General Ostomy Information:

• World Ostomy Resource - informative resource with International links
• American Medical Association
• Medline Plus - service from the National Library of Medicine
• HealingWell.com - Ostomy-related web links

Understanding Ileostomy Surgery

An Ileostomy is a surgically created opening in the abdomen through which the end of the ileum is brought up to the surface of the skin. This new opening, called a stoma, allows waste to pass directly out of the body, bypassing a diseased or damaged section of the colon. In many cases, the colon is removed. Its function is to reabsorb water and electrolytes, will be carried out to some degree by the small intestine.

After Ileostomy surgery, body waste will pass through your stoma, the opening on your abdomen, and empty into a pouch. Since you will no longer have voluntary control over body movements, it is important to know that the discharge of body waste will be fairly constant. Liquid or pasty in consistency, it will occur several times a day, usually after a meal.

Caring For Your Stoma

A Stoma (the Greek word for "mouth") is shiny, wet and red in color, similar to the inside lining of your mouth. It will usually have a round or oval shape, varying in size. After surgery, the stoma may appear swollen. The swelling will go down and it will gradually shrink in size after a few months. During this time, it is necessary to continue to measure your stoma, making sure the pouching system fits correctly.

A stoma does not have nerve endings; therefore, it doesn't transmit pain or other sensations. It is, however, rich in blood vessels and may bleed slightly if irritated or rubbed. This is normal, but if bleeding is prolonged or if the discharge from the stoma is bloody, be sure to contact your doctor.

The skin surrounding the stoma, called the peristomal skin, must be protected from direct contact with discharge. This discharge is potentially irritating, since it is very high in digestive enzymes. The peristomal skin should be gently cleansed with plain soap that leaves no residue, then rinsed with water during each change of the ostomy pouching system. Water will not enter a stoma because of it's gentle outward contractions, so it's not necessary to cover the stoma while bathing or showing. You'll find other practical skin care tips in later sections.

Ostomy Pouching Systems

Today's pouches, made from odor-barrier material, are lightweight and low profile under clothing. They come in one-piece and two-piece systems, designed to give you the fit you need, as well as the comfort, flexibility and security you deserve. An ostomy pouching system consists of a special adhesive skin barrier and a drainable or closed-end pouch.

A drainable pouch lets you easily empty the output by releasing a clip and allowing it to drain through an opening at the bottom of the pouch. A closed-end or disposable pouch is a practical alternative to use during traveling or for convenience at any time. Drainable and closed-end pouches are available in both one-piece and two-piece systems.

Initially, the selection of your pouching systems will be made while you're in the hospital. Your enterostomal therapist or ET nurse will show you how to change the system and care for your skin.

As you resume your normal routine you may decide to experiment with a different type of system. Although your ultimate choice will depend on the location and output of your stoma, it makes sense to learn about options that can enhance your lifestyle and meet your special needs.

Guard Against Skin Irritations

To make sure you have the proper pouch fit, you will need to measure your stoma frequently, especially during recovery, when the stoma is in the process of shrinking to its permanent size. To be on the safe side, measure your stoma every time you purchase supplies.

If you gain or lose weight, you may need to check the fit of your pouching system.

Empty your pouch after each meal or when it's one-third full.

HEALTHY IDEAS FOR COMFORTABLE LIVING with AN OSTOMY

Diet

After your recovery from surgery, you can gradually resume eating a balanced diet, unless your physician requires you to follow a special diet. However, you may wish to avoid certain foods that can cause blockages, odor or gas. It's good to remember that if a certain food disagreed with you in the past, chances are it will still disagree with you after surgery.

High-fiber foods can cause blockages in the ileum, which has a relatively narrow diameter, especially after surgery. Chewing food well helps break down the fiber into smaller pieces that are less likely to accumulate at a narrow point within the bowel. Drinking plenty of fluids can also help eliminate any residue.

Many healthcare professionals suggest that you avoid high fiber foods for the first six to eight weeks after surgery. These foods can then be added one at a time in small amounts to see how well you tolerate the fiber. If you experience cramping, diarrhea, nausea or vomiting, call your healthcare professional immediately.

Diarrhea

Just like before your surgery, at times you can experience diarrhea. It can be caused by many things, including viruses, antibiotic therapy, some medications, and your intolerance to certain foods. To reduce diarrhea, omit fiber and bulk from your meals and eat foods that thicken your stools, such as white rice, applesauce, bananas, creamy peanut butter, yogurt, pasta and bread. Continued diarrhea can cause dehydration, so increase that amount of fluids and salts in your diet, which will help replenish the electrolytes in your system.

High-Fiber Foods That May Cause Blockages:

Skins dried fruit orange rinds Celery grapefruit popcorn Chinese vegetables meats with casings potato skins Coconut (sausage, hot dogs, raisins Coleslaw bologna) seeds Corn nuts

Gas

Intestinal gas can be caused by swallowing air, chewing gum, talking while eating, smoking, and sipping through a straw. You may want avoid gas-producing foods and liquids.

Foods and Beverages That Can Produce Gas:

beans cabbage-family vegetables beer broccoli carbonated beverages brussels sprouts cucumbers cabbage dairy products cauliflower mushrooms onions

Foods That Can Produce Odor:

 asparagus cabbage-family vegetables cheese broccoli eggs brussels sprouts fish cabbage some spices cauliflower onions

Dehydration

After an Ileostomy, you no longer have a working colon. This may cause you to lose water and electrolytes. It is necessary for you to drink at least six to eight glasses (or 64 ounces) of water or fluid or fruit juice each day to prevent dehydration, unless instructed otherwise by your physician.

