Caring for a Continent Ileostomy or K-Pouch
General Guidelines for Draining the K-Pouch continued...
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
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.