You had an injury or disease in your digestive system and needed an operation called an ileostomy. The operation changed the way your body gets rid of waste (stool, feces, or poop).
Now you have an opening called a stoma in your belly. Waste will pass through the stoma into a pouch that collects it. You will need to take care of the stoma and empty the pouch many times a day.
What to Expect at Home
Your stoma is made from the lining of your intestine. It will be pink or red, moist, and a little shiny.
Stool that comes from your ileostomy is thin or thick liquid, or it may be pasty. It is not solid like the stool that came from your colon. Foods you eat, medicines you take, and other things may change how thin or thick your stool is.
Some amount of gas is normal.
You will need to empty the pouch 5 - 8 times a day.
Chew your foods well. This will help keep high-fiber foods from blocking your stoma.
Some signs of blockage are sudden cramping in your belly, a swollen stoma, nausea (with or without vomiting), and sudden increase of very watery output.
Drinking hot tea and other liquids may flush any foods that are blocking the stoma.
There will be times when nothing comes out of your ileostomy for a little while. This is normal.
Call your doctor or nurse right away if your ileostomy bag stays empty longer than 4 to 6 hours. Your intestine may be blocked.
Do NOT just take a laxative if this problem happens.
Some foods that may block your stoma are raw pineapple, nuts and seeds, celery, popcorn, corn, dried fruits (such as raisins), mushrooms, chunky relishes, coconut, and some Chinese vegetables.
Tips for when no stool is coming from your stoma:
Try loosening the opening of the pouch if you think it is too tight.
Change your position. Try holding your knees up to your chest.
Take a warm bath or warm shower.
Loose Stools and Increased Output
Some foods will loosen your stools and can increase output after you eat them. If you believe a certain food has caused a change in your stools, do not eat it for a while, and then try again. These foods may make your stools looser:
Milk, fruit juice, and raw fruits and vegetables
Prune juice, licorice, large meals, spicy foods, beer, red wine, and chocolate
Some foods will make your stool thicker. Some of these are applesauce, baked potatoes, rice, bread, peanut butter, pudding, and baked apples.
Drink 8 to 10 glasses of fluid a day. Drink more when it is hot or when you have been very active.
If you have diarrhea or your stools are looser or more watery:
Drink extra fluids with electrolytes (sodium, potassium). Drinks such as Gatorade, PowerAde, or Pedialyte contain electrolytes. Drinking soda, milk, juice, or tea will help you get enough liquids.
Try to eat foods that have potassium and sodium every day to keep your potassium and sodium levels from getting too low. Some examples of foods that contain potassium are bananas. Some high-sodium foods are salted snacks.
Do not wait to get help. Diarrhea can be dangerous. Call your doctor or nurse if it does go away.
Pretzels may help reduce water loss in stool. They also have extra sodium.
When to Call the Doctor
Call your doctor or nurse if:
Your stoma is swelling and is more than a half inch larger than normal.
Your stoma is pulling in, below the skin level.
Your stoma is bleeding more than normal.
Your stoma has turned purple, black, or white.
Your stoma is leaking often.
Your stoma does not seem to fit as well as it did before.
You have a skin rash, or the skin around your stoma is raw.
You have a discharge from the stoma that smells bad.
Your skin around your stoma is pushing out.
You have any kind of sore on the skin around your stoma.
You have any signs of being dehydrated (there is not enough water in your body). Some signs are dry mouth, urinating less often, and feeling lightheaded or weak.
You have diarrhea that is not going away.
Cima RR. Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M. Friedman LS, Brandt LJ. Sleisenger & Fordtran’s Gastrointestinal and Liver Disease. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2006:chap 110.
Fry RD, Mahmoud N, Maron DJ, Ross HM, Rombeau J. Colon and rectum. In: Townsend Jr. CM, Beauchamp RD, Evers BM, Mattox KL. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 50.
Scriver G, Hyman N. Ileostomy construction. Ileostomy construction. Operative Techniques in General Surgery. 2007 Mar;1: 43-49.
Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine; and Joshua Kunin, MD, Consulting Colorectal Surgeon, Zichron Yaakov, Israel. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.