An ostomy is a surgically created opening on the abdomen for the passage of stool. The stoma is the actual end of the small or large bowel that can be seen protruding through the abdominal wall. The most common types of ostomies are ileostomies and colostomies.
A colostomy is made of the colon or large intestine. The stool that comes out is soft, and bowel habits are a little more predictable than with an ileostomy. This is similar to stool that comes from the anus.
An ileostomy is made from your small bowel. Your small bowel breaks down and absorbs nutrients from your food. This stool is more liquid and contains digestive enzymes. It has less smell.
Either type of ostomy can be permanent or temporary. A temporary ostomy may be made to allow bowel further down to heal after surgery.
The following instructions will help you with you new ostomy.
Before you leave the hospital, you should have:
- Ostomy supplies for four pouch changes
- A follow-up outpatient appointment with your surgeon
- Prescriptions for ostomy supplies (if needed)
- A chart for you to record your intake and output at home
- A graduate cylinder to help you measure output
People with an ileostomy may have mucus or stool coming from their rectum. This is not a cause for alarm.
Your large bowel absorbs water from your stool. When you have an ileostomy, food and fluid does not go through your large bowel. If you have diarrhea and lose too much water, you can be at high risk for dehydration. Normal output will be liquid to applesauce like.
Dehydration is the most common reason people with an ileostomy have to come back to the hospital in the month after their surgery.
Please call us if you have any signs and symptoms of dehydration, such as:
- You are more tired than normal
- Urine that is dark in color and less in amount
- A hard time keeping the bag on
- Abdominal pain
To prevent dehydration you should:
- Drink 10 to 12 cups (four to five refillable UI Hospitals & Clinics mugs) of different liquids each day. This is about 2000 ml (64 ounces).
- Gatorade, green tea, milk, watered down fruit juice, and lemonade work well.
- Drinks with a lot of sugar can cause diarrhea.
- Alcohol, coffee, tea, soda, and sugary drinks (such as juice) can cause dehydration. They should not be used to help replace your liquids.
- Use medicine to help thicken your stool, such as:
- Metamucil (Psyllium)
- Start by using one teaspoon each day in four ounces of juice or water for two to three days.
- Increase to two teaspoons each day in four ounces of juice or water for two to three days.
- Increase to a final dose of three teaspoons each day in four ounces of juice or water.
- Imodium (Loperamide HCl)
- Take one tablet by mouth before breakfast and just before supper.
- Metamucil (Psyllium)
- Measure your ileostomy output with your graduate cylinder and follow the chart on when to call.
- Call sooner rather than later if you:
- Think your ileostomy output is more than 2000 ml
- Are getting dehydrated