What Should You Expect after Ileostomy Closure?
What Is an Ileostomy?
An ileostomy is the ileum, which is the end of the small intestine that comes out of the body via surgery. The ileostomy is outside of the body that has an opening on the abdomen (belly). The bowel on the abdomen is called a stoma. It allows stool (poop) to pass out of the body and into a stoma bag. An ileostomy closure is the procedure to allow stool to be passed from the rectum instead of the pre-existing ileostomy. When the surgeon closes the ileostomy, there will be no stoma or bowel opening at the skin, for stool will now come out from the bottom or at the rectum.
Before the Surgery
- If your child had a health problem where anal dilations were started to prevent narrowing of the anus as it heals, your child must reach the goal size anal dilator.
- The Same Day Surgery nurse will call you 24-48 hours (one to tw days) before to the surgery date to discuss:
- Specific instructions about eating and drinking
- Which hospital location to arrive to
- When to arrive at the hospital
- Talk with the doctor if your child takes any medications. Do not give your child any medicine on the morning of surgery your child’s doctor says to.
- On the day of surgery, the healthcare team and anesthesiologist will make sure your child is ready for surgery.
Your child cannot have anything by mouth until the bowel starts working after surgery by having either a bowel movement or passing gas. Patients often start passing stool through the rectum in 24 to 48 hours (one to two days), but sometimes it takes 72 hours (three days). By the third or fourth day after surgery, patients are usually discharged from the hospital.
The wound in the belly is closed with a suture (stitch) that you may not be able to see. The stitches stay under the skin and go away on their own as the incision heals.
When your child starts passing stool through the rectum, the stool is most often liquid. They may have many liquid stools, until the colon gets used to taking in more water. These loose frequent stools can last for 1 to 3 weeks after surgery.
Since the child's skin in this area has not had contact with stool for some time, the skin is very sensitive. Children who wear diapers could get a bad diaper rash.
After surgery, the surgeon will want the patient to limit physical activity of heaving lifting and organized exercise activities for up to four weeks to allow the area to heal.
Preventing Diaper Rash
- The best way to avoid diaper rash is to keep stool from touching the skin.
- Change the diapers/pull ups as often as you can.
- Do not rub the skin; that can make the diaper rash worse. Baby wipes can be irritating to the skin. Instead, pat the skin with soapy water and a soft cloth until clean and dry.
- Put on diaper cream as directed by your child’s colorectal doctor or nurse.
Encouraging Regular Bowel Movements (stools)
- After one to three weeks, the number of stools will start to decrease.
- Your child’s nurse or dietician will give you nutrition advice to help increase the consistency or form of your child’s stool.
- Your child’s doctor may order a medicine that slows down the number of stools.
Your child’s doctor will talk with you about your child’s outlook for bowel control and potty training. These tips will help to promote regular bowel habits. This will increase your chance for success with potty training.
- Make sure your child has at least one stool per day.
- Try to keep your child’s meals at the same time each day.
- Follow the nutrition advice given by our center.
When to Call Doctor
Call your child’s doctor if you notice any of these:
- Bleeding from your child’s surgery site or within the stool
- No stool in diaper for more than 24 hours (one day)
- Not passing gas
- Any nausea or vomiting
- Fever (temp over 100.4 degrees)
- Infection around the wound site
Call the Colorectal Center at 513-636-3240 if you notice any of these issues or if you have any questions or concerns.