ileostomy

mef123

My husband had to get an emergency ileostomy a week after his original surgery. But my question is how often will he need to empty it? Right now the nurses are emptying every hour! I hope he doesn't have to do that when he gets home which will be anywhere from tomorrow to Monday. How often does it need to be empties at night?

Thanks in advance.

You all are great here.

Michele

khl8

It will need to be emptied
It will need to be emptied when the bag is 2/3 full. and how often that happens depends on what has been eaten and how quickly it fills. I usually woke up once during the night to empty. He will get the hang of it.

John23

Michele -

Every manufacturer of ostomy appliances will tell you that
the pouch -must- be emptied when it is no more than 1/3 full.
(yes, that is one-third)

More than that, and you run the risk of dislodging the appliance,
causing erosion under the wafer, and/or plugging the filter.

Most of us with an ileostomy have had times that it will fill to
beyond capacity before we can empty it, but it is not a habit
you would want to get into. 1/3 is optimum.

Your husband should change the appliance himself, without
assistance. It should not be changed while laying down, as
it's probably being done now, in the hospital. He should
stand in front of the bathroom sink, with all items prepared and
laid out on the sink's counter. Some sheets of newspaper on the
floor will make clean-up easier.

The peristomal area (the skin around the stoma) should be washed
with -nothing more- than hot water and a very clean wash rag.
Do not use any face cloths that may have soap or fabric softener
in it. Dry the area using paper towels, to avoid the possibility
of contamination from fabric softeners.

NO adhesive removers should ever be used on the peristomal area,
since they all leave petroleum residue on the skin. Any residue will
prevent the appliance's adhesives from sticking properly, and greatly
decrease the wear-time.

Likewise, no topical dressing, skin protectors, etc., should ever
be used on the peristomal area for the same reason as above.

For sore areas, use Convetec's Stomahesive Powder used directly
on the sore area. No other topical dressing, liquid, powder, or otherwise,
should ever be used under or over the Stomahesive powder. The
appliance is placed directly on top of the powdered area, and will
adhere as it should.

You can click on my name, and go to the "blog" section to find some
other info that may be of help!

As far as frequency of emptying?

My first Ileostomy (2006) would vary from hourly to four to
five hours, depending on conditions.

My second ileostomy (2011) is connected to a shortened small
intestine, and the frequency for the need to empty can vary from
every fifteen minutes, to hourly.

The frequency of a normal ileostomy ; one that is at the end of the
full amount of small intestine (25 foot), will be less trouble than one
on a short bowel.

Food product usually takes about four hours to transverse from
mouth to the beginning of the colon. Liquid takes less time, and
can push food through faster.

That said...... All ileostomates are prone to dehydration. Drinking
small amounts of water more frequently, rather than large amounts
all at once, is best. Large amounts of water will just pass through
quickly, and can actually cause dehydration!

It takes time for the intestines to settle down, so emptying more
frequently at first, is common.

Any sign of a burning sensation under the wafer/appliance is a
sign that waste is seeping under the adhesive and eating away
at the skin. You DO NOT want to leave that condition unresolved.
The appliance should be changed ASAP, with Stomahesive Powder
applied to the damaged skin.

The hole for the stoma should be cut as snugly to the stoma as
possible to avoid seepage. No skin should be seen around the stoma
when the wafer is in place. A snug fit is best!

He'll do OK with things, but it will take awhile for him to get
accustomed to the new system. The stoma and peristomal area
can take six months to settle into what will be it's final state.
So changes in the size of the stoma is to be expected. It is the
reason your should be using "cut to fit" appliances, rather than
"pre-cut".

Check the "blog"..... If there's any other info I can provide,
just ask...

Best wishes,

John

lauragb

John23 said:

Michele -

Every manufacturer of ostomy appliances will tell you that
the pouch -must- be emptied when it is no more than 1/3 full.
(yes, that is one-third)

More than that, and you run the risk of dislodging the appliance,
causing erosion under the wafer, and/or plugging the filter.

Most of us with an ileostomy have had times that it will fill to
beyond capacity before we can empty it, but it is not a habit
you would want to get into. 1/3 is optimum.

Your husband should change the appliance himself, without
assistance. It should not be changed while laying down, as
it's probably being done now, in the hospital. He should
stand in front of the bathroom sink, with all items prepared and
laid out on the sink's counter. Some sheets of newspaper on the
floor will make clean-up easier.

The peristomal area (the skin around the stoma) should be washed
with -nothing more- than hot water and a very clean wash rag.
Do not use any face cloths that may have soap or fabric softener
in it. Dry the area using paper towels, to avoid the possibility
of contamination from fabric softeners.

