Laparoscopic Total Colectomy & Ileoanal Pullthrough
Ileostomy Care and Management
Your nurses will help you start to feel comfortable taking care of your stoma so that you can get back to doing the things you enjoy doing. Once you have healed from surgery, having an ostomy will not stop you from doing activities such as swimming, playing sports, or riding a bike, to name a few things.
The stoma is moist and bright red and looks like the tissue on the inside of your cheek. There are no nerve endings in the bowel so the stoma does not hurt if bumped. Intestinal contents (stool or "poop") drain from the stoma into a pouch that your wear on the abdominal surface. The stoma doesn't have a muscle to control when stool or gas is releases, you must wear a pouch all the time. The pouch attached to your abdominal surface by an adhesive (sticky) backed wafer and is fitted over and around the stoma to collect its output.
Gas passing from the stoma is one of the first signs that the bowel has started to "wake up" and work after surgery. Some kids say it's "farting"! It can be somewhat noisy the first 1-2 weeks after surgery, but will be less noticeable as you eat a regular diet again. The first stool from the stoma usually begins within 1-3 days after surgery and is a green liquid. As you begin to drink fluids and start to eat, the consistency of ostomy output will vary from semi-liquid to a thick, pasty consistency. The stool from ileostomy contains enzymes (proteins that help digest the food) that are part of the normal digestive process, but can be irritating to the skin around the stoma. It is important to wear a properly fitted pouch and stick with pouch emptying guidelines that the nurse teaches you so that you can avoid skin irritation.
Your nurse will teach you how to empty the ostomy pouch whenever it has air or is 1/3 full. You will learn to put on a new pouch every 2-3 days and how to care for the skin around your stoma. After approximately 4-6 weeks, the swelling goes down and the stoma usually shrinks. See our Family Education Sheet, "Home Care Instructions for Changing an Ostomy Pouch" for instructions. A nurse from Boston Children's Hospital will arrange for a Visiting Nurse to come to your home to continue teaching and answer any questions you may have.