Signs And Symptoms Of Dehydration: Dark-colored urine dry mouth and mucous muscle cramps

Decreased urine output membranes (abdominal or leg)

Medication

After ostomy surgery, digestion and absorption of medications, either alone or in combination, may be affected. It is very important to review your medications, both over-the-counter and prescription drugs, with your ET nurse or healthcare provider and your pharmacist.

Also, be aware that some medications can change the color of your stool. You may wish to wear an opaque pouch in order to reduce visibility through clothing.

Over-The-Counter Treaments Can Include:
Antacids laxatives

Antidiarrheal salt substitutes

Anti-inflammatory agents sugar substitutes

Aspirin vitamins

Returning To Work

Check with your doctor and ET nurse before returning to work. The recovery time will vary.

Ask your employer if you can work at home or part-time for the first few weeks you're back on the job.

For peace of mind, find a more private rest room.

Keep spare pouches and a change of clothes at work.

Skin Care

Soap and water do not hurt the stoma, so you can bathe and shower just as you always have. However, it's a good idea to choose a soap that is residue free. Soaps containing moisturizers and oils-such as cream soaps, liquid wipes and baby wipes-leave a residue that can interfere with how well the skin barrier adheres to your skin.

Remember: It's important to avoid adhesive buildup. Adhesive removers can help you wash away adhesive residue easily, without traumatizing sensitive skin.

Skin irritations, including changes, rashes or breakdown of the skin around the stoma, may be caused by leakage from around the skin barrier or pouch, or by irritation from an improperly fitting pouching system. Skin infections can also be caused by a combination of events, such as moisture accumulation and buildup of normal fungi on the skin, leading to a yeast infection called Candida albicans.

Cutting the wafer to the correct size, correctly applying your pouch, and carefully cleaning and drying the skin around the stoma with every pouch change are the best ways of preventing skin irritation. If redness, swelling or a rash persists, call your healthcare professional.

Clothing

Don't worry-you will not need a new wardrobe. Modern Ileostomy pouches are inconspicuous under almost any kind of clothing because they're designed to lie flat against the body. Ostomy pouches for both men and women can be worn inside or outside underwear; whatever feels most comfortable. No special underwear is necessary. Yet if your stoma is at or near the waistline, be sure to avoid pressure from tight-waisted pants or belts. Girdles or panty girdles can be worn, as long as they are soft and stretchy, without stays or a front panel. For men, if you wear an athletic supporter, it is helpful to wear it one size larger.

Activities

Whether you play tennis or golf or enjoy jogging, swimming, water-or snow skiing, you can still keep fit. With your doctor's permission, after you're feeling stronger you can go back to the same sports and activities you engaged in before your surgery.

However, you should avoid heavy lifting and refrain from rough contact sports such as boxing, wrestling or football without special protection for the stoma.

Traveling

Here are some tips that will make travelling pleasant and worry free.

Always carry your stoma supplies in your hand luggage, in case your suitcase are lost or stolen. Pack twice as many supplies as anticipated for emergencies.

Fasten your seat belt below or well above your stoma.

Store your supplies in a cool place.

Heat can melt the adhesive on your pouch.

Carry all your products' order numbers on a reference card in your wallet.

Relationships

Very few people, even those you see on daily basis, will ever know that you have had ostomy surgery-unless you choose to tell them. Whether you tell others is entirely up to you. Most likely your relatives and friends already know you've had a health problem that required surgery. But you may feel uncomfortable about revealing more, fearing they might have negative attitudes about ostomies. It's true that some people have uninformed ideas, but if these people are important to you, you can either help to educate them or simply not mention your surgery.

Intimate

Communication and trust are at the heart of the healing process. It is normal to feel sensitive about the change in your body. Yet it's important to share your feelings with your spouse or loved ones, and to respond to their concerns as well. Also, let your partner know that sexual relations won't hurt your stoma. With time, understanding and a positive attitude, you can enjoy a mutually satisfying sexual relationship.

There are a few things you can do to enhance intimacy. You may wish to wear a small pouch. Be sure to empty your pouch first. If you feel uneasy about your partner seeing your pouch, you can cover it with a specially designed underwear, lingerie or pouch cover.

Ostomy surgery does not, in general, interfere with a person's sexual or reproductive capabilities. Ostomy surgery is a procedure in which the diseased part of the small or large intestine is removed and the remaining intestine is attached to an opening in the abdomen. Although some men who have had radical ostomy surgery for cancer lose the ability to achieve and sustain an erection, most men do not experience impotence, or, if they do, it is temporary. If impotence does occur, a variety of solutions are available. A urologist, a doctor who specializes in such problems, can help find the best solution. In women, ostomy surgery does not damage sexual or reproductive organs, so it does not directly cause sexual problems or sterility. Factors such as pain and the adjustment to a new body image may create some temporary sexual problems, but they can usually be resolved with time and, in some cases, counseling. Unless a woman has had a hysterectomy to remove her uterus, she can still bear children.

Taken from The National Digestive Diseases Information Clearinghouse (NDDIC), a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Ostomy Supplies and Information of Brandon, Inc.
706 W. Lumsden Rd. Brandon, Florida 33511 813-654-2415