An ileostomy needs appropriate care. Key practices include keeping the stoma site clean and dry, regularly emptying the pouch, eating well, and storing the equipment properly.

The output from the stoma — an opening created during an ileostomy — can damage the skin and produce gas and odors that may cause discomfort or embarrassment. Taking care of the pouch and the skin surrounding the stoma can help reduce the risk of these complications.

This article will review how people can take care of their stoma, how they can avoid damaging their pouch, and how an individual can prevent odors, dehydration, and other problems ileostomy may cause.

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People should not empty their pouch more than once per day unless there are any issues. This reduces the risk of injury to the stoma.

It is best to empty the pouch when it is about a third or up to halfway full to prevent bulging and leaks.

To empty the pouch, follow these steps:

  • Sit at the back of the toilet or sit on a chair facing it.
  • Reduce splashing by placing a strip of toilet paper in the toilet.
  • Lift the bottom of the pouch and open the clip at the end.
  • Carefully unroll the tail over the toilet.
  • Gently empty the contents of the pouch into the toilet.
  • Wipe the outside and inside of the pouch tail with toilet paper.
  • Roll up the end of the pouch and secure it with the clip.

Sometimes, the ileostomy output has contact with the skin and can make the skin sore or cause irritation.

People should use the right-sized pouch and skin barrier opening to protect their skin. This can help avoid cuts or injuries. Changing the pouch regularly can also help prevent leaks or other problems that may cause skin irritation.

Always clean the skin around the stoma with water, and pat dry before applying the new skin barrier and pouch.

If someone experiences signs of sensitivity and allergy to the tape, pouch, or skin barrier material, they should contact a healthcare professional. Doctors may recommend a different type of pouch or barrier to rectify any issues.

People can shower with their pouch on or off. However, it may be better to keep the pouch on to avoid output from the bowels exiting the stoma.

When bathing, people should keep their pouch on to prevent water from entering the bowels.

People with ileostomy should avoid foods that cause bloating, gas, or diarrhea. This is because it may cause them discomfort.

Some other tips to try include:

  • eating slowly
  • eating smaller meals throughout the day
  • chewing food well
  • choosing low fiber foods

These measures can help with digestion and nutrient absorption.

Also, a person with an ileostomy may wish to avoid large meals in the evening to limit bowel movements while sleeping.

Find out more about what to eat after ileostomy.

A person with an ileostomy does not have to wear any special clothing.

The pouches are usually flat and easy to hide under most types of clothing. A person should always wear what makes them comfortable with their pouch.

Keep in mind that wearing tight-fitting clothing does not prevent bowel function or harm the stoma. However, too much pressure may cause discomfort. If this occurs, consider wearing looser clothes to prevent any risk of injury.

Undergoing an ileostomy procedure and wearing a pouch can sometimes cause problems. However, doctors can recommend ways to manage these problems or prevent them.

Gas and odor

Gas can exit the stoma and enter the pouch. While this is a concern, most pouches have a built-in charcoal filter that vents the gas and eliminates odor without the need to open the pouch.

Emptying the pouch before bed can also help reduce the risk of filling the pouch with gas overnight.

If someone has concerns about odors, they may wish to add a deodorant, such as drops, charcoal tablets, or lubricating gel, into their pouch. Some oral deodorants are also available to decrease the odor that bowel movements can cause.

Before using any of these, a person should always discuss it with a healthcare professional.

Severe skin complications

Keeping the skin around the stoma dry and clean can help prevent skin complications. If a person develops a minor skin irritation, they should seek treatment. Doctors may prescribe oral or topical medications to apply around the stoma to allow the skin to heal.

Poor hygiene can irritate large areas of skin, causing symptoms of soreness and redness. In the more severe cases, people may even develop ulcers. Contact a doctor immediately if ulcers develop.

Medications

With an ileostomy, people may not completely absorb medications, as their bowel is shortened, and some drugs are absorbed in the lower segment of the intestines. If a person takes pills regularly, or if they notice the pill in their pouch, they should speak with a doctor.

Do not crush pills unless a doctor says so. Crushing pills can cause problems with digestion and affect how the medications work.

Dehydration and electrolyte imbalance

Dehydration and electrolyte loss occur in about 17% of people who underwent an ileostomy procedure in the last 60 days.

People should drink at least 2 liters of fluids to avoid dehydration. This includes beverages containing electrolytes, such as:

  • Gatorade
  • Powerade
  • Pedialyte

People with an ileostomy should contact a doctor if they experience any of the following:

  • vomiting
  • no bowel movement for 3 to 6 hours
  • abdominal pain
  • any symptoms of dehydration, such as:
    • dry mouth
    • weakness or dizziness
    • increased thirst
    • muscle or abdominal cramps
    • amber-colored urine
    • decreased urine output
    • loss of appetite

People can order supplies online or at their local pharmacy. When the supplies arrive, they should be stored in a room with a controlled temperature.

Keeping the supplies in a place that gets too cold or hot over time may compromise the stock.

Ensuring the stoma site is clean and dry, regularly emptying the pouch, eating well, and storing the equipment appropriately are all ways to help prevent issues with ileostomy. People should also try to avoid eating foods that can cause diarrhea or gas. This can reduce the risk of complications and the need to empty the pouch multiple times per day.

Always consult a doctor if there are any concerns about caring for the ileostomy or if there are signs of infection and ulcers.