Description

Ileostomy/enterostomy

An is an opening in your belly wall that is made during surgery. are used to deliver waste out of the body when the colon or rectum is not working properly.

The word "ileostomy" comes from the words "" and "." Your ileum is the lowest part of your . "Stoma" means "opening." Your ileum will pass through a stoma after your surgery

An ileostomy is a surgical incision performed by bringing the end of the small intestine onto the surface of the skin. The procedure is usually performed in instances where the has become incapable of safely processing intestinal waste, as a result of the colon being partially or fully removed. Diseases most associated with ielostomy surgery include Crohn's disease, ulcerative colitis, and colorectal cancer. After surgery, ileostomy patients are often required to wear an "ostomy pouch" to collect intestinal waste, where the appearance of the pouch is worn.

Before you have surgery to create an ileostomy, you may have surgery to remove all of your colon and rectum, or just part of your small intestine. Ileostomies are used to deliver waste out of the body when the colon or rectum are not working properly.

Signs and symptoms

y Bleeding inside your belly y Damage to nearby organs y (not having enough fluid in your body) Dehydration if there is a lot of watery drainage from your ileostomy y Difficulty absorbing needed nutrients from food y Infection, including in the lungs, urinary tract, or belly y Poor healing of the wound in your perineum (if your rectum was removed) y Scar tissue in your belly that causes a blockage in your intestines y Wound breaks open

Causes

Ileostomy surgery is done when problems with your large intestine cannot be treated without surgery.

y Inflammatory bowel disease (ulcerative colitis or crohn¶s disease), the most common reason y Colon cancer y A condition called familial polyposis y Birth defects that involve your intestines y An accident that damages your intestines or another intestinal emergency y An ileostomy replaces or goes around (bypasses) the parts of your digestive system that store waste and pass it. These parts are your large and small intestine and rectum. y Waste now leaves your body through the stoma in your belly. The waste drains into a pouch that is attached to the skin around your stoma. The pouch is made to fit your body well. You must wear it all the time. y The waste that collects will be liquid or pasty, depending on what you eat, what medicines you take, and other things. Waste collects constantly, so you will need to empty the pouch 5 to 8 times a day.

Your ileostomy may be short-term. If you have surgery on part of your large intestine, your doctor may want the rest of the large intestine or your small intestine to rest for a while. You will use the ileostomy while you recover from this surgery. When you do not need it anymore, you will have another surgery to reattach the ends of the small intestine, and you will no longer need the ileostomy.

When your ileostomy is short-term, it usually means all of your large intestine was removed but you still have at least part of your rectum.

Medical management

Always tell your doctor or nurse what drugs you are taking, even drugs, supplements, or herbs you bought without a prescription.

Before your surgery, talk with your doctor or nurse about the following things:

y Intimacy and sexuality y Pregnancy y Sports y Work

During the 2 weeks before your surgery:

y Two weeks before surgery you may be asked to stop taking drugs that make it harder for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), Naprosyn (Aleve, Naproxen), and others. y Ask your doctor which drugs you should still take on the day of your surgery. y If you smoke, try to stop. Ask your doctor for help. y Always let your doctor know about any cold, flu, fever, herpes breakout, or other illness you may have before your surgery. y Eat high fiber foods and drink 6 to 8 glasses of water every day.

The day before your surgery:

y Eat a light breakfast and lunch. y You may be asked to drink only clear liquids such as broth, clear juice, and water after noon. y Do NOT drink anything after midnight, including water. Sometimes you will not be able to drink anything for up to 12 hours before surgery. y Your doctor or nurse may ask you to use enemas or laxatives to clear out your intestines. They will give you instructions.

On the day of your surgery:

y Take the drugs your doctor told you to take with a small sip of water. y Your doctor or nurse will tell you when to arrive at the hospital

After the procedure

You will be in the hospital for 3 to 7 days. You may have to stay longer if your ileostomy was an emergency operation.

You may be able to suck on ice chips on the same day as your surgery to ease your thirst. By the next day, you will probably be allowed to drink clear liquids. Your doctor or nurse will slowly add thicker fluids and then soft foods as your bowels begin to work again. You may be eating again 2 days after your surgery.

Nursing management

People who have had an ileostomy can usually eat a normal diet. But some foods may cause problems. Foods that may be fine for some people may cause trouble for others.

Your pouch should keep in any odor from your output. You may notice more odor when you empty your pouch after you eat certain foods. Some of these foods are onions, garlic, broccoli, asparagus, cabbage, fish, some cheeses, eggs, baked beans, Brussels sprouts, and alcohol.

Doing these things will keep down the odor:

y Eating parsley, yogurt, and buttermilk y Keeping your ostomy devices clean y Using special deodorants or adding vanilla oil or peppermint extract to your pouch before closing it. Ask your doctor or nurse about this.

Control gas, if it is a problem:

y Eat on a regular schedule. y Eat slowly. y Try not to swallow any air with your food. y Do not chew gum or drink through a straw. Both will make you swallow air. y Do not eat cucumbers, radishes, sweets, or melons. y Do not drink beer or soda, or other carbonated drinks. Try eating 5 or 6 small meals a day.

y This will help keep you from getting too hungry. y Eat some solid foods before you drink anything if your stomach is empty. This may help decrease gurgling sounds. y Drink 6 to 8 cups of fluids every day. y Chew your food well.

It is OK to try new foods, but try only 1 at a time. That way, if you have any trouble, you will know which food caused the problem.

Unless you are underweight because of your surgery or any other illness, try not to gain weight. It is not healthy for you, and it may change how your ostomy works or fits.

When you feel sick to your stomach:

y Take small sips of water or tea. y Eat a soda cracker or a saltine.

Some red foods may make you think you are bleeding.

y Tomato juice, cherry-flavored drinks, and cherry gelatin may make your stool reddish. y Red peppers, pimientos, and beets may show up as small red pieces in your stool. y If you have eaten these, you are most likely OK. But, call your doctor or nurse if the redness does not go away.

Drink at least 8 to 10 (eight ounce) cups of water each day. Healthy liquids for most people to drink are water, juices, and milk. Limit the amount of caffeine you drink, such as coffee, tea, and soda.