You had an injury or disease in your digestive system and needed an operation called an ileostomy. The operation changed 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 the stoma and empty the pouch many times a day.
Change your pouch every 5 to 8 days. If you have itching or leakage, change it right away.
If you have a pouch system made of 2 pieces (a pouch and a wafer) you can use 2 different pouches during the week. Wash and rinse the pouch not being used, and let it dry well.
Choose a time of day when there is less stool output from your stoma. Early in the morning before you eat or drink anything (or at least 1 hour after a meal) is best.
You may need to change your pouch more often if:
Wash your hands well and have all equipment available. Put on a clean pair of medical gloves.
Gently remove the pouch. Push the skin away from the seal. Do not pull the ostomy away from your skin.
Wash your stoma and the skin around it carefully with soapy water.
Look carefully at your stoma and the skin around it for any changes. Allow your stoma to dry completely before connecting the new pouch.
Trace the shape of your stoma onto the back of the new pouch and barrier or wafer (wafers are part of a 2-piece pouch system).
Trace this shape onto the back of your new pouch or wafer. Then cut the wafer to the shape.
Use skin barrier powder or paste around the stoma, if your doctor or nurse has recommended this.
Remove the backing from the pouch. Make sure the opening of the new pouch is centered over the stoma and pressed firmly onto your skin.
Fold the bag and secure it.
See also: Ileostomy - caring for your stoma
Call your doctor or nurse if:
Standard ileostomy - pouch change; Brooke ileostomy - pouch change; Continent ileostomy - changing; Abdominal pouch changing; End ileostomy - pouch change; Ostomy - pouch change
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.
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