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Ileostomy - what to ask your doctor

Ostomy - what to ask your doctor; What to ask your doctor about ileostomy or colostomy; Colostomy - what to ask your doctor

You have had an operation to create an ileostomy or colostomy. Your ileostomy or colostomy changes the way your body gets rid of waste (stool, feces, or "poop").

You now have an opening in your belly called a stoma. Waste will pass through the stoma into a pouch that collects it. You will need to take care of your stoma and empty the pouch.

Below are some questions you may want to ask your health care provider to help you take care of your ileostomy or colostomy.

Questions

Will I be able to wear the same clothes as before?

What will the stool look like that comes from the ileostomy or colostomy? How many times a day will I need to empty it? Should I expect an odor or smell?

Will I be able to travel?

How do I change the pouch?

How often do I need to change the pouch?
What supplies do I need, and where can I get them? How much do they cost?
What is the best way to empty the pouch?
How do I clean the bag afterward?

Can I take showers? Can I take a bath? Do I need to wear the pouch when I bathe?

Can I still play sports? Can I go back to work?

Do I need to change the medicines I am taking? Will birth control pills still work?

What changes do I need to make in my diet?

What can I do if my stools are too loose? Are there foods that will make my stools more firm?

What can I do if my stools are too hard? Are there foods that will make my stools looser or more watery? Do I need to drink more liquids?

What should I do if nothing is coming out of the stoma into the pouch?

How long is too long?
Are there foods that may cause blockage of the stoma or opening?
How can I change my diet to prevent this problem?

What should my stoma look like when it is healthy?

How should I care for the stoma every day? How often should I clean it? What types of tape, creams, or paste can I use on the stoma?
Does insurance cover the cost of ostomy supplies?
What should I do if there is bleeding from the stoma, if it appears red or swollen, or if there is a sore on the stoma?

When should I call the health care provider?

Open References

References

American Cancer Institute. Ileostomy guide . Last Revised: 03/17/2011. Accessed 01/08/2015 Available at: www.cancer.org/acs/groups/cid/documents/webcontent/002870-pdf.pdf.

Cima RR, Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease . 9th ed. Philadelphia, PA: Elsevier Saunders; 2010:chap 113.

Large intestine anatomy

Presentation

<strong>Colostomy - Series</strong><p>The colon or the large intestine connects the small intestines to the rectum. </p>

<strong>Indication</strong><p>A colostomy is done when the lower large intestine, rectum, or anus is unable to function normally or needs rest from normal functions. Intestinal obstruction with associated inflammation, as in diverticulitis, is a common indication for colostomy. </p>

<strong>Procedure, part1</strong><p>A colostomy creates an opening on the abdomen (stoma) for the drainage of stool (feces) from the large intestine (colon). Colostomies are usually performed after the diseased colon has been removed. Colostomies may be temporary or permanent. While the patient is deep asleep and pain-free (general anesthesia), an incision is made in the abdomen. The diseased colon is removed. </p>

<strong>Procedure, part 2</strong><p>The proximal end of the healthy colon is then brought out to the skin of the abdominal wall, where it is sutured in place. An adhesive drainage bag (stoma appliance) is placed around the opening. The abdominal incision is then closed. </p>

<strong>Aftercare</strong><p>In more than 90% of the cases, the surgery is successful. The patient may experience considerable pain after surgery as the anus tightens and relaxes. Medications to relieve pain may be used. To avoid straining, stool softeners will be used. Avoid any straining during bowel movement or urination. Soaking in a warm bath can bring additional comfort. Depending on the disease process being treated, colostomies can be "taken down" and the colon reconnected in a second operation within weeks to months after the first operation. </p>

Large intestine anatomy

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Review Date: 2/11/2015

Reviewed By: Subodh K. Lal, MD, Gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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