Roughly 48,000 people will have ileostomy surgery each year in the United States and that number is expected to grow as the baby boomer generation ages. A person who has an ileostomy will experience changes in how waste is removed from his body. In an ileostomy surgical procedure, the colon and rectum are removed and an opening in the skin, called a stoma, is created in the abdominal region to provide an exit point for the excrement coming from the small intestines. An ileostomy pouch is connected to the stoma to collect the excrement. If you have this type of surgery, you are going to have to get used to wearing and using an ileostomy pouch. Here are some things you should know about an ileostomy pouch to make the transition easier to handle.
The pouch will collect the drainage from the small intestines. The drainage will look and feel like a brown or green mushy sludge. The drainage will seep out of the stoma and right into the pouch. If the drainage gets on your skin, the skin can become irritated and develop a rash.
You need a skin barrier that fits right over the stoma to keep the drainage from leaking onto your bare skin and irritating it. The stoma shrinks after surgery and you will have to use different sized skin-barriers until it stops shrinking. Once the stoma stops shrinking, you’ll be able to purchase just a single-sized skin barrier.
There are five main skin barriers available. There’s the flat-skin barrier for stomas that protrude more than an inch from the skin, and a convex barrier for stomas protruding less than an inch. You can use cut-to-fit barrier while your stoma is shrinking or has an abnormal shape. There are pre-sized barriers for when the stoma stops changing. A flexible barrier is considered the best choice for ileostomy patients.
A skin barrier is applied by pressing the adhesive side of it against your skin and holding it there for about a minute with your hand. The heat from your body activates the adhesive on the barrier so it will stick to your skin. Removing the skin barrier is similar to taking off a Band-Aid. Grab an edge and gently pull down on it to take the barrier off of your body.
There is a one-piece system pouch and a two-piece system pouch available to use. The one-piece pouch has the skin barrier already attached to it. You simply take off the film over the adhesive on the pouch and place it over your stoma. With the two-piece pouch, the skin barrier is placed over the stoma and the pouch is connected to the barrier with a flange that snaps together.
A drainable pouch is best to use during the day. A drainage pouch has an interlocking seal you use to open the pouch after you’ve detached it from the skin barrier so you can deposit the drainage into a toilet. When you are done, close the pouch, wipe it clean, and reattach it to the skin barrier. A closed pouch can only be filled once and then it has to be discarded. The pouch should be drained or replaced once it is a third to halfway full.
You can shower like normal with the pouch on or off as water and soap will not get into the stoma. You do want to make sure that you are using shampoos and soaps that won’t affect the adhesive on the skin barrier. You will want to rinse the area completely with water and let it dry before reattaching the skin barrier and pouch if you took if off before bathing.
The skin barriers are typically changed about twice a week depending on your routines and schedules. Your doctor will help you determine the best times for you. The pouch is changed when it gets filled up a third to halfway full. This can vary depending on your dietary habits and activity level. The one thing you don’t want to happen is having the pouch get too full that it leaks or have it pull away from the skin because it has gotten too heavy.