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This surgery will close your ileostomy and takes about 2 hours. Stool will now travel through the bowel and exit through the anus.
A few days before, you need to buy 1 bottle of magnesium citrate (10 oz). It tastes best when chilled.
The Day Before Surgery
Eat a light breakfast and you may eat lunch if you know your system will clear over the next 6 hours by drinking more fluids.
Drink only clear liquids (no sediment or pulp) after breakfast/lunch until 4 hours before your surgery starts. Clear liquids include:
Juice without pulp (apple, grape)
Sparkling water or soda
Coffee or tea, no creamer
Clear Jell-O (no fruit, etc. in it)
At 6 pm (It is okay to do this earlier)
______ If you are passing fluid with sediment/particles into your pouching system, then drink 1/2 bottle of magnesium citrate (5 oz).
______ If you are passing clear fluid (no sediment or particles) into your pouching system, you do not need magnesium citrate.
Your wound at the ileostomy site will not be stitched shut. There will be a small opening the size of a quarter to a half dollar that will be pink and moist. It may be swollen, pink, sore, numb, and bruised with clear pink drainage.
You may have more drainage than from your other incisions. This is normal. In the hospital, the wound will be packed with gauze for a few days. Then, the dressing will be laid over the wound without packing, so the wound can become smaller, form a scab and heal.
When it is okay to shower, gently wash the wound with a mild soap and water, pat dry.
Do not soak in a bathtub, hot tub, or swim until it is healed.
Do not put lotion, powder, or ointments on the wound.
Watch for signs of infection:
Increased redness or warmth
Excess swelling or bleeding
Fever above 100.4F for two readings (taken by mouth) taken 4 hours apart
Expect to have pain after surgery. In the hospital, we may give you Tylenol and ibuprofen on a regular basis. We will order narcotic medicine to treat severe pain.
We will talk to you about pain medicines before you go home. We will order a small amount of pain medicine for you at discharge. We will also talk about other ways to manage your pain.
Your diet will advance from clear to full liquids then to a soft diet. Expect to go home on a low- residue, low-fiber diet.
Eat 3 meals a day. Try not to eat between meals. This can help regulate bowel movements.
Eating an early evening meal produces more bowel movements at night. Many people choose to eat a larger midday meal and a smaller early evening meal to decrease bowel movements at night.
At your 2-week follow-up visit, expect the fiber in your diet to be increased. This will help to decrease the number of stools each day. We may ask you to try a bulk fiber such as Benefiber, or Metamucil. We may ask you to try Imodium or Lomotil to help slow stools. This can make travel easier.
You may need to keep track of foods that increase your stools or cause loose stools. The process is different for each person. It can take months to more than a year to get back to normal.
If you had a bowel resection when your ileostomy was placed, you may have more bowel movements after this surgery. They may be loose at first, this is normal. As your body heals and you have more fiber in your diet, you will have fewer and more formed stools.
At first, avoid acidic foods like orange juice, lemonade, tomato products and foods with vinegar. These can cause rectal skin problems.
If you are having loose, frequent bowel movements then you will need to protect the skin around your anus. Keep this area clean and dry. Use water to cleanse and gently dab dry. Use a protective skin ointment such as Boudreaux’s Butt Paste®, Desitin, Proshield Plus®, A&D ointment®, zinc oxide, or Calmoseptine® on the rectal skin area after each stool to prevent skin problems.
Two Things to Watch for After an Ileostomy Takedown
Dehydration is a concern when you have frequent loose stools. Be sure to drink extra water and fluids (14-15 8 oz. glasses) until your stool output decreases. Sip on fluids. Do not drink too much too fast, this causes them to move through your system even faster. Symptoms of dehydration are:
Dry mouth and skin
Weight loss of more than 3 pounds overnight
Feeling dizzy when you stand or sit up
Bowel obstruction can be caused by food, bands of scar tissue, a hernia, and a twisted or kinked bowel. This can occur even if you are passing liquid stool or mucus. Symptoms of obstruction are:
Tender and bloated stomach
Nausea or vomiting
Fever of 100.4 F or higher, reading taken by mouth
Unable to pass gas or stool
Do not drive if you are taking narcotic pain pills.
Do not lift more than 10 pounds for the first 2 weeks. Then, do not lift more than 20 pounds for the next 4 weeks.
Limit activity to walking until okayed by your doctor.
Check with your doctor before going back to work.
Sex may be resumed when you feel ready.
Avoid all tobacco and second-hand smoke.
When to Call
• Nausea or vomiting
• Rectal skin problems
• Bowel movement problems
• Pain not controlled by pain pills
• Signs of infection
Who to Call
Digestive Health Center: (608) 242-2800
Monday – Friday, 8 am – 5 pm
Tool free (855) 342-9900
After hours, weekends or holidays this number will be answered by the paging operator. Ask for the doctor on call. Leave your name and phone number with area code. The doctor will call you back.