Ileostomy: What to Expect at Home

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Your Recovery

Part of your intestine was removed or separated from the rest of the intestine. This is most often done because of a disease. During the ileostomy, 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 are likely to have cramps that come and go for the next few days. You may also feel like you have the flu, and you may have a low fever and feel tired and nauseated. This is common. You will 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 tube.
  • 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 blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she 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.
  • 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 (WOCN) 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 sudden chest pain and shortness of breath, or you cough up blood.
  • You have severe pain in your belly.

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

  • You have little or no waste going into your pouch.
  • Your stoma turns purple or a dark colour.
  • Your stoma pushes out or bleeds.
  • Your stoma shrinks into your belly.
  • You have very bad-smelling drainage from your stoma.
  • You have a lot of drainage from your stoma.
  • You have belly pain or cramping.
  • You are sick to your stomach and cannot drink fluids or keep them down.

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

Where can you learn more?

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

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