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Ileostomy Complications

During an ileostomy, a surgical team reroutes waste from the lowest part of the small intestine, away from the colon and rectum, and toward a hole cut into the stomach wall so the waste gets collected in a drainable and removable pouch. The procedure can be necessary for patients suffering from severe ulcerative colitis, cancer, Crohn's disease or an unclearable intestinal obstruction. Patients who undergo an ileostomy can experience complications ranging from malnutrition to a condition known as phantom rectum.

  1. Skin Irritation

    • The ileostomy pouch rests directly against the skin, and most patients also wear a tight, elastic belt to support the pouch. Chafing, chapping and other forms of skin irritation are unavoidable for most patients. The American Cancer Society advises patients to moisturize the affected areas at the first sign of problems and to seek medical attention for any serious skin problems such as ulceration.

    Poor Nutrition

    • Food does not travel completely through the digestive tract after an ileostomy. Because a good deal of digestion takes place in the small intestine, patients may not extract all the nutritional value of the foods they eat. The same may be true for solid medication dosage forms such as capsules and tablets. Patients may need to follow a special diet, take nutritional supplements or change the kinds of medications they take.

    Diarrhea and Dehydration

    • Patients with an ileostomy can experience diarrhea more frequently than others, and this puts them at risk for dehydration and electrolyte imbalances. To reduce the risk for diarrhea, the American Cancer Society recommends limiting intakes of raw fruits, milk and fruit juices. Emotional stress can also trigger watery stools.

    Obstruction

    • Waste does not flow into the ileostomy pouch continuously, but no discharge for four hours can signal a problem. Foods such as nuts and pineapple can physically block waste, and abdominal cramps or internal scars can clamp down on the outflow tube. Taking a warm bath can relieve cramping, but a prolonged obstruction requires medical attention.

    Phantom Rectum

    • When a patient's rectum has been removed as part of an ileostomy procedure, he can continue to feel that the rectum is still there. The patient will experience the tightness and mild pain that signals it is "time to go" even though no signals could be sent. According to the United Kingdom's National Health Service, this phantom rectum syndrome can persist for years, and some patients find that sitting on the toilet relieves the cognitive dissonance.

    Short Bowel Syndrome

    • Patients with short bowel syndrome have lost the ability to fully digest most foods, usually because they have had a significant portion of their small intestines removed. Short bowel syndrome does not constitute merely a more-advanced form of the poor nutrition that many ileostomy patients can experience. Patients with short bowel syndrome can have severe, recurrent diarrhea, painful cramping, heartburn, weakness, fatigue and gaseous bloating. A special diet controls mild short bowel syndrome, but the most serious cases require patients to be fed parenterally (i.e., intravenously).

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