Ileostomy
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A practical guide to stoma care

Contents The content of this brochure was originally developed in the UK by SecuriCare ltd who are specialist stoma care and continence nurses, providing patient care in hospitals, the community and via their friendly home delivery and support service for ordering medical supplies. Not all products mentioned in this brochure will be available in all markets, please check with your supplier. The information presented in this brochure is for general use only and is not intended for people living with any medical conditions who are seeking personal medical advice; it is not a substitute...

How the digestive system normally works It is a worrying time when you learn that you need to undergo major surgery. It can be particularly traumatic when you learn that as a result of that surgery your bodily functions will not be the same – that you will have an ‘ileostomy’ and will not be able to pass motions in the normal way but will wear a ‘pouch’ on your abdomen. Digestion begins in the mouth where the food is chewed. Swallowed food passes down the oesophagus 1 into the stomach. You may not have heard of an ileostomy or a stoma before or have only a vague idea what one is. You may...

What is an ileostomy? There are three types of stoma procedures: colostomy, ileostomy and urostomy. An ileostomy usually involves removing, or temporarily bypassing the colon © and sometimes the rectum (4 . Faeces cannot then be passed via the anus in the usual way 1 Oesophagus 2 Small intestine (ileum) 3 Large intestine (colon) 4 Rectum 5 Anus I Ileostomy To allow waste matter (faeces) to leave the body, the surgeon makes a small opening on the outside of the patient's abdomen and brings through the end of the small intestine (ileum) Q . This is a stoma and because it is a stoma...

Before your operation Like any other major surgery an ileostomy is not undertaken lightly and doctors will only recommend it where absolutely necessary. Members of the medical team will help to prepare you and advise you about your coming operation and answer queries. The procedure will be carefully explained to you and the doctor will tell you whether your ileostomy is going to be a permanent one or if it is being created as a temporary measure. Although there are other causes, the main conditions that may give rise to the need for an ileostomy are covered by the general term ‘inflammatory...

After your operation You may be in hospital for somewhere between five to ten days. The stoma care nurse will teach you how to change pouches, how to measure the stoma to see that the aperture of the stoma pouch is correct and how to care for your stoma generally. Your stoma care nurse will also fit you with a more discreet type of pouch, after discussing with you what types of pouch are available. When you first come round you will find there are various tubes attached to you and you may feel some weakness or discomfort. This is quite normal after any operation. All the tubes and drains...

Stoma pouches When you return home The waste passed out from an ileostomy is quite liquid and the volumes involved are around 300-700ml per day (roughly ½ to 1 pint). A drainable pouch, fastened at the bottom, is used so that the pouch can be unfastened and the contents emptied into the toilet as often as necessary during the day. There are basically two types of drainable pouches – ‘one-piece’ and ‘two piece.’ Support is available from your stoma care nurse and/or community nurse. The stoma care nurse can be contacted by phone, and many hold regular stoma clinics. There are many support...

The type of self-adhesive flange and precise means of attaching the pouch vary with different types and makes, so it is worth experimenting to find one that suits you, your skin and your way of life. Welland pouches, for example, are affixed with a special thin and flexible 'skin protector' called HyperFlex® hydrocolloid. Hyperflex® hydrocolloid is extremely conformable to your body shape, and therefore very secure. The material the pouches are made from also varies. The most modern ones are very fine, soft and discreet, with a backing that is very comfortable next to the skin. Two-piece...

Protecting your skin Changing a stoma pouch Stoma care accessories An ileostomy pouch is drained as often as necessary during the day. One piece pouches are usually replaced with a new one every 2-3 days according to personal preference. The flange of a two-piece system is usually replaced once or twice a week. The importance of cleaning carefully and gently and of taking care of the skin around the stoma to avoid soreness cannot be emphasised too much. The waste matter in the stoma pouch contains digestive juices which can harm the skin if they come into contact with it. If the skin...

Back to normal Cleaning the stoma area Clean gently around the stoma with plain warm water (do not rub), using soft wipes or tissue. Dry the skin thoroughly by gently patting with tissue or kitchen roll - again, do not rub. Changing a stoma pouch If necessary, check the size of your stoma, using a measuring card. If your pouch needs adjusting, cut a hole to the required size using a pair of pouch cutting scissors. A skin barrier may be used if required before fitting a new pouch or flange around the stoma. Replacing the appliance Remove the protective cover from the adhesive flange. It may...

You will probably find that you are thirstier and need to drink more than you did previously. This is because you lose more fluids than you used to (your colon is no longer there to reabsorb the liquid and some of the minerals from your digestive system’s waste matter). So drink plenty of fluids (and take a little more salt to replace that lost). After such major surgery it is bound to take you some time to get back to normal. Don’t be in too much of a hurry about love-making, take your time. How about alcohol? Alcohol in moderation will not harm you, although large quantities of beer or...