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Ileostomy a Practical Guide to Stoma Care

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Ileostomy a Practical Guide to Stoma Care ® Ileostomy A practical guide to stoma care Putting you fi rst Foreword Contents Having ileostomy surgery can be a life-changing experience. For some, it Introduction 4 is relief from a debilitating illness and for others a temporary measure to How the digestive system normally works 5 heal and prepare for further treatments. Although major surgery of this nature with a change of bodily function may disrupt a person’s lifestyle, What is an ileostomy? 6 the advances in surgical techniques, specialist nursing care and the Why are Ileostomies carried out? 8 developments in ostomy equipment over the years help ease the journey to recovery. Before your operation 9 In hospital – After your operation 10 Recovery can also be enhanced by the support available from ia, whose main aim is to help those with an ileostomy or internal pouch return to a fully At home – When you return home 12 active and normal life as soon as possible after surgery. Established in 1956 – How to obtain stoma care supplies 12 as the Ileostomy Association by a group of people with ileostomies and some Stoma pouches – One-piece pouches 13 members of the medical profession, ia now has 54 member organisations – Two-piece pouches 14 throughout the UK and Ireland. These local groups, which are managed by – Aperture sizes 15 volunteers, most of whom have an ileostomy or internal pouch, provide contact and meeting points. With a unique non-medical perspective based Protecting your skin – Stoma care accessories 16 on personal experience, ia can offer practical help and encouragement pre- Changing a stoma pouch 17 and post-surgery. Back to normal – Food 19 Literature such as this booklet also plays an important role, providing a – Drink 20 reference point for information on all aspects of life with an ileostomy. – Travelling 21 – Sex life 21 – Contraception 22 – Pregnancy 22 Your questions answered 23 Anne Demick National Secretary Problems that may arise with a stoma 24 ia (the ileostomy and internal pouch Support Group) Associations and support groups 26 Contact details for ia can be found on page 27. Notes 27 2 3 Introduction How the digestive system normally works It is a worrying time when you learn that you need to undergo major surgery. Digestion begins in the mouth Simplifi ed diagram of the digestive system It can be particularly traumatic when you learn that as a result of that surgery where the food is chewed. your bodily functions will not be the same – that you will have an ‘ileostomy’ Swallowed food passes down and will not be able to pass motions in the normal way but will wear a ‘pouch’ the oesophagus into the on your abdomen. stomach. You may not have heard of an ileostomy or a stoma before or have only a The stomach acts like a vague idea what one is. You may feel horrified and upset, or temporarily liquidiser, churning the food numb at the news. You may, on the other hand, feel relief that something is in digestive juices until it is being done to relieve what may have been years of debilitating symptoms. reasonably liquid and passing Whatever your reactions and feelings, you will find hospital staff very it into the ileum or small understanding and supportive. They have helped a great many people intestine. through the same experience. The food passes along the Very experienced nurses who specialise in stoma care will be there to care small intestine (the walls of for you and help you with information, practical assistance, advice and the stomach and intestines reassurance about what having a stoma involves. A support organisation like contain muscles that expand the Ileostomy and Internal Pouch Support Group (ia) can help with advice and contract to produce a and visits from other (happy, healthy) ileostomists. The creation of a stoma wave like movement that can not only be a life saving operation, but for many people (and there are urges the food onwards – thousands and thousands of people with ileostomies) it actually greatly this is called peristalsis). improves the quality of their lives. During its journey through By the time you leave hospital you will be able to manage the pouches for the small intestine most of the nutrients in the Oesophagus your ileostomy. You will in your own way learn to cope and to come to terms food are absorbed into the body, leaving a fairly with the change in your body and with your stoma. Caring support is also liquid mixture of indigestible matter and water. Small intestine (ileum) readily available within the community, so you won’t feel alone. Soon, your Large intestine (colon) stoma seems less important, and becomes just an everyday part of your life. The large intestine, or colon , has the job of taking water back into the body, leaving the Rectum This booklet is intended to ‘fill in’ on some of the information you may have indigestible or waste matter (faeces) in a semi- Anus been unable to take in at the time of your surgery, to give you background solid form. information and practical advice about the day-to-day care of a stoma and to answer some of the queries that are bound to arise. It will also act as a At the end of the colon, waste material is stored in reference source of other relevant organisations and of advice available. the rectum , before being expelled through the anus . 4 5 What is an ileostomy? What is an ileostomy? There are three types of stoma procedures: ileostomy, colostomy and To allow waste matter (faeces) to leave the body, the surgeon makes a small urostomy. opening on the outside of the patient’s abdomen and brings through the end of the small intestine (ileum) . This is a stoma and because it is a stoma An ileostomy usually involves removing, or temporarily bypassing the colon created using the ileum, it is called an ileostomy. and sometimes the rectum . Faeces cannot then be passed via the anus in the usual way. (The words ostomy and stoma come from the Greek word meaning ‘mouth’ or ‘opening’). An ileostomy looks like a small spout, deep pink in colour similar to the inside of the mouth. Although it looks raw, it has no feeling. Waste matter (faeces) comes out of the stoma and is collected in a special stoma pouch attached around it. Mucous fistula Sometimes, if the rectum has not been removed but is left in place, the cut end of that may also be brought to the surface to make a small opening called a mucous fistula. This usually needs little attention. Consistency of the waste matter Food from the stomach travels round the small intestine, where the nutrients I Oesophagus the body needs are absorbed leaving just indigestible matter and water. Small intestine (ileum) This then leaves the body through the stoma. Because the waste matter has not travelled through the colon, much of the water in it will not have been Large intestine (colon) absorbed. The waste material passed will therefore be runny and passed Rectum frequently. There is no control over this and a stoma pouch is usually worn at all times. Anus I Ileostomy 6 7 Why are ileostomies carried out? Before your operation Like any other major surgery an ileostomy is not undertaken lightly and Members of the medical team will help to prepare you and advise you about doctors will only recommend it where absolutely necessary. the coming operation and answer your queries. The procedure will be carefully explained to you, and the doctor will tell you whether your ileostomy is going Although there are other causes, the main conditions that may give rise to the to be a permanent one, or if it is being created as a temporary measure. need for an ileostomy are covered by the general term ‘inflammatory bowel It is quite likely that you will not be able to take in all the information at first. disease.’ This includes Ulcerative Colitis and Crohn’s disease. It may help to jot down any queries you have as you think of them, so that when you see the doctor you can remember what to ask. Inflammatory bowel disease varies tremendously in its degree of severity and can cause a variety of symptoms. Having inflammatory bowel disease does In many hospitals specially trained stoma care nurses will be available to help not necessarily mean that an ileostomy will have to be carried out. Only in you and your family. These nurses will be closely involved in your care and will the more serious cases, where adults or children have suffered from severe, make sure you have continued support in the hospital and at home. It may be debilitating symptoms for some time or where emergency surgery becomes helpful to meet another person who has experienced living with an ileostomy necessary, will an ileostomy be considered. and this can be arranged, usually through the Ileostomy and Internal Pouch Support Group (ia). Ileostomies are sometimes created just as a temporary measure, to allow the Ususal site for an remaining intestine a chance to rest and heal, and ‘reconnection’ takes place Where will the stoma be? ileostomy at a later date. A temporary ileostomy may be necessary in conjunction with An ileostomy is usually sited on the right side of the the removal of a tumour or with the construction of an internal pouch. Your abdomen but sometimes if previous operations have surgeon will advise if the ileostomy is just a temporary measure. been performed, leaving scars, the stoma is put on the left.
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