How to Treat an Ileostomy Blockage

Many people with ileostomies have experienced food blockages. This is when the stool is blocked from moving through your digestive tract by a food bolus – like a cat getting a fur ball – and the stool can’t evacuate. When this happens, most people experience cramping and notice that they have little or watery output in recent hours. If this goes unresolved, the individual may begin to experience abdominal distention, pain, and stomal swelling. If the blockage is still unresolved, the individual may begin having nausea and vomiting fecal material. At this point, hopefully the individual is on their way to the emergency department.

Treating an Ileastomy Blockage at Home

Food blockages can be treated at home in the early stages with a variety and combination of techniques. When applying a new ostomy system, make sure the opening is cut larger than your usual stoma size. This is to accommodate any stomal swelling you might experience with the passage of the bolus.

Once your new appliance with a larger-than-normal opening is applied, try the following techniques to dislodge the bolus.

1. Drink hot tea.
2. Gently massage your belly, particularly around the stoma (most blockages occur close to the stoma).
3. Lie in bed and bring your knees to your chest, either one at a time or both together, and rock side to side. Repeat several times.
4. Take a warm bath or shower to help relax your abdominal muscles.
5. If you can feel the bolus near the stoma, you can try to squeeze it out by gently pushing on both sides of your stoma.

Don’t eat any solid food, and don’t take laxatives or stool softeners, which can cause your body to lose more water. If you’re unable to dislodge the bolus at home, it’s time to call your healthcare provider or go directly to the hospital. You should always call your healthcare provider or head to the emergency room if you start to vomit, or if you have increased pain and cramping with no stoma output for two hours or more.

Treating an Ileastomy Blockage in the Hospital

Food blockages are treated differently in the hospital than they are at home. In the hospital, a naso-gastric tube is put through your nose and into your stomach to suction out any fecal material and bile. You will be put on IV fluids and not permitted to eat anything by mouth. Then a nurse or physician will do an ostomy lavage, which entails gently inserting 10-20 mL of warm saline repeatedly into your stoma using a soft rubber catheter until the blockage is released. If this is unsuccessful, other diagnostic tests will be done and possibly surgery. It is not recommended to try this procedure at home without guidance from your physician or nurse.

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Sources:

Carmel, J.E. (2016). Specific patient management issues. In Wound, Ostomy and Continence Nurses Society Core Curriculum: Ostomy Management (p. 144). Philadelphia; Wolter Kluwer.