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Continue ShoppingThis week, we share some words of wisdom from Carol Marshall-Hanson, RN who is a Certified Wound Ostomy Nurse (CWON) at Seton Healthcare Family in Austin, TX. She gives her tips and best practices for patients with ileostomies.
“Ileostomy” by BruceBlaus is licensed under CC BY-SA 4.0.
Ileostomy is a surgery in which a small opening, called a stoma, is made in the abdomen. The surgeon brings a piece of the lowest part of the small intestine, called the ileum, through the opening where digested food passes into a pouch attached to the stoma. A temporary stoma is one that is usually taken down within 6-8 weeks. It can be a loop or end stoma. A permanent ileostomy is one that will stay with the patient for life. These are usually due to cancer. Causes for ileostomies include Crohn’s disease, colonic dysmotility, ulcerative colitis, familial polyposis, diverticulitis, and some cancers.
Drink plenty of water, Gatorade, and similar fluids!
A person with an ileostomy loses a great deal of fluid as it does not stay inside the body long enough for liquids to be absorbed. Probably the most common cause for readmission to the hospital within a week of going home is dehydration accompanied by electrolyte imbalance
If dehydration and electrolyte imbalance is suspected, attempt oral intake of food and water or electrolyte-based fluids to replenish. If unable to tolerate food/water or too confused, have family/friend transport or call EMS to transport them to the ER immediately
Bowel transit time is at best around 3-hours with an ileostomy, so large hard pills or those with coatings intended to dissolve over several hours will be excreted before they dissolve.
Ileostomy stool contains digestive enzymes (bile and pancreatic fluids) that digest food. If they leak onto the skin, they will “digest” the skin causing severe irritation and pain. (See instructions on using Antifungal Powder and No-Sting wipes for skin irritation around the stoma or ask your ostomy nurse for help if irritation develops on the skin around the stoma).
Do not, under any circumstances, let your doctor prescribe ointments or creams to go on the peristomal skin. No pouch will adhere on top of ointments and creams.
To avoid skin problems from enzymatic erosion:
Eating marshmallows can slow down output within 5-10 minutes. Eating a few before bedtime can reduce the risk of leakage at night. Marshmallows are also great to carry in an emergency kit for changing appliances and traveling. The best part? It’s okay to make smores!
Remember to check with your doctor before making any dietary wound care changes.
United Ostomy Associations of America
Patti
Jan 26, 2022
I am gluten free and if I ate the wrong food the bag blows up like a balloon. I have an ileostomy 13 years and I wear Coloplast. All of a sudden the bag started ballooning whatever I ate and I couldn’t control it so I had to get out of the pouch and go into Convactec with no filter. Also my stoma shunk. That has never happened to me and I don’t know why. So all those Coloplast pouches I just ordered are too big on me. I don’t like Convactec it’s a long bag it’s flimsy and Coloplast is thicker material. Convactec when you try to open up the bag it’s very hard to open. When I put the drops in M9 they don’t go to the bottom and when I have to reopen the pouch to empty the M9 drops right on the top makes a mess. I don’t think Coloplast makes no filter pouch. I cannot eat marshmallows because there’s corn syrup in there and it blows my pouch up and gives me cramps. I have struggled with ballooning for 13 years. All your tips I have read before. Nothing is new. I wish I could find a pouch that is not flimsy that will work for me & Hollister is no different. I also have a divid In the middle of my stomach and I don’t like square wafers I like round wafers it seems like no one makes round wafers anymore and the Assura from Coloplast has been discontinued so I don’t have a round wafer I have is oval wafer and that falls into the divid and can cause leaks. I am very challenged. I have cut it down but it’s a short wait for her to begin with. Thank you.