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Ileostomy: What to Expect at Home

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Your Recovery

Part of your intestine was removed or separated from the rest of the intestine. It's most often done because of a disease. During surgery, the surgeon made a hole in your belly and connected part of the small intestine to that opening in the skin. This opening is called the stoma.

A pouch is attached to the outside of the stoma. Stool collects in the pouch and must be emptied several times each day. The stool will be softer or have more liquid than before surgery.

You're likely to have cramps that come and go for the next few days. You may feel tired, have some pain, and feel sick to your stomach. This is common. You'll probably feel better in a week or so. A nurse or other health professional will show you how to care for your stoma and pouch after you go home.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

 
  • Rest when you feel tired. Getting enough sleep will help you recover.
  • Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia.
  • Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. When you are active again, a support belt can help secure the ileostomy pouch.
  • For at least 6 weeks, avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
  • Ask your doctor when you can drive again.
  • You will probably need to take a month or more off from work. It depends on the type of work you do and how you feel.
  • Your doctor will tell you when you can shower after surgery. You can shower with or without the ileostomy pouch. You do not need to worry about getting your stoma wet.
  • Your doctor will tell you when you can have sex again. You may feel uncomfortable about sex after an ileostomy. Talk to your doctor if you have problems. You can get special underclothing that holds the pouch in place during sex.

Diet

 
  • You may not have much appetite after the surgery. But try to eat healthy foods.
  • Eat a low-fiber diet for several weeks after surgery. It is best to eat many small meals throughout the day. Add high-fiber foods a little at a time.
  • Your doctor will tell you if you need to take certain supplements, such as vitamins.
  • Drink plenty of fluids to avoid becoming dehydrated (unless your doctor tells you not to).

Medicines

 
  • Your doctor will tell you if and when you can restart your medicines. The doctor will also give you instructions about taking any new medicines.
  • If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
  • Take pain medicines exactly as directed.
    • If the doctor gave you a prescription medicine for pain, take it as prescribed.
    • If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
  • If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
  • If you think your pain medicine is making you sick to your stomach:
    • Take your medicine after meals (unless your doctor has told you not to).
    • Ask your doctor for a different pain medicine.
  • Your doctor will tell you if you need to take some medicines in a different form now that you have a stoma. You may need to crush pills or take a liquid form of the medicine.

Incision care

 
  • If you have strips of tape on the cut (incision) the doctor made, leave the tape on until it falls off.
  • Gently wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it oozes or rubs against clothing.
  • Change the bandage every day or if it gets wet or dirty.
  • Keep the area clean and dry.

Other instructions

 
  • If the skin under your pouch is red, irritated, or itchy, you need to treat your skin. Follow these steps:
    • Gently remove the pouch.
    • Clean the skin under the pouch with water.
    • Dry the skin.
    • Sprinkle ostomy protective powder on the skin, and then blot it off.
    • Reattach or replace the pouch.
    • If you continue to have skin irritation, consult your ostomy nurse or other health professional.
  • Follow all instructions from your doctor or ostomy nurse.
  • Empty and replace your ileostomy bag as often as directed by your doctor or ostomy nurse.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

  • You passed out (lost consciousness).
  • You are short of breath.

Call your doctor now or seek immediate medical care if:

  • You have pain that does not get better after you take pain medicine.
  • You cannot pass stools or gas.
  • You have loose stitches, or your incision comes open.
  • You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
    • Pain in your calf, back of knee, thigh, or groin.
    • Redness and swelling in your leg or groin.
  • You have signs of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • Bright red blood has soaked through your bandage.
  • You are sick to your stomach or cannot drink fluids.
  • You have a problem with your stoma, such as a change in color or a bloody discharge, or it seems blocked.

Watch closely for changes in your health, and be sure to contact your doctor if you have any problems.

Where can you learn more?

Go to http://www.healthwise.net/patientEd

Enter C949 in the search box to learn more about "Ileostomy: What to Expect at Home".

The Health Encyclopedia contains general health information. Not all treatments or services described are covered benefits for Kaiser Permanente members or offered as services by Kaiser Permanente. For a list of covered benefits, please refer to your Evidence of Coverage or Summary Plan Description. For recommended treatments, please consult with your health care provider.