Caring for a Continent Ileostomy or K-Pouch
General Guidelines for Draining the K-Pouch continued...
If you still think pouch drainage has stopped, remove the catheter in case food particles or debris have blocked it. Flush the catheter with cool tap water then reinsert it.
After the first three to four weeks, you can stop the continuous draining and start draining several times per day or as instructed by your health care provider. Though you usually make this change after seeing your doctor for the first time after the operation, sometimes your doctor will tell you to start doing the following earlier:
- 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.
Over the next several weeks, the time interval between pouch drainages will increase. At night, you may be able to stop the constant drainage and go for longer periods without waking to drain the pouch.
Three months after surgery, there are usually no specific restrictions. Sound practice is to empty the pouch four to six times per day and use irrigation on two of these times. However, any time you feel full, bloated, or distended, drain the pouch. Just as you would empty your bladder before engaging in physical activity or going to bed, so should you empty the continent ileostomy.
How Do I Care for the Continuous Draining Catheter 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
- Irrigation supplies: tap water, bulb syringe, and basin
2. Wash your hands with soap and warm water and dry them with a clean towel.
3. Irrigate the catheter.
- 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.
4. Reconnect the catheter.
5. Cleanse the skin around the stoma and catheter.
- 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.