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Instructions After Your Ileostomy Closure

This resource will help you care for yourself after your ileostomy closure.

What to Expect After Ileostomy Your Closure

For the first few weeks after your surgery, you may have a lot of irregular bowel movements. This is because the lower part of your colon (large intestine) has not been used in a while. It will take time for your body to recover.

To help you heal, you may need to take pain medication. Pain medication may cause constipation, so you may also need to take stool softeners to help your stool (feces) move through your colon. One example of a stool softener is docusate sodium (Colace®). Take all medications as instructed by your doctor or nurse.

You will also have an open wound where your ileostomy used to be. Before you are discharged, you will get supplies and instructions on how to care for it. If needed, a visiting nurse can come to your home to help you care for your wound. Your wound should close in 4 to 6 weeks.

What to do during the first 4 weeks after your surgery

  • Try to maintain your weight. Eat 5 to 6 small meals throughout the day. Remember to eat slowly and chew your food well.
  • Do not do any heavy lifting, pushing, or pulling. Also, do not do any abdominal exercises. This will help prevent a hernia. A hernia is when a part of your bowel bulges through a weak area of your abdominal muscle.
  • Clean your anal area with warm water only. Soap or wipes can make your skin more irritated. If your skin breaks from a lot of wiping, apply a cream to your anus as needed. Examples of creams are Balmex® and Desitin®. You can also try taking warm water sitz baths twice a day.
  • You may need to take a probiotic supplement. Probiotics are very small organisms, such as bacteria and yeast, that naturally live in your digestive tract. Taking these supplements may help improve your bowel function. Ask your doctor or nurse for recommendations.

What to do 5 weeks after your surgery

  • If you were on a low fiber diet, you can now slowly start adding foods with fiber back into your diet. You may need to follow a blander diet temporarily if you are having multiple bowel movements a day. On a bland diet, avoid:
    • Dairy products, including milk, cheese, and ice cream
    • Spicy foods
    • Fried foods
    • Gravies and cream sauces
    • High fat deli meats
    • Sausage and bacon
    • Fruit juices
    • Sugar-free foods

Speak with your doctor or nurse if you have any questions. 

  • Make sure to chew all your food thoroughly.
  • Take ½ to 1 tablespoon of a fiber supplement a day. You can take more of it as needed. Examples of fiber supplements are Metamucil® and Citrucel®. If you are experiencing bloating and gas, take simethicone (GasX®) as needed.
  • Drink at least 6 to 8 glasses of water each day.

Changes to Your Rectum

Your rectum is a storage tank for stool. You had surgery to remove part of it, so now this tank is smaller. This means that it cannot hold as much stool.

If you had radiation therapy, your rectum may have also become stiff. It will not be able to stretch and hold stool as well as before your surgery. This is usually temporary.

After your ileostomy closure, you may have “clustering” right after the surgery. Clustering is when you have a lot of small bowel movements because your rectum cannot hold a lot of stool. Over time, your rectum will stretch and increase the amount of stool it can hold. This process can take several months to years.

Changes to Your Bowel Function

It is very important that you take fiber supplements for your bowel function. Fiber is a bulking agent and laxative. This means that it stops constipation (not being able to have a bowel movement) by soaking up water out of the stool. This will combine all the small pieces of stool together to create a larger bowel movement. These larger stools will also stretch out your rectum and you will be able to hold more stool. Your rectum squeezes better when it is full. You will eventually have fewer and larger bowel movements.

You may need to change your diet after your surgery. Certain foods can cause diarrhea (watery, loose bowel movements). Every person is different, so there is no way to know which foods will make this happen. During the first few months after your surgery, it may be helpful to keep a food diary. This will help identify which foods may have caused the diarrhea.

There are many ways to control and change your bowel function. Your nurse or doctor can help you do this. If you need help or have any questions or concerns, please call your doctor's office.

Follow-up Care

Make an appointment to see your doctor 2 weeks after your ileostomy closure surgery. At this visit, your doctor and nurse will check to see how you are doing. Your nurse will tell you how to improve your bowel function based on your symptoms.

 

Call Your Doctor or Nurse If You Have:

  • Diarrhea more than 8 times a day. If this happens, stop taking any stool softeners until you have talked to your doctor or nurse.
  • Stomach cramps, nausea, and vomiting
  • Redness, swelling, or fluid coming out of your wound
  • A temperature of 101° F (38° C) or higher
  • Problems with your bowel function in between appointments
  • Any questions or concerns