Problems You May Incurr With Your Ileostomy
Other Things You Probably Don't Like To Think About
This part was actually part of another hub that I decided, with some advice, needed some "shortening". Pardon the pun here. LOL I will say again, that it is my hope to be here for others who have faced, or is facing, an Ileostomy all alone.
If this does help someone, please drop me a line. And I am always open for constructive critisism. It has done wonders for my writing.
My problems consisted of: Severe Skin Problems- Large areas of skin that are reddened, sore and weeping (always wet) will prevent a good seal around the stoma. ~I have some scarring from these types of problems. It took me quite awhile to learn how to heal these problems and still be able to wear my appliance. Just ask. :)
There are occasions when the ileostomy does not function for short periods of time. This is normal. However, if the stoma is not active for 4 to 6 hours and is accompanied by cramps and/or nausea, the intestine could be obstructed. An obstruction (or blockage) may be partial; that is, some liquid may pass through. Call your doctor or ostomy nurse in either case to discuss the situation. ~When I had this type of problem, I was taught to "milk" the tummy area right against my stoma. It worked the obstruction out, and then I would get flooded. So be prepared if that should happen to help you.
Watch for swelling of the stoma and adjust the opening of the pouch accordingly until the problem has passed. Take a warm bath to relax the abdominal muscles. Sometimes a change in body position, such as assuming a knee to chest position, may encourage movement of the bolus of food. Do not take a laxative. Obstruction can be caused by high-residue foods such as Chinese vegetables, pineapple, nuts, coconut and corn. It can also be caused by internal changes such as adhesions. ~Adhesions- I have many of those. Most are from the colectomy, and some are from other surgeries I have had since.
Adhesions are VERY painful. They will scare you and send you to your doctor. I would advise you though to not be concerned with how many times you have to see him or her, always, ALWAYS, make sure everything is okay with your ostomy and your remaining digestive system.
Keep The Electrolytes Balanced
Diarrhea When diarrhea occurs, the intestinal contents pass through the small intestine too quickly for the absorption of fluids and electrolytes to take place and may cause excessive loss of fluids and electrolytes. You must quickly replace these electrolytes to avoid becoming ill from dehydration and mineral deficiency.
However, loose stool can come from eating certain foods and is usually temporary. Raw fruits and vegetables, milk, fruit juice, prune juice or contaminated drinking water are examples. Loose stool may also be caused by emotional stress.~ (I had plenty of that)Some people with ileostomies may always have “watery discharge” and this is normal for them.
Diarrhea has these characteristics:
• The intestine discharges great quantities of watery stool.
• It comes on suddenly and may be accompanied by cramps.
Diarrhea can be caused by:
• Intestinal flu which may be accompanied by fever and vomiting.
• Antibiotics, penicillin and other prescription medications.
• Partial obstruction characterized by odorous discharge, cramps, forceful liquid output and excessive noises from the stoma. It can be caused by food or other factors. You should seek medical attention if this occurs.
If diarrhea persists, consult your physician or ostomy nurse. Take medications as prescribed. Then replace fluids by taking one cup of sweetened, clear tea or one glass of orange juice followed the next hour by one cup of salty broth. Continue alternating the drinks until diarrhea subsides.
Electrolyte balance (especially potassium and sodium) is important. When the colon (large intestine) is removed, a greater risk for electrolyte imbalance can occur.
Diarrhea, excessive perspiration and vomiting can increase this risk. Your diet should include fluids and foods rich in sodium and potassium. ~If you continue to have problems with nausea or vomiting, make sure to talk to your Dr. and possibly have him or her prescribe medication for this. It can become very dangerous if you become very dehydrated.
Dehydration is a common concern with symptoms of increased thirst, dry mouth, decreased urine output and fatigue. Increase any type of fluids such as Gatorade®, PowerAde® ,or Pedialyte®~ which is high in potassium and sodium.
I have dealt with many bouts of blockage and diarrhea. When dealing with blockage I would have to continuously massage my tummy around the stoma area. I would have to "milk" the stoma site also. Sometimes I would have to remove my appliance in order to let something pass through. During bouts of blockage and diarrhea, it was very hard to maintain my work, wherever I was working. I learned quickly to always have a change of jeans and underclothes with me in case of leakage also.
Short Bowel Syndrome
This condition happens in Crohn’s disease or diseases of the small intestine when surgery is required to remove a substantial amount of the small bowel. This condition merits special attention because of the loss of the intestine’s vital absorptive function.
People with this condition must remain under a physician’s supervision. They can live a normal life but must be careful to maintain adequate nourishment, avoid diarrhea and to be within reach of medical care. The shorter the small intestine, the more liquid the discharge will be. This may reduce the time a pouch can be worn because of more rapid undermining of the skin barrier. Special pouching systems areavailable for high, liquid ileostomy output.
~Though I do not have Crohns and such, I have this condition, especially since the BCIR. I have to have a monthly B-12 shot, and have many problems with digestion of many medications. During my first pregnany I began to lose a few of the fillings I had in my teeth. And during my second pregnancy my teeth actually began to fall apart. I had to have several of my teeth removed at the age of 30 and by the age of 32 I was wearing dentures. This was because of the depletion of calcium in my body from absorption problems. At the age of 34 I was diagnosed with Osteopenia. My height had been 5'5 1/2" at that time. This past year my osteopenia developed into Osteoporosis, and my height is now 5'" 4 1/4". I have a slight hump to my back at the age of 43. None of the medications that a normal ostoep. sufferer takes breaks down and absorbs for me so I am now taking daily shots of Forteo. ~
~Medication in the form of coated tablets or time release capsules may come out whole in the pouch and be of no benefit at all. Discuss this with your healthcare provider or pharmacist if this occurs. There may be alternative medications that you can use to avoid this problem. Liquid or liquid gel medications provide faster and more effective absorption.
Check With Your Pharmacist
Small Every Day Health Issues
I loved my little old Dr./Surgeon. He had taken care of my grandma and her 2 cancer scares/concerns. I felt comfort from him. I would never forget how hard it was to tell me what he had had to do to me. But, after about 6 mo. of running to him for every little thing, he informed me that I would need to see my PCP for all the little stuff. LOL
Couldn't help it, just couldn't seem to leave him, but I did. And that may be the case that you will be faced with. Don't worry, most PCP's are well informed these days. But, if you ever question a PCP's judgement, always give your surgeon a call. Most likely, it will be a question that your surgeons Med. Asst. can answer for you. Do not be afraid to inform your PCP of your concerns either. Believe it or not, you CAN teach an old dog new tricks. LOL
The more involved you are with your recovery and new life skills, the more your PCP will take notice, generally.
Do not get scared if you see minute bits of blood. More than likely you will have some of this from your stoma being rubbed against or pinched. But if you are in any kind of pain, see your surgeon immediately.
This is about all I can think of right now. But as always, if you have any questions, just ask.
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