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Nov 02, 2021

Considering Reconnecting - Seeking Advice on Ileostomy vs. Colostomy

This topic is about deciding whether to stick with a current colostomy or switch to a temporary ileostomy after bowel reconnection surgery. The person is feeling anxious about changing from a colostomy, which they are used to, to an ileostomy. They have a medical history that includes inflammatory bowel disease, colitis, and other digestive issues. They are also concerned about the cost and practicality of managing a new type of stoma. Here are some points to consider:

1. Clarify the surgical plan:
- Ask the surgeon if the procedure will involve a loop ileostomy or an end ileostomy, how long it will be in place, the criteria for reversal, and the detailed steps involved.
- Consider getting second or third opinions from other surgeons before making a decision.

2. Diet tips for loop ileostomies:
- Start with plain, soft foods like mashed potatoes, finely minced meats, boil-in-the-bag fish, cuppa soups, cheese toasties, and plain chicken.
- Avoid hard or fibrous vegetables, tomato and pepper skins, onions, and tough red meat until fully healed. Chew food thoroughly.

3. Hydration guidance:
- It's important to drink more fluids with an ileostomy to prevent dehydration, which can lead to obstructions.
- If making homemade electrolyte drinks, limit or omit added sugar to avoid raising liver enzymes, weight gain, and fatigue. Salty water with normal dietary sugars might be enough.

4. Living successfully with a loop ileostomy is possible:
- A loop stoma can be small, low-profile, and leak-free if it protrudes adequately.
- It's realistic to expect an appliance wear time of 5–6 days.
- Some people can eat all foods, including hot sauces, once healed and with proper chewing.

5. Staying with a colostomy is a valid option:
- This choice avoids the risk of previous bowel issues returning and maintains the ability to irrigate, which can reduce the need for pouches.

6. Practical tip:
- If spicy foods like jalapeños cause problems, consider eliminating or significantly reducing them from your diet.
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