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Patient advice leaflet following a Formation of Ileostomy

Post Procedural Activities

The following guidelines will make caring for your ileostomy easier. Keep this information at hand for quick reference.

An Ileostomy is formed surgically when part of the small bowel is brought through an opening in the abdominal wall. The part of the intestine that is brought onto the surface of the skin is called a stoma. Body waste can then exit the body through the stoma and is collected externally using a drainable appliance.

An ileostomy can be permanent or temporary depending on the surgical procedure you have had done.

In the majority of cases the stoma is placed on the right hand side of your abdomen, midway between your hip and umbilicus. However the siting of the stoma is discussed with the stoma care nurse in order to determine the best position for the individual patient.

There are many reasons why you might require a Stoma, but it is usually performed in order to improve your current condition. The reasons will be discussed with you by your consultant and Stoma care nurse.

It is important to remember that because a stoma is without sphincter muscles, there is no control over when bodily waste leaves the body. This is why a stoma appliance is required to collect this waste.

The Stoma should be red and moist in appearance and similar to the texture of the inside of your mouth. An Ileostomy tends to protrude by a few centimetres. There is little if no sensation to the stoma, however because it is a vascular area then it not unusual for the stoma to bleed slightly when cleaning it. Initially following surgery the stoma will appear quite swollen and it usually takes around 4-6 weeks to shrink to its expected size.

The output from the stoma immediately after surgery can be very watery however it can alter depending on the amount of small bowel that has been resected. Once your body settles down and you begin to manage to return to a normal diet the stool should start to thicken up. The ideal consistency is like porridge, so that it can be drained easily from the appliance. Factors that influence the output can be certain foods and drinks, which will be mentioned later in this information sheet. It is essential that you drink plenty following the formation of an Ileostomy and ensure you have plenty of salt in your diet. This is because those people with an Ileostomy loose more salt.

If your Ileostomy stops working this can be due to a blockage from adhesions or undigested food. This will normally result in a minimal watery output or no output at all. You may also experience abdominal pain, distention, nausea and vomiting. It is important in these circumstances to reduce oral intake and take clear fluids only, as the blockage can often spontaneously resolve with resting the bowel. A food blockage will normally resolve with no intervention however if symptoms persist you must seek medical advice as a hospital admission may be required.

Helpful Hints

  • Eat a well balanced diet. Eat on a regular basis. Drink at least 8 to 10 glasses of fluids per day.
  • Eat slowly and chew your food thoroughly. Avoid chewing gum, smoking and drinking through a straw, as this may help to reduce gas.
  • Eating yoghurt or peppermint preparations may help to reduce gas.
  • Eating parsley, natural yoghurt and buttermilk can act as a natural deodorizer.
  • To help control gas at night, try not to eat after 8pm. This will allow your bowel time to settle down prior to going to bed.
  • There are certain foods that can cause blockages in the ileum. These include foods such as nuts, dried fruit, mushrooms, sweetcorn. Ensure that these foods are taken with caution and that they are chewed well or pureed.
  • Do not try to reduce your output by skipping a meal. Your Ileostomy will continue to work whether you eat or not. An empty stomach is more likely to cause nausea and produce gas.
  • To avoid gurgling sounds, eat solid food on an empty stomach prior to drinking liquids.
  • If you eat foods such as beetroot or cherries you may experience a red tinge in your stool. This is normal as these foods do not loose their colour during digestion.

Applying the pouch system.

Equipment Required

New Appliance
Bowl of warm water
Disposal bag
Any accessories required, e.g. adhesive remover, protective wipe/spray etc Measuring device/template