An ileostomy is a surgically created opening, called a stoma, which brings the last part of the small intestine, the ileum, to the surface of the abdomen. This procedure is typically necessary when the large intestine, or colon, is unable to function correctly due to disease or injury, such as Crohn’s disease or ulcerative colitis. Since the colon is bypassed, waste material from the small intestine exits through the stoma and is collected in an external ileostomy bag, also known as a pouching system. Regularly emptying this collection pouch is a routine process important for maintaining comfort, discretion, and the integrity of the skin barrier.
Knowing When and How to Prepare
The most appropriate time to drain the ileostomy pouch is when it is between one-third and one-half full. Allowing the bag to become too full is discouraged because the weight of the effluent can pull on the adhesive seal, which may cause leakage or skin irritation. For most individuals with an ileostomy, this means emptying the pouch between four and ten times per day, depending on individual output volume.
Before beginning the process, it is helpful to gather necessary supplies, which typically include toilet paper, disposable wet wipes, and an optional deodorizer product. It is also recommended to place a few sheets of toilet paper into the toilet bowl water before emptying to help reduce the possibility of splashback. The most common position for emptying the pouch is sitting on the toilet, facing forward.
The Step-by-Step Emptying Procedure
The drainage process begins by carefully preparing the tail, or outlet, of the pouch, which is usually secured with a clip, Velcro closure, or an integrated folding mechanism. Once the closure is unfastened, the tail should be unrolled or unfolded slowly, and then lowered toward the toilet water. Ensure the opening is aimed correctly into the bowl to prevent any spillage or splashing.
The effluent will begin to drain into the toilet. Gentle pressure can be applied to the sides of the pouch, running the fingers down towards the outlet, to help push out any residual contents and ensure complete emptying. This action helps prevent the accumulation of older stool near the outlet, which can contribute to odor.
After the contents have been drained completely, the inside and outside of the pouch outlet must be cleaned thoroughly. This cleaning is best accomplished using toilet paper or a damp disposable wipe to remove any remaining residue from the plastic tail. Ensuring the outlet is meticulously clean is important for maintaining the integrity of the closure and preventing premature wear.
Once the outlet is clean, it must be completely dry before being re-secured, as moisture can interfere with the closure mechanism. The tail is then refolded or re-clipped tightly and securely to prevent leaks and maintain a discreet profile.
Addressing Common Issues After Emptying
Ileostomy output is naturally more liquid because the large intestine, which absorbs water, has been bypassed. If output is consistently high or excessively liquid, which can lead to dehydration, thickening agents or dietary adjustments may be needed. Foods like marshmallows, pretzels, or white rice can help thicken output, but a healthcare provider should be consulted if high output persists beyond 48 hours.
Odor is a common concern during and after the emptying process. To manage this, specialized deodorizing drops or gels can be placed inside the pouch before securing the tail. Using a room spray or a pre-toilet spray helps neutralize airborne odors in the immediate environment, offering a simple way to maintain discretion.
After the pouch is secured, any used cleaning wipes or paper towels should be disposed of in a trash bin. Wipes should not be flushed, as they may cause plumbing issues. Finally, handwashing with soap and water should be performed to maintain hygiene.