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Patient Instructions

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 many times a day.

Your stoma is the lining of your intestine. It will be pink or red, moist, and a little shiny. Stomas are usually round or oval.

Most stomas stick out a little over the skin, but some are flat. Your stoma may bleed a little when you clean it. The skin around your stoma should be dry.

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 seal well on your stoma. If this happens:

• Ask your doctor or nurse about medicine to treat your skin.
• Call your doctor or nurse if it is does not get better when you treat it.

If your stoma is leaking, your skin will get inflamed (sore).

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 there is hair on the skin around your stoma, your pouch may not stick.

• Ask your ostomy nurse about shaving.
• If you do shave the area, use a safety razor and soap or shaving cream
• Always rinse your skin well after you shave the area

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

Do not put anything into the stoma, including a suppository, thermometer, or enema.

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.

Standard ileostomy - stoma care; Brooke ileostomy - stoma care; Continent ileostomy - stoma care; Abdominal pouch - stoma care; End ileostomy - stoma care; Ostomy - stoma care

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.

Khatri VP, Asensio JA, eds. Subtotal colectomy/panproctocolectomy and j-pouch reconstruction. Operative Surgery Manual. 1st ed. Philadelphia, Pa: Saunders Elsevier; 2003:chap 35.

Scriver G, Hyman N. Ileostomy construction. Ileostomy construction. Operative Techniques in General Surgery. 2007 Mar;1: 43-49.

Updated by: George F Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.