An ileostomy is an opening in the abdominal wall that a surgeon makes to provide a way for the small intestine to release stool. After an ileostomy, a person’s stool will be loose or porridge-like.

The end part of the small intestine is known as the ileum. During an ileostomy, a surgeon brings the ileum through the abdominal wall to create a stoma.

An ileostomy ensures that the digestive system bypasses the colon and rectum. This means stool no longer travels through that part of the digestive tract and out of the anus. Instead, the stool leaves the body through the stoma and collects in a pouch that sticks to the person’s skin. As such, the consistency of the stool will be slightly different.

In this article, we will discuss the consistency of stool after an ileostomy. We will also discuss what a person should eat if they have had an ileostomy and outline how to empty their pouch.

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Digestion refers to the process of breaking down food into substances that the body can use. To do so, food will typically travel through the digestive system, which includes the intestines.

The colon, which forms a large section of the large intestines, is where the body absorbs the water out of the food in the digestive system. This process makes the stool more solid.

After a person has had an ileostomy, their digestive system bypasses the colon. This means the person’s digestive system does not absorb all the water from the stool. This lack of absorption means a person’s stool will not be as solid.

As such, the output from an ileostomy will often consist of a stool that is loose or porridge-like. The amount of stool that passes through the ileostomy will vary. It typically ranges from 200–700 milliliters (mL) per day.

After a person has an ileostomy, they may eventually be able to return to eating their regular diet. However, in some cases, a healthcare professional may recommend that they change their diet.

For the first few weeks after the surgery, a doctor may recommend that a person try:

  • eating a healthy diet that provides them with the nutrients they need to help recover from surgery
  • drinking enough liquids to prevent dehydration
  • avoiding foods that are high in fiber, such as:
    • raw fruits
    • vegetables
    • seeds
    • nuts
    • corn
  • avoiding spicy foods
  • avoiding foods that are high in fat

As a person recovers from surgery, their doctor may recommend adding new foods to their diet gradually.

Read on to learn more about an ileostomy diet.

After an ileostomy, certain foods are still more likely to cause:

A person may wish to keep a food journal to help track the foods they eat and how they affect them.

In some cases, a person may develop a high output stoma (HOS). The definition of a HOS is controversial, but if a person’s stoma output is more than 2,000 mL per day, this may be clinically significant and cause possible complications to develop.

If a person with an HOS experiences dehydration, they should avoid excessive intake of hypotonic drinks, such as:

  • water
  • tea
  • coffee

These drinks are suitable for healthy individuals. However, they can aggravate dehydration in people with an HOS. This is because their digestive system cannot properly absorb the sodium.

Instead, healthcare professionals may recommend that a person with an HOS and dehydration consume a rehydration solution consisting of:

  • 100 mL water
  • 20 grams (g) glucose
  • 2.5 g sodium bicarbonate
  • 3.5 g sodium chloride (table salt)

A person should empty their ileostomy pouch when it is between one-third and one-half full. This is to prevent it from bulging and leaking.

When emptying their pouch, a person should follow these steps:

  1. Sit as far back on the toilet as possible or on a chair that is facing the toilet.
  2. Place some toilet paper in the toilet to decrease splashing.
  3. Hold the bottom of the pouch up.
  4. Open the clip on the end or the tail of the pouch.
  5. Slowly unroll the tail over the toilet.
  6. Empty the contents of the pouch into the toilet as gently as possible.
  7. Clean the inside and outside of the pouch with toilet paper.
  8. Roll up the end of the pouch and close the clip or tail.

Below is some advice on how to manage certain ileostomy problems.

Flatulence

A person with a stoma will still experience flatulence. A person can muffle the sounds of flatulence by folding their arms across their belly so their forearm rests over their stoma.

A person may also wish to check with their doctor about certain products that can help lessen their gas.

Certain foods may cause flatulence. These include:

  • eggs
  • cabbage
  • broccoli
  • onions
  • fish
  • beans
  • milk
  • cheese
  • carbonated drinks
  • alcohol

A person can also help prevent flatulence by eating regularly and eating smaller amounts of food 4–5 times per day. A person should not skip meals to avoid flatulence or output.

Odor

A number of factors can cause odor from a person’s ileostomy. These include:

  • certain foods
  • normal bacteria in a person’s intestine
  • illness
  • certain medications
  • certain vitamins

A person can take some steps to help reduce odor. These include:

  • avoiding certain foods that cause odor
  • using an odor-resistant pouch
  • checking to ensure that the skin barrier is securely stuck to the skin
  • regularly emptying the pouch
  • placing deodorant liquids or tablets into the pouch

Blockage

A person may have a blockage in their ileostomy if it does not have any output for 4–6 hours and they experience cramps, nausea, or both.

A person should contact their doctor right away if they suspect they have a blockage.

To help move things through their ileostomy, a person can try:

  • watching for swelling of the stoma and adjusting the opening of the skin barrier until the swelling goes down
  • taking a warm bath to relax the abdominal muscles
  • taking fluids if there is some stool output

A person may also wish to change position to move food along the digestive tract. This can include drawing their knees up to their chest.

A person should not take a laxative to clear their blockage.

A person with an ileostomy may wish to contact a doctor if they:

  • experience cramps that last more than 2–3 hours
  • experience continuous nausea and vomiting
  • have no output for 4–6 hours alongside cramping and nausea
  • have severe watery discharge that lasts more than 5–6 hours
  • notice a bad odor that lasts more than a week
  • have a cut in their stoma
  • have an injury to their stoma
  • experience bad skin irritation or deep sores
  • have a lot of bleeding from the stoma opening
  • have a moderate amount of blood in the pouch that they notice several times when emptying it
  • have continuous bleeding where the stoma meets the skin
  • have an unusual change to the stoma’s size or color
  • have severe watery diarrhea

An ileostomy is a procedure where a surgeon makes an opening in the abdominal wall to provide a way for the small intestine to release stool.

The ileostomy allows the digestive system to bypass the colon and rectum. This means stool exits the body through a stoma and collects in a pouch.

The colon usually absorbs water from a person’s food. Due to the bypassing of the colon, the stool that exits the stoma will be loose or porridge-like.