End Ileostomy

What is End Ileostomy

End ileostomy is a procedure to permanently or temporarily redirect part of the small intestine (ileum) to an external opening (stoma) in the abdomen.

This means that waste is passed through the stoma and into an external bag (ostomy pouch), instead of passing through the rest of the intestines and the rectum (bowel). This procedure may be necessary when the bowel is diseased or partially removed.

Tell a health care provider about:

• Any allergies you have.
• All medicines you are taking, including vitamins, herbs, eye drops, creams, and over-the-counter medicines.
• Any problems you or family members have had with anesthetic medicines.
• Any blood disorders you have.
• Any surgeries you have had.
• Any medical conditions you have.
• Whether you are pregnant or may be pregnant.

What are the risks?

Generally, this is a safe procedure. However, problems may occur, including:

• Infection.
• Bleeding.
• Allergic reactions to medicines.
• Damage to other structures or organs.
• Skin irritation around the stoma.
• Narrowing or collapsing of the stoma.
• Blockage of the intestine (ileus).
• Tissue bulging through a weak spot in the abdomen muscles (hernia).
• Part of the small intestine coming out through the stoma (prolapse).
• Difficulty absorbing nutrients from foods.
• Dehydration.

What happens before the procedure?

• You will have a physical exam, which may include a rectal exam.
• You may have tests, such as:
  • Blood tests.
  • Stool tests.
  • X-rays.
  • Colonoscopy.
• Follow instructions from your health care provider about eating or drinking restrictions.
• Ask your health care provider about:
  • Changing or stopping your regular medicines. This is especially important if you are taking diabetes medicines or blood thinners.
  • Taking medicines such as aspirin and ibuprofen. These medicines can thin your blood.Do nottake these medicines before your procedure if your health care provider instructs you not to.
• Ask your health care provider how your surgical site will be marked or identified.
• You may be given antibiotic medicine to help prevent infection.
• Do notuse any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• Plan to have someone take you home after the procedure.
• If you will be going home right after the procedure, plan to have someone with you for 24 hours.

What happens during the procedure?

• To reduce your risk of infection:
  • Your health care team will wash or sanitize their hands.
  • Your skin will be washed with soap.
• An IV tube will be inserted into one of your veins.
• You will be given a medicine to make you fall asleep (general anesthetic). You may also be given a medicine to help you relax (sedative).
• An incision will be made in your abdomen.
• Your ileum will be cut so that it is divided in two. The end of the ileum will be attached to your abdomen with stitches (sutures) to make the stoma.
• An ostomy pouch will be attached to your stoma.
• Your stoma will be covered with a bandage (dressing).

The procedure may vary among health care providers and hospitals.

What happens after the procedure?

• You may continue to receive fluids and medicines through an IV tube.
• You will have some pain. Medicines will be available to help you.
• Your blood pressure, heart rate, breathing rate, and blood oxygen level will be monitored often until the medicines you were given have worn off.
• You may not be able to drink fluids normally or eat solid food until at least 24 hours after your procedure. You may be given ice chips to suck on until you are able to drink fluids normally.
• You may have fluid draining from your stoma and your rectum.
• You will be taught how to care for your stoma and ostomy pouch.
• Your stoma may be dark-colored, swollen, and bruised.
• You may have to wear compression stockings. These stockings help to prevent blood clots and reduce swelling in your legs.
• Do notdrive for 24 hours if you received a sedative.

Care After End Ileostomy

These instructions provide you with information about caring for yourself after your procedure. Your health care provider may also give you more specific instructions.

Your treatment has been planned according to current medical practices, but problems sometimes occur. Call your health care provider if you have any problems or questions after your procedure.

What can I expect after the procedure?

After the procedure, it is common to have:

• A small amount of blood or clear fluid leaking from your stoma.
• Pain and discomfort in your abdomen, especially around your stoma.
• Irregular bowel movements for several days.
• Loose stool.

Follow these instructions at home:

Medicines

• Take over-the-counter and prescription medicines only as told by your health care provider.
• If you were prescribed an antibiotic medicine, take it as told by your health care provider.Do notstop taking the antibiotic even if you start to feel better.

Stoma Care

• Keep your stoma and the skin that surrounds it clean and dry.
• Follow your health care provider’s instructions about how to take care of your stoma. It is important to:
  • Wash your hands with soap and water before you change your bandage (dressing). If soap and water are not available, use hand sanitizer.
  • Change your dressing as told by your health care provider.
  • Leave stitches (sutures), skin glue, or adhesive strips in place. In some cases, these skin closures may need to be in place for 2 weeks or longer. If adhesive strip edges start to loosen and curl up, you may trim the loose edges. Do notremove adhesive strips entirely unless your health care provider tells you to remove them.
• Check your stoma area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Warmth.
  • Pus or a bad smell.
• Follow your health care provider’s instructions about changing and cleaning your ostomy pouch.
• Keep supplies with you at all times to care for your stoma and ostomy pouch.

Eating and drinking

• Follow instructions from your health care provider about eating or drinking restrictions.
• Pay attention to which foods and drinks cause problems with digestion, such as gas, constipation, or diarrhea.
• Avoid spicy foods and caffeine while your stoma heals.
• Eat meals and snacks at regular intervals.
• Drink enough fluid to keep your urine clear or pale yellow.

Activity

• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
• Rest as much as possible while your stoma heals.
• Avoid intense physical activity for as long as you are told by your health care provider.
• Do notlift anything that is heavier than 10 lb (4.5 kg) for 6 weeks or for as long as told by your health care provider.

Driving

• Do notdrive for 24 hours if you received a sedative.
• Do notdrive or operate heavy machinery while taking prescription pain medicine.

General instructions

• Wear compression stockings as told by your health care provider. These stockings help to prevent blood clots and reduce swelling in your legs.
• Do nottake baths, swim, or use a hot tub until your health care provider approves.
• Do notuse any tobacco products, such as cigarettes, chewing tobacco, and e-cigarettes. If you need help quitting, ask your health care provider.
• (Women) Talk with your health care provider if you plan to become pregnant or if you take birth control pills.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have more redness, swelling, or pain around your stoma.
• You have more fluid or blood coming from your stoma.
• Your stoma feels warm to the touch.
• You have pus or a bad smell coming from your stoma.
• You have a fever.
• You have loose stools that do not get firmer after several weeks.
• You have bowel movements more often or less often than your health care provider tells you to expect.
• You feel nauseous.
• You vomit.
• You have abdominal pain, bloating, pressure, or cramping.
• You have problems with sexual activity.
• You have an unusual lack of energy (fatigue).
• You are unusually thirsty or you always have a dry mouth.

Get help right away if:

• You feel dizzy or light-headed.
• You have pain or cramps in your abdomen that get worse or do not go away with medicine.
• Your stoma suddenly changes size or color.
• You have shortness of breath.
• You have bleeding from your stoma that does not stop.
• You vomit more than one time.
• You faint.
• You have internal tissue coming out of your stoma (prolapse).
• You have an irregular heartbeat.
• You have chest pain.