An ileostomy is a surgically created opening in the small bowel (also called the small intestine).

The purpose of an ileostomy is to allow stool to drain after the removal of the colon or to divert stool following a restorative surgical procedure.

An ileostomy may be permanent or temporary.

Your ileostomy is NOT sterile! Prepare your new pouch before removing the old one. Wipe off stool (faeces) with toilet paper. You can bath/shower with your pouch (bag) ON or OFF - water cannot get inside the stoma. Use ordinary soap. There is no guarantee that the ileostomy will not function during this period. Ideally, time this activity before eating and drinking. Keep some toilet paper handy to place over the stoma while you dry your body.

You may notice a little blood on touching the stoma whilst cleaning - this is NORMAL

Avoid using cream, powder or bath oil as they may interfere with the adhesion of the pouch.

MEN - shave or trim the hair around the stoma. Hold toilet paper over the ileostomy whilst shaving to protect it. Ensure all soap is washed off the skin.

Be sure to place your SKIN PROTECTION wafer or washer CLOSE to the stoma to avoid getting sore skin from stool contact. Gentian violet may be used if skin has become inflamed or itchy.

When emptying your pouch on the toilet, you may sit "side saddle," right back or "back to front" on the seat with your legs apart. Place some toilet paper in the bowl to lessen the splash.

Only drainable pouches (one or two piece) are used for an ileostomy as the stool is fairly soft and the pouch requires emptying several times a day. It is not necessary to wash out the pouches, but if you wish to do so, do not use too much water near the top of the pouch as you may loosen the adhesive causing leakage and odour.

Do not attempt to flush pouches down the toilet - they will cause a blockage. Insert warm water in the pouch prior to emptying it in the toilet, wrap in paper, tie in a plastic bag and discard in your dustbin.

MATCHES make a cheap deodorant. Strike a match before and after releasing gas (flatus) or stool. HOWEVER, DO NOT USE MATCHES IN AIRCRAFT TOILETS!! Some pouches have filters incorporated in them to prevent build up of gas.

Plastic sticks to itself and stool may not be able to drop into the pouch if you have not first passed flatus. Always leave a little air in your pouch when you apply it or after emptying so that stool does not "pancake" around the ileostomy causing possible leakage and odour.

Ileostomates can eat a normal diet and must chew well. Certain foods may cause blockages and should be eaten in moderation or avoided. Remember that Indians and Malays eat spicy foods and many are vegetarians. South Africa's "rainbow" people eat what is culturally normal for them. Your stomaltherapist will advise you accordingly.

The last piece of the small intestine - the terminal ileum - undergoes a change over a period of time taking over some of the functioning of the colon (large bowel) that has been removed. Food that may have not been well tolerated or absorbed in the early post-operative period, should be tried again. You may find you have no problem!

Should you get an upset stomach, keep up your fluids and avoid spicy foods and milk products. Banana, grated apple, toast, cream crackers, mashed potato, pasta, rice may be helpful in thickening the stool. Ileostomates lose potassium and sodium with diarrhoea and may drop their blood sugar levels. Bananas are rich in potassium and sodium is obtained in Marmite, Bovril or Oxo. Glucose sweets or sweetened black tea will raise blood sugar levels and stop the shakes! Imodium, Lomotil, Kaolin or Kantrexil can be taken. If the condition does not settle within 24 - 48 hours, contact your doctor. If your BABY has an ileostomy and gets diarrheoa/vomiting, contact your doctor as soon as possible as babies dehydrate quickly.

People with LOOP ILEOSTOMIES who have diarrheoa/vomiting, must contact their doctor, pharmacist or stomaltherapists as soon as possible because of dehydration.

TRAVELLING - your stomaltherapist will give you a TRAVELLING OSTOMY CARD noting your surgical/medical history and product used. Body searches are routine at many airports and the ostomy card requests that a doctor be present should security staff feel your pouch and wish to search you further. Choose an aisle seat on the plane. Aircraft toilets work on a vacuum system. Line them with toilet paper before emptying your pouch. Carry your ostomy supplies and anti-diarrheoa medication in your HAND LUGGAGE as your suitcase in the hold may go astray. Always take more pouches than you normally use to ensure you do not run out!!

FREE INFORMATION BOOKLETS ARE OBTAINABLE. Don't be afraid to ask your stomaltherapist questions! You are a special individual and answers pertaining to your return to work, sport and sexuality will be tailor-made to suit you and your situation.