doctor tells you it is okay.
Your doctor will tell you when you can have sex again. You may feel uncomfortable about sex after an ileostomy. Talk to your doctor if you have problems. You can get special underclothing that hides the pouch during sex.

Diet

You may not have much appetite after the surgery. But try to eat a healthy diet.
Eat a low-fibre diet for several weeks after surgery. It is best to eat many small meals throughout the day. Add high-fibre foods a little at a time.
You may need to take vitamins that contain sodium and potassium. Ask your doctor.
Drink plenty of fluids to avoid becoming dehydrated.

Medicines

Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
If you take aspirin or some other blood thinners, be sure to talk to your doctor. They will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
- Do not take more than two pain medicines at the same time unless your doctor told you to. Many pain medicines contain Tylenol, which is also called acetaminophen. If you take too much acetaminophen, you can become very sick.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
Your doctor will tell you if you need to take some medicines in a different form now that you have a stoma. You may need to crush pills or take a liquid form of the medicine.

Other instructions

If the skin under your pouch is red, irritated, or itchy, you need to treat your skin. Follow these steps:
- Gently remove the pouch.
- Clean the skin under the pouch with water.
- Dry the skin.
- Sprinkle ostomy protective powder on the skin, and then blot it off.
- Reattach or replace the pouch.
- If you continue to have skin irritation, consult your wound, ostomy, and continence nurse (NSWOC) or other health professional.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have chest pain, are short of breath or cough up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

You have pain that does not get better after you take pain medicine.
You cannot pass stools or gas into your ileostomy pouch.
You have loose stitches, or your incision comes open.
You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of knee, thigh, or groin.
- Redness and swelling in your leg or groin.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
Bright red blood has soaked through your bandage.
You are sick to your stomach or cannot drink fluids.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems with your stoma.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

Enter C949 in the search box to learn more about "Ileostomy: What to Expect at Home".

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