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Ileostomy - caring for your stoma

Standard ileostomy - stoma care; Brooke ileostomy - stoma care; Continent ileostomy - stoma care; Abdominal pouch - stoma care; End ileostomy - stoma care; Ostomy - stoma care; Crohn's disease - stoma care; Inflammatory bowel disease - stoma care; Regional enteritis - stoma care; IBD - stoma care

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Ileostomy - stoma and pouch

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Description

You had an injury or disease in your digestive system and needed an operation called an ileostomy. The operation changes 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 your stoma and empty the pouch several times a day.

About Your Stoma

Things to know about your stoma include:

The feces that come out of the stoma can be very irritating to the skin. So it is important to take special care of the stoma to avoid damage to the skin.

Stoma Care

After surgery, the stoma will be swollen. It will shrink over the next several weeks.

The skin around your stoma should look like it did before surgery. The best way to protect your skin is by:

Stoma appliances are either 2-piece or 1-piece sets. A 2-piece set consists of a baseplate (or wafer) and pouch. A baseplate is the part that sticks to the skin and protects it against irritation from feces. The second piece is the pouch into which feces empty. The pouch attaches to the baseplate, similar to a Tupperware cover. In a 1-piece set, the baseplate and appliance is all one piece. The baseplate usually needs to be changed only once or twice a week.

To care for your skin:

If you have hair on the skin around your stoma, your pouch may not stick. Removing the hair may help.

Carefully look at your stoma and the skin around it every time you change your pouch or barrier. If the skin around your stoma is red or wet, your pouch may not be sealed well on your stoma.

Sometimes the adhesive, skin barrier, paste, tape, or pouch may damage the skin. This may happen when you first start using a stoma, or it may happen after you have been using it for months, or even years.

If this happens:

If your stoma is leaking, your skin will get sore.

Be sure to treat any skin redness or skin changes right away, when the problem is still small. Do not allow the sore area to become larger or more irritated before asking your doctor or ostomy nurse about it.

If your stoma becomes longer than usual (sticks out from the skin more), try a cold compress, like ice wrapped in a towel, to make it go in.

You should never stick anything into your stoma, unless your doctor tells you to.

When to Call the Doctor

Call your provider if:

Call your provider if the skin around your stoma:

Also call if you:

Related Information

Intestinal obstruction repair
Large bowel resection
Small bowel resection
Ileostomy
Total abdominal colectomy
Total proctocolectomy and ileal-anal pouch
Total proctocolectomy with ileostomy
Crohn disease
Ulcerative colitis
Colorectal cancer
Ileostomy and your child
Ileostomy and your diet
Types of ileostomy
Ileostomy - discharge
Living with your ileostomy
Large bowel resection - discharge
Small bowel resection - discharge
Total colectomy or proctocolectomy - discharge
Bland diet
Ileostomy - changing your pouch
Crohn disease - discharge
Ulcerative colitis - discharge
Ileostomy - what to ask your doctor

References

Beck DE. Ostomy construction and management: personalizing the stoma for the patient. In: Yeo CJ, ed. Shackelford's Surgery of the Alimentary Tract. 8th ed. Philadelphia, PA: Elsevier; 2019:chap 178.

Lyon CC. Stoma care. In: Lebwohl MG, Heymann WR, Coulson IH, Murrell DF, eds. Treatment of Skin Disease: Comprehensive Therapeutic Strategies. 6th ed. Philadelphia, PA: Elsevier; 2022:chap 232.

Raza A, Araghizadeh F. Ileostomy, colostomy, pouches, and anastomoses. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 117.

Tam KW, Lai JH, Chen HC, et al. A systematic review and meta-analysis of randomized controlled trials comparing interventions for peristomal skin care. Ostomy Wound Manage. 2014;60(10):26-33. PMID: 25299815 pubmed.ncbi.nlm.nih.gov/25299815/.

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Review Date: 5/6/2022  

Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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