What is ileostomy?

Ileostomy
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Ileostomy

Ileostomy

An ileostomy is a surgical procedure that is used when the lower part of the digestive system (the colon) is diseased or damaged and it may not be possible to restore a connection so that stool can leave the body as usual. An ileostomy allows body waste to leave the body through a surgical opening.

In this procedure, a hole is made in the abdomen. Then a portion of the small intestine (the ileum) is brought to an opening in the skin (a stoma). Waste leaves the body through the stoma instead of the anus. The waste is collected in a pouch attached to the stoma with adhesive.

Ileostomies may be done if all of the colon is removed or diseased, such as from ulcerative colitis or Crohn's disease.

How can you care for your child after ileostomy surgery?

Activity

  • Allow your child's body to heal. Don't let your child move quickly or lift anything heavy until your child is feeling better. When your child is active again, a support belt can help secure the ileostomy pouch.
  • Have your child rest when they feel tired.
  • Your child will probably need to take 2 to 4 weeks off from school. But check with your doctor first.
  • Many children are able to return to normal activities within a few weeks after surgery.
  • Your doctor will tell you when your child can shower or take a bath after surgery. Your child can shower with or without the ileostomy bag. You don't need to worry about getting the stoma wet.

Diet

  • Your child may not have much appetite after the surgery. But try to help your child eat healthy foods.
  • Have your child drink plenty of fluids to avoid becoming dehydrated (unless the doctor tells you not to).
  • Give your child a low-fiber diet for several weeks after surgery. It's best for your child to eat many small meals throughout the day. Add high-fiber foods a little at a time.
  • Your doctor will tell you which foods are best for your child and which ones to avoid. This will help reduce gas and prevent runny stools and blockage of the stoma.
  • Your doctor will tell you if your child needs to take certain supplements, such as vitamins.

Medicines

  • Be safe with medicines. Read and follow all instructions on the label.
    • If the doctor gave your child a prescription medicine for pain, give it as prescribed.
    • If your child is not taking a prescription pain medicine, ask the doctor if your child can take an over-the-counter medicine.
  • Your doctor will tell you if and when your child can restart their medicines. The doctor will also give you instructions about your child taking any new medicines.
  • If the doctor prescribed antibiotics for your child, give them as directed. Do not stop using them just because your child feels better. Your child needs to take the full course of antibiotics.
  • Your doctor will tell you if your child needs to take some medicines in a different form now that they have a stoma. You may need to crush pills or give your child a liquid form of the medicine.

Incision care

  • If your child has strips of tape on the cut (incision) the doctor made, leave the tape on until it falls off.
  • Gently wash the area daily with warm water, and pat it dry. Don't use hydrogen peroxide or alcohol. They can slow healing.
  • You may cover the area with a gauze bandage if it oozes fluid or rubs against clothing.
  • Change the bandage every day or if it gets wet or dirty.

Other instructions

  • If the skin under your child's pouch is red, irritated, or itchy, you need to treat the skin. Follow these steps:
    • Gently remove the pouch.
    • Clean the skin under the pouch with water.
    • Dry the skin.
    • Sprinkle ostomy protective powder on the skin, and then blot it off.
    • Reattach or replace the pouch.
    • If your child keeps having skin irritation, talk to the doctor.
  • Follow all instructions from your doctor or ostomy nurse.
  • Empty and replace your child's ileostomy bag as often as directed by your doctor or ostomy nurse.

How do you prepare for your child's ileostomy surgery?

Surgery can be stressful for both your child and you. This information will help you understand what you can expect. And it will help you safely prepare for your child's surgery.

Preparing for surgery

  • If your child is old enough, talk to them about the surgery. Say that it will help your child's body get rid of waste. Hospitals know how to take care of children. The staff will do all they can to make it easier for your child.
  • You may need to take your child to the hospital the day before surgery to prepare your child's colon. Your child will get laxatives to completely empty the colon.
  • Ask if a special tour of the surgery area and hospital is available. This may make your child feel less nervous about what happens.
  • Plan for your child's recovery time. Your child may need more of your time right after the surgery, both for care and for comfort.
  • Understand exactly what surgery is planned, along with the risks, benefits, and other options.
  • Tell the doctor ALL the medicines, vitamins, supplements, and herbal remedies your child takes. Some may increase the risk of problems during the surgery. Your doctor will tell you if your child should stop taking any of them before the surgery and how soon to do it.

