What is Ileostomy Home Guide

An ileostomy is a surgical procedure to make an opening (stoma) for stool to leave your body. The surgery is done when a medical condition prevents stool from passing through the intestines and leaving your body through the rectum.

During the surgery, a part of the small intestine (ileum) is attached to the stoma made in the abdominal wall. A bag or pouch is fitted over the stoma. Stool and gas will collect in the pouch.

After having this surgery, you will need to empty and change your ileostomy pouch as needed. You will also need to take steps to care for the stoma.

How do I care for my stoma?

Your stoma should look pink and moist. At first, the stoma may be swollen, but this swelling will go away within 6 weeks. To care for the stoma:

• Keep the skin around the stoma clean and dry.
• Use a clean, soft washcloth to gently wash the stoma and the skin around it.
• Use stoma powder or ointment on your skin only as told by your health care provider.
• If your skin becomes irritated, change your ileostomy pouch. The irritation may indicate that the pouch is leaking.
• Measure the stoma opening regularly and record the size. Watch for changes. Share the information with your health care provider.
• Check your stoma area every day for signs of infection. Check for:
  • More redness, swelling, or pain.
  • More fluid or blood.
  • Pus or warmth.

How do I care for my ileostomy pouch?

The pouch that fits over the stoma can have either one or two pieces.

• One-piece pouch: The skin barrier and the pouch are combined in one unit.
• Two-piece pouch: The skin barrier and the pouch are separate pieces that attach to each other.

Empty your pouch when it is one-third to one-half full. Do not let more stool or gas build up. This could cause the pouch to leak. Some pouches have a built-in gas release valve.

Change your pouch every 3–4 days for the first 6 weeks, and then every 5–7 days. You should also change the pouch right away if your skin near the stoma looks irritated.

How do I empty my ileostomy pouch?

You will be taught how to empty your pouch before you leave the hospital. Basic steps include:

1. Wash your hands with soap and water.
2. Sit far back on the toilet.
3. Put pieces of toilet paper into the toilet water. This will prevent splashing as you empty the stool into the toilet bowl.
4. Unclip the tail end of the pouch or separate the hook-and-loop fastener at the end of the pouch.
5. Unroll the tail and empty stool into the toilet.
6. Clean the tail with toilet paper.
7. Reroll the tail, and clip it closed or press the hook-and-loop fastener pieces together.
8. Wash your hands again.

How do I change my ileostomy pouch?

You will be taught how to change the pouch before you leave the hospital. Basic steps include:

1. Lay out your supplies.
2. Wash your hands with soap and water.
3. Carefully remove the old pouch.
4. Wash the stoma and the skin around the stoma. Allow the area to dry. Men may be told to carefully shave any hair around the stoma.
5. Use the stoma measuring guide that comes with your pouch set to decide what size hole you will need to cut in the skin barrier piece. Choose the smallest possible size that will hold the stoma but will not touch it.
6. Use the guide to trace the circle on the back of the skin barrier piece.
7. Cut out the hole.
8. Hold the skin barrier piece over the stoma to make sure the hole is the correct size.
9. Remove the adhesive paper backing from the skin barrier piece.
10. Squeeze stoma paste around the opening of the skin barrier piece.
11. Clean and dry the skin around the stoma again.
12. Carefully fit the skin barrier piece over your stoma.
13. If you are using a two-piece pouch, snap the pouch onto the skin barrier piece.
14. Close the tail of the pouch.
15. Put your hand over the top of the skin barrier piece to help warm it for about 5 minutes. This helps it conform to your body better.
16. Wash your hands again.

What are some general tips?

• Avoid wearing clothes that are tight directly over your stoma.
• You can shower with or without the pouch in place. Do not use harsh or oily soaps or lotions. Always keep the pouch on if you are taking a bath or swimming.
• If your pouch gets wet, you can dry it with a hair dryer on the cool setting.
• Whenever you leave home, take an extra skin barrier and pouch with you.
• Store all supplies in a cool, dry place. Do not leave supplies in extreme heat because parts can melt.
• To prevent odor, you can put drops of ostomy deodorizer in the pouch. Your health care provider may also recommend putting ostomy lubricant inside the pouch. This helps the stool to slide out of the pouch more easily and completely.
• Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.

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 coming from your stoma.
• Your stoma extends in or out farther than normal.
• Your stoma becomes purple, black, or pale white.
• You need to change the pouch every day.
• You have a fever.
• You have abdominal pain, nausea, or bloating.
• No stool is passing from the stoma.
• You have diarrhea, requiring you to empty the pouch more frequently than normal.

Get help right away if:

• Your stool is bloody.
• You vomit.
• You have trouble breathing.
• You feel dizzy or light-headed.