DISCHARGE AND AFTERCARE

Discharge Instructions for Ileostomy

August 15, 2018

Discharge Instructions for Ileostomy

During an ileostomy, a surgeon removes the colon (large intestine) and part of the last section of the ileum (small intestine) if they are diseased. The surgeon may also disconnect parts of the intestine if they have been injured. Disconnection allows time for injured intestines to heal; then they are reconnected. In other cases, the ileostomy is permanent. During the ileostomy, the end of the ileum is brought through the abdominal wall. This makes an opening, called a stoma, for the contents of your intestines and mucus to pass out of the body. The following are general guidelines to follow after your ileostomy. Your healthcare provider and ostomy nurse will go over any information that is specific to your condition.

Activity

Tips for activities include the following: 

  • Don’t lift anything heavier than 5 pounds until your healthcare provider says it is OK.

  • Don’t drive until after your first healthcare provider's appointment following your surgery.

  • If you ride in a car for more than short trips, stop often to stretch your legs.

  • Ask your healthcare provider about when you can expect to return to work. Most people are able to return to work within 4 to 6 weeks after surgery.

  • Increase your activity gradually. Take short walks on a level surface.

  • Don’t overexert yourself to the point of fatigue. If you become tired, rest.

Other home care

Suggestions for home care:

  • Take care of your stoma as directed. Your healthcare provider and ostomy nurse discussed how to do this with you before you left the hospital.

  • Ask your healthcare provider or ostomy nurse for a patient education sheet about ileostomy care before you leave the hospital. This will help remind you how to care for yourself. A wound-ostomy-continence nurse will likely see you before and after surgery for questions and teaching. Let the nurse know if you want a significant other to be present for the education on your ostomy care. 

  • Ask your healthcare provider to prescribe medicines to reduce the output from your ostomy if necessary.

  • Don’t be alarmed by bowel movements that contain mucus. This is common following this procedure. Increased gassiness is also common. 

  • Shower or bathe as instructed by your healthcare provider.

  • Wash the incision site with soap and water and pat dry.

  • Check your incision every day for redness, drainage, swelling, or separation of the skin.

  • Don’t take any over-the-counter medicine unless your healthcare provider tells you to do so.

When to call your healthcare provider

Call your healthcare provider right away if you have any of the following:

  • Excessive bleeding from your stoma

  • A change in your stoma's color or a stoma that looks like it's getting longer 

  • Bulging skin around your stoma

  • Blood in your stool

  • Fever above 100.4°F (38.0°C) or higher, or as directed by your healthcare provider

  • Redness, swelling, bleeding, or drainage from your incision

  • Constipation or diarrhea

  • Nausea or vomiting

  • Increased pain in the belly or around the stoma

Updated:  

August 15, 2018

Sources:  

Pathophysiology and Treatment of Fever in Adults. UpToDate

Reviewed By:  

Fraser, Marianne, MSN, RN,Lehrer, Jenifer, MD