The day before surgery

  • A nurse may call you (or you may need to call the hospital). This is to confirm the time and date of your child's surgery and answer any questions.
  • Remember to follow your doctor's instructions about your child taking or stopping medicines before surgery. This includes over-the-counter medicines.

What are the risks of proctocolectomy and ileostomy surgery?

Examples of complications are dehydration, infection, blockage of the small intestine, not absorbing medicines so they don't work as they should, and problems with the stoma. Some people need one or more surgeries to treat complications.

Ileostomy

Colon and small intestine, with small intestine attached to stoma

During an ileostomy (say "ill-ee-AW-stuh-mee"), the doctor attaches the end of the small intestine to an opening in the skin. This allows waste to leave the body through a new opening called a stoma. A pouch attaches to the skin around the stoma. Stools collect in the pouch. You must empty the pouch several times each day.

After ileostomy surgery in children: When to call

Call 911 anytime you think your child may need emergency care. For example, call if:

  • Your child passes out (loses consciousness).
  • Your child is short of breath.

Call your doctor now or seek immediate medical care if:

  • Your child has pain that does not get better after taking pain medicine.
  • Your child has loose stitches, or the incision comes open.
  • Your child is bleeding through the bandage.
  • The skin around your child's stoma is red, has broken open, or is too wet.
  • You have trouble attaching the bag to the stoma.
  • Your child's stoma has bloody discharge or seems to be blocked.
  • Your child has symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the incision.
    • Pus draining from the incision.
    • A fever.
  • Your child is sick to their stomach or can't keep down fluids.
  • Your child has signs of a blood clot in the leg (called a deep vein thrombosis), such as:
    • Pain in the calf, back of knee, thigh, or groin.
    • Redness and swelling in the leg or groin.
  • Your child's stoma changes color, such as turning dark red or black.

Watch closely for changes in your child's health, and be sure to contact your doctor if:

  • Your child's stoma sticks out above the skin or has sunk below it.
  • Your child has any problems with the stoma.

After your child's ileostomy surgery: Overview

Part of your child's intestine has been removed or separated from the rest of the intestine. This is most often done because of a problem that affects your child's intestines. During the ileostomy, the surgeon made a hole in your child's belly and connected part of the small intestine to that opening in the skin. This opening is called the stoma.

A pouch is attached to the outside of the stoma. Stool collects in the pouch and must be removed several times each day. The stool will be looser or have more liquid than before surgery.

Your child is likely to have cramps that come and go for the next few days. Many children have nausea and may feel tired. This is common during healing. Your child will probably feel better in a week or so. A nurse or other member of your child's care team will show you and your child how to care for the stoma and pouch after you go home.

What happens on the day of your child's ileostomy surgery?

  • Follow the instructions exactly about when your child should stop eating and drinking. If you don't, your child's surgery may be canceled. If your doctor told you to have your child take any medicines on the day of surgery, have your child take them with only a sip of water.
  • Follow the doctor's instructions about when your child should bathe or shower before the procedure. Do not apply lotion or deodorant.
  • Your child may brush their teeth. But tell your child not to swallow any toothpaste or water.
  • Do not let your child wear contact lenses. Bring your child's glasses or contact lens case.
  • Be sure your child has something that's a reminder of home. A special stuffed animal, toy, or blanket may be comforting. For an older child, it might be a book or music.

At the hospital

  • A parent or legal guardian must accompany your child.
  • Your child will be kept comfortable and safe by the anesthesia provider. Your child will be asleep during the surgery.
  • The surgery will take a few hours.
  • After surgery, your child will be taken to the recovery room. As your child wakes up, the recovery staff will monitor your child's condition. The doctor will talk to you about the surgery.
  • You will probably be able to go with your child to the hospital room after the surgery.
  • Your child may have a tube in the nose that goes into the stomach to drain fluid and acid. This is to rest your child's intestines for a few days.

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