Ileostomy

General

An ileostomy is created by bringing the lowest part of the small intestine (the ileum) through the abdominal wall. It is usually on the lower right side of the abdomen. If part of the rectum remains after surgery, it is possible that the ileostomy may be temporary. The output from an ileostomy will be liquid to pasty, and the pouch will need to be emptied 4 to 8 times per day.

Recovery

The stoma will begin to function a day or two after surgery. Initially the output will be greenish like bile and the pouch may need to be emptied 8 to 10 times per day. Gradually the consistency will thicken and the volume of output will decrease as your body adjusts. Your stoma will be swollen at first and will eventually shrink to its final size in 6 to 8 weeks. Avoid lifting until your doctor approves it because it can easily cause a hernia.

Dietary Modifications

peanut butter sandwichYou should at least drink 8 to 10 glasses of fluid each day including a sports drink to maintain electrolyte balance. Tomato juice is a good way to replace sodium and potassium. For the first 6 to 8 weeks after surgery, avoid high fiber foods because your intestines may be swollen. After that, foods should be added in one at a time to determine if you can tolerate each one. Chew food well! Record those foods that cause cramping or diarrhea. Some foods that will thicken stool are bananas, rice, applesauce, marshmallows, potatoes,  cheese, pasta, pudding, bread and creamy peanut butter.

Medication Issues

Close-up of birth control pills in two plastic tablet dispenser casesSome modifications to your medications may be needed. Pills and capsules are often designed to be broken down and gradually absorbed over the length of the intestinal tract. If you have an ileostomy, there just isn’t as much length for this process to occur. Enteric-coated tablets, large pills and time-release or extended release capsules are likely to be problematic. Liquid forms of medications are generally more effective, and you can ask your doctor to substitute accordingly. It is especially important to request the liquid forms of antibiotics or antidiarrheal medications. Also, never take a laxative because it may cause diarrhea and severe fluid and electrolyte imbalances. Because birth control pills are absorbed in the small intestine, you may need to consider other methods;  talk to your doctor. Vitamin B12 is absorbed in the last part of your ileum, so it is likely that you will eventually need a B12 supplement. Discuss monitoring your levels with your doctor.

Pouching

Durable wafer, drainable, filter or non-filter depending on gas.