NO adhesive removers should ever be used on the peristomal area,
since they all leave petroleum residue on the skin. Any residue will
prevent the appliance's adhesives from sticking properly, and greatly
decrease the wear-time.

Likewise, no topical dressing, skin protectors, etc., should ever
be used on the peristomal area for the same reason as above.

For sore areas, use Convetec's Stomahesive Powder used directly
on the sore area. No other topical dressing, liquid, powder, or otherwise,
should ever be used under or over the Stomahesive powder. The
appliance is placed directly on top of the powdered area, and will
adhere as it should.

You can click on my name, and go to the "blog" section to find some
other info that may be of help!

As far as frequency of emptying?

My first Ileostomy (2006) would vary from hourly to four to
five hours, depending on conditions.

My second ileostomy (2011) is connected to a shortened small
intestine, and the frequency for the need to empty can vary from
every fifteen minutes, to hourly.

The frequency of a normal ileostomy ; one that is at the end of the
full amount of small intestine (25 foot), will be less trouble than one
on a short bowel.

Food product usually takes about four hours to transverse from
mouth to the beginning of the colon. Liquid takes less time, and
can push food through faster.

That said...... All ileostomates are prone to dehydration. Drinking
small amounts of water more frequently, rather than large amounts
all at once, is best. Large amounts of water will just pass through
quickly, and can actually cause dehydration!

It takes time for the intestines to settle down, so emptying more
frequently at first, is common.

Any sign of a burning sensation under the wafer/appliance is a
sign that waste is seeping under the adhesive and eating away
at the skin. You DO NOT want to leave that condition unresolved.
The appliance should be changed ASAP, with Stomahesive Powder
applied to the damaged skin.

The hole for the stoma should be cut as snugly to the stoma as
possible to avoid seepage. No skin should be seen around the stoma
when the wafer is in place. A snug fit is best!

He'll do OK with things, but it will take awhile for him to get
accustomed to the new system. The stoma and peristomal area
can take six months to settle into what will be it's final state.
So changes in the size of the stoma is to be expected. It is the
reason your should be using "cut to fit" appliances, rather than
"pre-cut".

Check the "blog"..... If there's any other info I can provide,
just ask...

Best wishes,

John

John has good advice here.
John has good advice here. John, I read your blog awhile back and it really helped. I now only use water and a wash cloth for barrier removal and follow the less is more approach, pretty much leaving the area alone except a quick swipe around the stoma before putting on a new barrier.

Something else that helped my skin is changing to a convex barrier. Even though I am thin, I still had creases plus the adhesive on the flat barrier stuck to my skin and then I would mess with it too much causing more irritation. Your husband's stoma nurses will be able to find the best fit for him. Cutting to fit can be a little frustrating in the beginning but that gets better too. As John says, fit it close so no skin shows but you don't want it pressing on the stoma either.

My pouch needs emptied every 1-4 four hours. I have greater output in the evenings and usually get up once per night to empty it. During the day is when I have the four hour time frames. Fruit juice runs through quickly but "juiced" juice takes a little longer I think from less sugars. I usually drink beverages before meals and wait for a while to drink after I eat unless I don't care about the food moving through quickly.

Goodluck to you and your husband. It isn't so bad after you get used to it.

tommycat

Very good advice here. Keep
Very good advice here. Keep in mind that although he may feel clumsy and awkward changing it himself at first, there will rapidly come a time when he can do with very little effort.

mef123

Thanks
Thank you everyone and John your advice is great and really appreciated. He's young so I think he should get a hang of it pretty easily. He's just a little grossed out about it right now, not happy. But I can see he is already getting more comfortable with it.

Also does it always make so much gurggling noises?

Michele

John23

mef123 said:

Thanks
Thank you everyone and John your advice is great and really appreciated. He's young so I think he should get a hang of it pretty easily. He's just a little grossed out about it right now, not happy. But I can see he is already getting more comfortable with it.

Also does it always make so much gurggling noises?

Michele

Michele -

Gurgling noises? You mean it isn't talking yet? Well, it's young....

Both colostomy and ileostomy noises are normal. Some are
louder than others, and both can be stifled somewhat by pressing
one's arm on the stoma itself. That will muffle the sound a little.

That stoma isn't what anyone actually ever sees in "real life",
it's usually buried inside, where the noises aren't so prevalent
to ears; The noises are natural, the new location isn't....

By the way.. The stoma is formed by pulling a section of intestine
through to the outside of the body, then it is carefully stitched
at the base. The section sticking out is then turned inside-out
upon itself (like a sock) and the open end stitched again at the
base. So what you're looking at, when you look at the stoma
sticking out, is actually the inside of the intestine!

