An opening in the ileum (small intestine) is known as an ileostomy. The opening (stoma) in the abdomen is created by pulling the end of the small intestine through an incision in the abdominal wall. The edges of that end of the intestine are sutured with the abdominal skin to prevent the prolapse or sinking of the stoma. The stoma is a point that allows stool to leave the body, bypassing the entire colon in case of an ileostomy. Normal cleansing of this opening, which is a part of the intestine, shouldn’t pose any risk of infection. However, you may not want to rub it while cleaning, as it can cause bleeding. A normal stoma is red and moist. You may see persistent swelling in the stoma in the first few weeks after ostomy surgery, but that shouldn’t be a cause of concern. The swelling subsides in six weeks after surgery. An ileostomy passes out loose or watery stool. It is due to the absence of the colon, which absorbs water and other digestive enzymes from the stool as it moves towards rectum and anus. Generally, an ileostomy evacuates about 1000 cc (1 liter) of liquid stool per day. This amount can increase during illness or chemotherapy treatment. You may want to notify your doctor if you notice a larger amount of stomal output discharge. A stoma doesn’t have any sphincters, which means that you won’t be able to control when to release stool in response to a bowel movement; it will flow out of the stoma. The only way to manage it is to use an ostomy bag that collects stool. When the bag is full to a certain degree, you will need to empty or replace it. An ostomy bag fits over the stoma. The flange of an ostomy appliance has an opening that allows the stoma to open into the bag. The adhesive side of the flange goes against the peristomal skin, forming a seal that ideally prevents the leakage of the stomal output. Stoma care Stoma care significantly involves caring for the skin around the stoma. The stoma has small veins that circulate blood across the structure the entire time, which means that a stoma can bleed easily. You can use soap to clean the stoma and the skin around it, but make sure that the soap you use doesn’t contain oils and perfumes. Soaps with such composition tend to leave a residue, which can interfere with the ability of the skin barrier to form a seal with the peristomal skin. The stool from an ileostomy has a high content of digestive enzymes, which are more corrosive to the peristomal skin. If stool comes in contact with the skin, it can cause irritation and other complications that are not only painful, but they can also compromise the skin's ability to form a seal with the skin barrier of an ostomy appliance. The best way to prevent this entire situation is to care for the skin around the stoma and make sure that the flange of the ostomy pouch is not allowing allow any leakage.
You may need to change an ostomy appliance every three to five days. During every pouch change, you will need to examine your skin for any complications. You may also benefit from skincare products specifically designed to prevent and treat peristomal skin infections. However, it is recommended to seek guidance from an ostomy care nurse or doctor before picking any skincare product.
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