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Caring for a Continent Ileostomy or K-Pouch

What Is a Continent Ileostomy?

The continent ileostomy, or K-pouch, is a connection of the end of the small intestine, called the ileum, to the skin of your abdomen. It allows waste to be drained. Unlike other ileostomies, the K-pouch or Kock ileostomy, has a valve made by sewing the intestine in a special way so that waste material doesn't leak out; rather, a tube called a catheter is inserted when it's time to empty the pouch.

As the pouch fills with intestinal contents (liquids, partly digested food, etc.), pressure builds up on the pouch and its many stitches. If this is not relieved, the pouch could perforate or tear from the excessive stretching or the valve could slip or leak.

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Who is at Risk?

For the great majority of people, the major factor that increases a person's risk for colorectal cancer (CRC) is increasing age. Risk increases dramatically after age 50 years; 90% of all CRCs are diagnosed after this age. The history of CRC in a first-degree relative, especially if before the age of 55 years, roughly doubles the risk. Other risk factors are weaker than age and family history. People with inflammatory bowel disease have a much higher risk of CRC. A small percentage (<5%) of CRCs...

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How Often Do I Drain the K-Pouch or Continent Ileostomy?

The best way to prevent problems is to drain your K-pouch as instructed by your doctor. How often to drain the pouch varies from person to person, but there are some general guidelines. Right after the operation, you will have what doctors call an indwelling catheter, meaning that the drainage tube will be left in the pouch to drain continuously. This will last for about three to four weeks to allow the pouch to mature. After the catheter is removed you will drain the pouch several times per day. The number of times you need to drain the pouch each day becomes less over time.

Please discuss your specific needs with your doctor, surgeon, or enterostomal therapist (ET), a nurse who specializes in the care of stomas. Most likely, this person has met with you before the operation and has instructed you on how to take care of your stoma, ostomy, or pouch.

General Guidelines for Draining the K-Pouch

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 several times a day with 1 ounce of tap water and let it drain off. (See "Instructions for Catheter Care" below for a step-by-step guide to skin and catheter care.)

If, at any time, you think pouch drainage has stopped during the course of the day, then check by:

  • 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 about an inch

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