The inside of the intestine is impervious to the acid, etc, that
dissolves food, while the outside isn't. So it's important that
the outside of the intestine doesn't come into contact with the
waste. Turning it inside-out protects the outside, and insures
that only the inside of the intestine comes into contact with the
waste inside the pouch. Simple, ehh? And that's why we try
to cut that hole in the appliance as snug to the stoma as possible;
it helps keep the waste from the skin around the stoma. That
acid waste will eat our skin as fast as it can dissolve food... UGH.
Think about that!

Normally, the acid in the waste is neutralized in the colon and
the liquid re-absorbed and re-used to keep us hydrated.

With an Ileostomy, the colon isn't part of the equation, so the
output can be painfully acidic.....And.... since we've lost that extra
re-absorption process, we ileostomates are usually always on
the brink of dehydration. It is something that you (and yer old man)
should keep in mind 24/7/365. Once dehydrated, it's very difficult
to get re-hydrated without a trip to the ER for an infusion of
saline solution. Always keep in mind, that if you ingest too much
liquid all at once, the body will purge it; dump it -all- into the pouch,
and that action will cause one to become dehydrated even faster.

The bottom line, is not to become dehydrated to begin with, and
we do that by drinking small amounts more often. 4oz per hour
should be sufficient for most of us...... 16 oz all at once will go right
through, taking food along with it.

There. I have used my share of pixels for this afternoon! I'll
have to see if Greta will waive an extra amount.....

Good health to you and the OM,

John

son of hal

John23 said:

Michele -

Every manufacturer of ostomy appliances will tell you that
the pouch -must- be emptied when it is no more than 1/3 full.
(yes, that is one-third)

More than that, and you run the risk of dislodging the appliance,
causing erosion under the wafer, and/or plugging the filter.

Most of us with an ileostomy have had times that it will fill to
beyond capacity before we can empty it, but it is not a habit
you would want to get into. 1/3 is optimum.

Your husband should change the appliance himself, without
assistance. It should not be changed while laying down, as
it's probably being done now, in the hospital. He should
stand in front of the bathroom sink, with all items prepared and
laid out on the sink's counter. Some sheets of newspaper on the
floor will make clean-up easier.

The peristomal area (the skin around the stoma) should be washed
with -nothing more- than hot water and a very clean wash rag.
Do not use any face cloths that may have soap or fabric softener
in it. Dry the area using paper towels, to avoid the possibility
of contamination from fabric softeners.

NO adhesive removers should ever be used on the peristomal area,
since they all leave petroleum residue on the skin. Any residue will
prevent the appliance's adhesives from sticking properly, and greatly
decrease the wear-time.

Likewise, no topical dressing, skin protectors, etc., should ever
be used on the peristomal area for the same reason as above.

For sore areas, use Convetec's Stomahesive Powder used directly
on the sore area. No other topical dressing, liquid, powder, or otherwise,
should ever be used under or over the Stomahesive powder. The
appliance is placed directly on top of the powdered area, and will
adhere as it should.

You can click on my name, and go to the "blog" section to find some
other info that may be of help!

As far as frequency of emptying?

My first Ileostomy (2006) would vary from hourly to four to
five hours, depending on conditions.

My second ileostomy (2011) is connected to a shortened small
intestine, and the frequency for the need to empty can vary from
every fifteen minutes, to hourly.

The frequency of a normal ileostomy ; one that is at the end of the
full amount of small intestine (25 foot), will be less trouble than one
on a short bowel.

Food product usually takes about four hours to transverse from
mouth to the beginning of the colon. Liquid takes less time, and
can push food through faster.

That said...... All ileostomates are prone to dehydration. Drinking
small amounts of water more frequently, rather than large amounts
all at once, is best. Large amounts of water will just pass through
quickly, and can actually cause dehydration!

It takes time for the intestines to settle down, so emptying more
frequently at first, is common.

Any sign of a burning sensation under the wafer/appliance is a
sign that waste is seeping under the adhesive and eating away
at the skin. You DO NOT want to leave that condition unresolved.
The appliance should be changed ASAP, with Stomahesive Powder
applied to the damaged skin.

The hole for the stoma should be cut as snugly to the stoma as
possible to avoid seepage. No skin should be seen around the stoma
when the wafer is in place. A snug fit is best!

He'll do OK with things, but it will take awhile for him to get
accustomed to the new system. The stoma and peristomal area
can take six months to settle into what will be it's final state.
So changes in the size of the stoma is to be expected. It is the
reason your should be using "cut to fit" appliances, rather than
"pre-cut".

