What Is an Ileostomy?

An ileostomy is a surgical opening in the ileum (last part of the small intestine) that diverts waste into an external pouch. It’s created when the colon is removed or bypassed due to Crohn’s disease, ulcerative colitis, familial adenomatous polyposis (FAP), or trauma.

Unlike a colostomy, an ileostomy produces liquid, enzyme-rich output because the colon — which absorbs water — is not involved. This requires different diet, hydration, and pouching strategies.

According to the Crohn’s & Colitis Foundation, over 100,000 Americans live with an ileostomy. Most adapt within 6–12 weeks.

Source: Cleveland Clinic

Types of Ileostomy: Location & Output

There are two main types of ileostomy:

  • End Ileostomy: May be temporary or permanent. Ileum is brought through the abdomen as a single stoma.
  • Loop Ileostomy: Usually temporary, although reversal is not always possible. A loop of ileum is pulled out, creating two openings (one active, one mucus fistula).
End vs loop ileostomy diagram

Output varies and can change after surgery. A large or watery output above your usual pattern needs advice because of the risk of dehydration.

Ileostomy Diet: Foods to Eat & Avoid in 2025

After 6–8 weeks, most foods are allowed with an ileostomy. The goal is to thicken output, prevent dehydration, and avoid blockage.

Key Rules:

  • Follow the fluid plan agreed with your team. If output rises substantially, seek advice; simply drinking more plain water can worsen losses.
  • Ask your team whether you need additional salt, taking your losses and medical conditions into account.
  • Chew well to prevent food bolus obstruction
  • Fluid type, amount and timing need an individual plan; there is no universal schedule.
GoalEatLimit
Thicken OutputMarshmallows, peanut butter, pasta, bananas, riceFruit juice, beer, caffeine
Prevent BlockageCooked veggies, peeled fruitsCelery, corn, mushrooms, nuts
Replace fluids and salts with high outputOral rehydration solution recommended by your teamSports drinks as a substitute for the prescribed solution

Source: Crohn’s & Colitis Foundation

High-Output Ileostomy Management

Large or watery output can cause substantial losses of water and salt. Contact your stoma team promptly to assess the cause and treatment.

Your team should specify the type and amount of drinks and an appropriate oral rehydration solution. Sports drinks do not replace a solution prescribed for high output.

Medicines and dietary measures need individual advice. Do not start or increase anti-diarrhoeal medicines on your own.

Seek urgent medical advice for marked dizziness, much less urine, vomiting, severe abdominal pain or worsening symptoms. Do not wait for dehydration to persist.

Source: Cambridge University Hospitals

Daily Pouch Care & Skin Protection

Ileostomy output is caustic — protect skin:

  • Change pouch every 3–5 days
  • Use convex barriers for flush/retracted stomas
  • Empty when 1/3 full
  • Apply crusting for denuded skin
Ileostomy pouch system with convex barrier

Clothing & Concealing Your Ileostomy

Wear anything! SIIL Ostomy underwear hides liquid movement and supports the pouch.

SIIL Ostomy high-waisted underwear for ileostomy

Sports, Work & Exercise

Resume after 8 weeks. Use hernia belt for lifting. Swimming is safe with waterproof tape.

Travel Tips with an Ileostomy

  • Pack 3x supplies
  • Bring ORS packets
  • Use seatbelt pad

Intimacy & Relationships

Resume at 4–6 weeks. Empty pouch. Use mini pouches or covers.

Complications & When to Call Your Doctor

Call if: No output >6 hrs, severe cramps, dehydration signs.

Frequently Asked Questions

Can I eat normally with an ileostomy?

Yes — after 6–8 weeks. Focus on thickeners and hydration.

How do I manage high-output ileostomy?

Contact your stoma team if output rises substantially. You need an individual plan for fluids, oral rehydration and, if appropriate, medication. Do not adjust medicines or restrict fluids on your own.

Can I wear regular clothes with an ileostomy?

Yes — SIIL Ostomy underwear hides and supports.