How Many Times a Day Should I Empty My Ileostomy?

An ileostomy is a procedure performed on the intestines.
An ileostomy is a procedure performed on the intestines.

Most people need to empty the ileostomy pouch four to 10 times a day. The frequency of emptying depends on the volume of waste produced.

  • You must empty your pouch when it is about one-third full. This prevents a visible bulge under the clothes and prevents the pouch from separating from the seal due to its weight.
  • The pouch has an end or a tail. You must always evert the tail before emptying the pouch. This prevents the waste from collecting in the tail and giving out a foul odor.
  • You must change the pouch once or twice weekly. You may do it more frequently if you notice leakage, itching, or burning around the stoma.
  • You may speak to your doctor regarding taking medications like Bismuth subgallate to reduce the stool odor.

What exactly is an ileostomy stoma?

An ileostomy stoma is an artificial opening over your abdomen that the surgeon creates during an ileostomy. It allows the stool and gases to pass out of the body bypassing the lower part of your gut. The stoma protrudes an inch or so above the skin of the abdomen. A normal stoma looks red, swollen, and moist. It may become smaller over the 6-8 weeks after surgery. The stromal surface is painless and may bleed a little during cleaning.

A stoma is attached to an ileostomy pouch with the help of a clamp. It needs manual emptying daily. It fills when the gut generates waste or stools.

How do I empty my ileostomy pouch?

This procedure is done in the privacy of the washroom. Wash your hands and put on gloves. You may have someone to help you if you need. Place a toilet paper into the commode before emptying the pouch. This will reduce the splashing of the pouch contents. Now, remove the clamp that holds the pouch to the seal. Hold the pouch by the bottom end and drain it into the toilet pan by squeezing the contents. You may rinse the pouch once done. Replace the clamp and fix it back.

Bad smell and gas are common worries for any individual with an ostomy. However, most ostomy pouches are odor proof. It will only smell when the pouch is being emptied.

What changes do I have to make in my lifestyle after an ileostomy?

It is normal to be anxious before and after an ileostomy procedure. With an honest discussion with your doctor and a bit of modification in your diet, you can lead a wholesome personal and professional life. An experienced ostomy nurse can provide proper advice regarding the size of the pouch and its care.

  • Dietary changes: The most important change is increasing the daily water intake by 500-750 mL. You may need to drink more during periods of diarrhea or heavy sweating. Preferred fluids include water, broth, and vegetable juices. Oral rehydration solutions may be acceptable as well. Learn to spot the signs of poor hydration and increase water intake appropriately.
  • Solids: You must completely avoid gas-producing foods like beans, cabbage, cauliflower, brussels sprouts, broccoli, and asparagus. Discuss better eating options with your doctor.
  • Over the counter gas reducing medicines like Beano and Gas-X may help to reduce flatulence. You may practice the ‘Muffling’ measures by exerting light pressure against the stoma with your hand. The pouching systems with filters that deodorize flatus can also help to deal with gases and odor.
  • Physical activity: Most activities like bathing and changing can be performed with the temporary removal of the ostomy pouch. There is no restriction on walking, jogging, and driving. Weightlifting for work-related or recreational reasons must be discontinued or reduced because it may put pressure on the pouch, causing leaks. Extreme contact sports are not allowed. Swimming may be done using the waterproof seals on the pouch.
  • Sexual activity: The ostomy does not affect organic sexual function. If you feel conscious about the stoma, you and your partner can undergo counseling to re-establish intimacy. You should empty the pouch before engaging in sexual activity. Lingerie or a cummerbund to conceal and secure the pouches are available in the market.
  • Travel: Always carry extra ostomy supplies and place them in the carry-on luggage. Ensure the pouches are not exposed to extremes of temperature. Drink only boiled or bottled water when you travel.

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References
https://www.uptodate.com/contents/ileostomy-or-colostomy-care-and-complications?

https://www.coloplastcare.com/en-US/ostomy/the-basics/before-surgery/b2.4-changing-and-emptying-your-ileostomy-pouch/