Check the "blog"..... If there's any other info I can provide,
just ask...

Best wishes,

John

Hi John- Hey, I know you are
Hi John- Hey, I know you are an old pro at this and I know why you say "NO adhesive removers" but I have to shave the area under my appliance each time and without the adh. remover wipes I can't get the hair off. If I don't get all the hair it will itch like crazy. I've been using the wipes for about six weeks now and i've had no issues with things sticking. I also use Convatec products and think they are great. I'm just throwing this out there because before the wipes, it was a real pain in the but to change and clean-up. I usually go three to four days between changes but have gone six days once without issue.
Just my 2cents...
Take care, CJ

mef123

John23 said:

Michele -

Gurgling noises? You mean it isn't talking yet? Well, it's young....

Both colostomy and ileostomy noises are normal. Some are
louder than others, and both can be stifled somewhat by pressing
one's arm on the stoma itself. That will muffle the sound a little.

That stoma isn't what anyone actually ever sees in "real life",
it's usually buried inside, where the noises aren't so prevalent
to ears; The noises are natural, the new location isn't....

By the way.. The stoma is formed by pulling a section of intestine
through to the outside of the body, then it is carefully stitched
at the base. The section sticking out is then turned inside-out
upon itself (like a sock) and the open end stitched again at the
base. So what you're looking at, when you look at the stoma
sticking out, is actually the inside of the intestine!

The inside of the intestine is impervious to the acid, etc, that
dissolves food, while the outside isn't. So it's important that
the outside of the intestine doesn't come into contact with the
waste. Turning it inside-out protects the outside, and insures
that only the inside of the intestine comes into contact with the
waste inside the pouch. Simple, ehh? And that's why we try
to cut that hole in the appliance as snug to the stoma as possible;
it helps keep the waste from the skin around the stoma. That
acid waste will eat our skin as fast as it can dissolve food... UGH.
Think about that!

Normally, the acid in the waste is neutralized in the colon and
the liquid re-absorbed and re-used to keep us hydrated.

With an Ileostomy, the colon isn't part of the equation, so the
output can be painfully acidic.....And.... since we've lost that extra
re-absorption process, we ileostomates are usually always on
the brink of dehydration. It is something that you (and yer old man)
should keep in mind 24/7/365. Once dehydrated, it's very difficult
to get re-hydrated without a trip to the ER for an infusion of
saline solution. Always keep in mind, that if you ingest too much
liquid all at once, the body will purge it; dump it -all- into the pouch,
and that action will cause one to become dehydrated even faster.

The bottom line, is not to become dehydrated to begin with, and
we do that by drinking small amounts more often. 4oz per hour
should be sufficient for most of us...... 16 oz all at once will go right
through, taking food along with it.

There. I have used my share of pixels for this afternoon! I'll
have to see if Greta will waive an extra amount.....

Good health to you and the OM,

John

Thanks again
Thanks again John, you are very helpful and I appreciate it. We are obviously newbies at this.

Michele

John23

son of hal said:

Hi John- Hey, I know you are
Hi John- Hey, I know you are an old pro at this and I know why you say "NO adhesive removers" but I have to shave the area under my appliance each time and without the adh. remover wipes I can't get the hair off. If I don't get all the hair it will itch like crazy. I've been using the wipes for about six weeks now and i've had no issues with things sticking. I also use Convatec products and think they are great. I'm just throwing this out there because before the wipes, it was a real pain in the but to change and clean-up. I usually go three to four days between changes but have gone six days once without issue.
Just my 2cents...
Take care, CJ

CJ -

Three to four days is a real short time, as far as wear-time;
six days or more is better...

From 2006 to 2011, my wafer stayed on for two to three
weeks average. The longer the wafer/appliance stays on, the
happier your skin will be!

Each time you remove the appliance, you take along some
skin with it, so most all of the manufacturers are now trying to
promote longer wear-time. They sell less of their product
when people complain about sore skin issues from using them.

I always tell anyone that's happy with what they're doing,
that if it's working out for them, to keep at it. Why try to
fix what's working to your pleasure?

But..... if you're not happy with only three days of wear time,
and wouldn't mind changing once a week or two, then heeding
the manufacturer's suggestions will do you better.

As far as the hair? ugh... I suppose you could check to see
if there's some way to have it permanently removed...??

I have some hair under the new location, but I rarely bother
with it. It gets ripped out when I take off the appliance and
takes longer to grow back after mass "tweezing".

I guess it's all subjective... what works for one, may not for another.

Good health!!

John