Diseases

Caring for a Continent Ileostomy Information

General Guidelines for Draining the K-Pouch

As mentioned above, please discuss your individual case with your health care providers. The following are general guidelines for draining the K-pouch. Constant drainage is recommended for the first three to four weeks for a new pouch. If the catheter or tube accidentally falls out before that time, you can easily put it back with these simple steps.

• Relax your abdominal muscles. It may be helpful to bend your knee as you relax your muscles.
• Relubricate the catheter with water-soluble lubricant (such as K-Y Jelly, Surgical Lubricant, or Surgilube; DO NOT use Vaseline or products containing petroleum jelly).
• Reinsert the catheter up to the preset mark. If you have difficulty with this, relax, change positions and try again.
• During this initial period, you will need to irrigate the catheter serveral times a day with 1 ounce of tap water and let it drain off. (See below "Instructions for Catheter Care" for a step-by-step guide to skin and catheter care.)

• Irrigating the catheter
• Pinching the catheter between your finger and thumb and check if a fluid or air column can be seen moving up and down
• Checking for fluid return
• "Wiggling" the catheter in and out for about an inch

• Drain the pouch every two hours during the day while you are awake.
• Drain at bedtime and first thing in the morning.
• Do not drink or eat within two hours of bedtime.
• During the night, you will usually set the catheter to constant drainage. You may also choose to set your alarm clock to wake you to empty the pouch.

How Do I Care for the Continuous Draining Catheter or Tube and my Skin

Good skin and catheter care need to be continued after you go home from the hospital. It is important to keep the skin around the catheter clean and protected, as well as make sure the catheter is open and draining. The following guidelines will help you properly care for your catheter. 1. Gather the following supplies

• Washcloths or paper towels
• Non-oily soap (Ivory and Dial are recommended brands)
• Plastic bag or newspaper
• Dressing
• Irrigation supplies: tap water, bulb syringe, and basin

• Remove the dressing over the stoma and discard it.
• Separate the catheter from the drainage bag and drain the contents of the catheter into the basin.
• Collect 30 cc (1 ounce) of tap water into the bulb syringe. Tip: Highlight the 30 cc mark on the bulb syringe with permanent marker or nail polish for accurate, easy measurement.
• Insert the 30 cc of tap water into the catheter by slowly squeezing the bulb syringe to release the water.
• While holding the syringe bulb down with your thumb, pinch the catheter and separate the bulb syringe from the catheter.
• Unpinch the catheter and drain its contents into the basin. Do not withdraw the fluid from the catheter into the syringe.
• If the fluid you just put in seems to be taking a long time to come back out, or if mucus blocks the catheter, repeat the previous irrigation steps as needed until stool flows freely through the catheter. If water doesn't go in or come back out, the tube may be blocked. You may have to remove the catheter from the stoma and rinse it with cool tap water to clean any mucus built up inside the catheter. Then reinsert the catheter. Do not put in more than 60cc (or 2 ounces) of water without the pouch contents emptying.
• When the stool flow has stopped, continue to step four.

• Wash the skin around the stoma and catheter with non-oily soap and warm water.
• Rinse the skin thoroughly with warm water.
• Pat the skin dry with a soft towel or paper towel.
• Apply two layers of "split" dry gauze dressing around the catheter and over the stoma. Secure with tape as needed.
• Discard the waste.
• Wash the basin and the bulb syringe with soap and warm water. Let the supplies air dry, or dry with a clean towel.
• Wash, rinse, and dry your hands.

Other Helpful Tips About K-Pouch Care

These other tips can help you properly care for your K-pouch:

• Inspect the catheter frequently to be sure drainage is flowing freely through the tube.
• Irrigate the catheter twice a day, or as instructed by your ET nurse or doctor. Irrigate with 1 ounce of tap water, and let it drain off.
• As a general rule, most patients will have continuous drainage into a drainage bag until their first follow-up appointment after surgery. During this time, you should not experience: Pressure beneath the pouch; Absence of stool draining from the catheter; Stool leaking around the catheter.
• If any of these signs or symptoms occur: Check the catheter for kinks; Irrigate the catheter; Pinch the catheter between your finger and thumb and check if a fluid or air column can be seen moving up and down. If the above steps do not work to relieve symptoms, remove the catheter, clean it, and replace it. Call your doctor if problems continue.
• Inspect the stoma daily. It should look shiny, moist, and red. Report any changes to your doctor.
• If stool becomes too thick and movement through the catheter appears slow or difficult, increase your fluid intake to 10-12 eight-ounce glasses of fluid daily. Include water, juice, and other non-caffeinated beverages.
• Never take laxative preparations, as they can cause diarrhea and lead to dehydration.