Patient/caregiver was educated on complications with ileostomy as follows:
Parastomal hernia:
- Often the intestines can bulge outward under the skin, near the stoma.
- This bulge is called a parastomal hernia, which can make attachment of the bag difficult, resulting in leakage, skin irritation, and need for frequent bag change.
- Development of parastomal hernia is quite common and they can be self-limited. Severe cases of parastomal hernia might necessitate a laparoscopic repair.
Increased gas production:
- Individuals on ileostomy must avoid or minimize consumption of foods that are increasingly gas-forming. Increased gas production can result in bloating, diarrhea, and severe abdominal discomfort.
- High fiber foods in general are also increasingly gas-forming. So, these individuals must avoid or minimize consumption of vegetables, such as, beans, artichoke, turnip greens, lentils, green peas, broccoli, brussels sprouts, cabbage, and onions.
- Exercise control on consumption of whole grains, such as brown rice, oatmeal, and whole wheat.
- Avoid or exercise caution with fiber rich fruits, such as, apples, banana, mango, pineapple, and strawberries.
- The golden rule for these individuals regarding any fruit in general is peel the skin off. Foods rich in starch/carbs, such as, potatoes and pasta can also be excessively gas-forming and so, must be limited on consumption.
- Skin peeled potatoes can be a healthier option for these individuals. Left undigested, the milk sugar lactose can also lead to the increased production of gas and contribute to bloating, abdominal pain, and discomfort.
- Individuals on ileostomy must avoid or exercise caution with whole milk and other products of whole milk, such as, cheese and yogurt.
- Picking milk and dairy products that are lactose-free can be a healthier option for individuals on ileostomy.
- Using an air freshener, especially when emptying or burping the bag in a public toilet, can help avoid/minimize this uncomfortable situation to oneself, caregivers, and others in the restroom.
- Using a mask or menthol vapor rub on the nose can be of additional help.
- Placing some deodorizing drops into the bag every time you empty the bag or into a fresh bag at the time of bag change can help reduce impact of the odorous states.
- This can help promote personal comfort and avoid embarrassing situations while in group. +
- Having an Osto-ez-vent device attached to the bag also helps easy burping.
Necrosis:
- Occasionally blood supply to the bowel at the site of stoma can get compromised, resulting in tissue infection, tissue death and necrosis.
- The tissue infection can spill into the blood stream and spread to distant sites, resulting in sepsis and shock.
- Individuals in sepsis and shock can present with low blood pressure, reduced urine output, fatigue, and confusion.
- Individuals with necrosis of bowel can present with symptoms, such as, fever, nausea, vomiting, severe abdominal pain, distension, black discoloration of the involved bowel segment, and bleeding at the stoma site.
- Severe cases of necrosis might necessitate an emergency excision of involved bowel segment and a revision surgery for ileostomy.
- Report any of these above findings to your physician at the earliest notice for further investigation and employing appropriate relief measures.
