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 but 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.
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 you specific needs with your doctor, surgeon, or enterostomal therapist (ET), a nurse who specializes in the care of stomas. Most likely this person will meet or has met with you before the operation and has or will be instructing you on how to take care of your stoma, ostomy, or pouch.
General Guidelines for Draining the K-Pouch
As mentioned above, please discuss your individual case with your health care providers. 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.
If, at any time, you think pouch drainage has stopped during the course of the day, then check by:
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 doctor or health care providers. 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.
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 or Tube 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
2. Wash your hands with soap and warm water and dry them with a clean towel.
3. Irrigate the catheter
4. Reconnect the catheter
5. Cleanse the skin around the stoma and catheter
Other Helpful Tips About K-Pouch Care
These other tips can help you properly care for your K-pouch:
WebMD Medical Reference
SOURCES:
Reviewed by Arnold Wax, MD on September 19, 2009
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