Most people live full, active lives with a temporary ileostomy. The two most important habits are drinking enough fluids to prevent dehydration and chewing food well to avoid blockage. A temporary ileostomy is often reversed about 6 weeks to 3 months after surgery, and sometimes later if you need chemotherapy, radiation, or medicines for inflammatory bowel disease.

A temporary ileostomy is often created to protect a new connection in the bowel while it heals, for example after rectal cancer surgery or some surgeries for ulcerative colitis or diverticulitis. This guide covers what daily life looks like until your reversal.

What is a temporary ileostomy?

A temporary ileostomy is an opening on the belly where the end of the small intestine is brought through the skin. Stool leaves the body through this opening, called a stoma, and collects in a pouch.

It is "temporary" because it is meant to be closed later in a second, smaller operation. While it is in place, stool skips the lower bowel so the healing area can rest. You can learn more about both stages on the ostomy surgery and reversal page.

Why is dehydration the biggest risk with an ileostomy?

Dehydration is the most common reason people return to the hospital after a new ileostomy. The large intestine normally absorbs much of the water from stool, and an ileostomy bypasses it.

That means output from an ileostomy is looser and contains more water and salt than a normal bowel movement. If you lose more fluid than you take in, you can become dehydrated quickly.

Signs of dehydration include:

• Increased thirst or a dry mouth
• Making less urine, or dark yellow urine
• Feeling dizzy or light-headed, especially when standing
• Feeling unusually tired or weak
• Muscle cramps

Tips to stay hydrated:

• Sip fluids steadily through the day instead of drinking large amounts at once.
• Include drinks with salt and sugar, not only plain water. Plain water alone can pass through quickly.
• An oral rehydration drink may be recommended if your output is high.
• Limit alcohol and very sugary drinks, which can increase output.
• Check your urine color. Pale yellow usually means you are drinking enough.

Some medicines, such as water pills (diuretics), can raise the risk of dehydration with an ileostomy. Do not stop any medicine on your own. Ask your surgeon and primary care doctor to review your medication list.

What can I eat with a temporary ileostomy?

Most people can eat a fairly normal diet with an ileostomy. The key is to chew well, add foods back slowly, and pay attention to how your body responds.

In the first few weeks after surgery, a lower-fiber (or low residue) diet is often recommended while the bowel settles, then foods are added back gradually.

Foods that may help thicken output:

• Bananas
• Applesauce
• White rice, pasta, and bread
• Oatmeal
• Smooth peanut butter
• Potatoes without skins
• Large Marshmallows (watch out for sugar content!)

Foods that can make output more watery:

• Fruit juice and prune juice
• Sugary drinks and sweets
• Spicy or greasy foods
• Alcohol

Foods that are harder to digest and more likely to cause blockage, especially early on:

• Popcorn, nuts, and seeds
• Raw vegetables and fruit skins
• Corn and celery
• Dried fruit
• Tough or stringy meats

These foods are not off-limits forever. Try small amounts, chew very well, and drink fluids with them.

How do I know if I have a blockage?

A blockage happens when food or swelling slows output through the stoma. Signs include cramping, belly swelling, nausea or vomiting, and output that stops or becomes very watery and forceful.

If output slows and you have cramping, stop eating solid food, sip warm fluids, and try gentle walking. If symptoms do not improve within a few hours, or you are vomiting, call your surgeon or seek care right away.

When should I call my surgeon?

Call your surgeon if you notice signs of dehydration, blockage, or a problem with the stoma itself.

• Output that is very high, such as more than about 1.5 liters (roughly six cups) for more than 2-3 days in a row
• No output for 4 to 6 hours along with cramping or nausea
• Dizziness, very little urine, or signs of dehydration that do not improve with drinking
• A stoma that turns dark purple, black, or very pale
• Skin around the stoma that is broken, raw, or bleeding
• A bulge around the stoma causing severe pain
• Fever or worsening belly pain

Can I work, exercise, and travel with an ileostomy?

Yes. Most people return to work, light exercise, and travel while they have a temporary ileostomy.

After bowel surgery, light activity is usually possible in about 2 to 6 weeks, and full recovery takes about 6 to 12 weeks. Walking is encouraged early. Ask before heavy lifting or core exercises, since straining can raise the risk of a hernia near the stoma. For more about healing, see recovery after robotic colorectal surgery.

When traveling, pack extra pouches and supplies in your carry-on, bring drinks for hydration, and take extra care in hot Houston weather, when you lose more fluid through sweat.

Who helps me manage my ostomy?

A specially trained ostomy nurse, often called a WOC (wound, ostomy, and continence) nurse, is a key part of your care team. National guidelines support ostomy education and stoma site marking before surgery whenever possible.

Your ostomy nurse can help you choose the right pouch, protect the skin around your stoma, and solve leaks. Do not hesitate to reach out if something is not working well.

Frequently Asked Questions

How long will I have a temporary ileostomy?

Depending on the reason for needing the ileostomy, it can be reversed as early as 6 weeks after surgery. In some cases, patients may need their ileostomy longer if they require immunosuppression for inflammatory bowel disease or chemotherapy and radiation for cancer.

Will people be able to tell I have an ostomy?

Usually not. Modern pouches are flat and fit under regular clothing.

Can I shower with an ileostomy?

Yes. You can shower with the pouch on or off. Water will not hurt the stoma.

Why is my output so watery?

Ileostomy output is normally looser than regular stool because the large intestine is bypassed. It often thickens somewhat over the first few weeks as you eat more solid food.

Can I take anti-diarrhea medicine?

Sometimes. Only take it if your surgeon recommends it, and follow their dosing instructions.

What happens before reversal?

Before closing the ileostomy, your surgeon usually checks that the bowel connection has healed. Learn more in what the ostomy reversal evaluation looks like.

Next steps

A temporary ileostomy is a short chapter in your recovery, and good habits make it much easier. If you live in Houston and have questions about ileostomy surgery or reversal, you can request a consultation with Dr. Belizaire at houstoncommunitysurgical.com.

Sources

• Davis BR, et al. The American Society of Colon and Rectal Surgeons Clinical Practice Guidelines for Ostomy Surgery. Dis Colon Rectum. 2022;65(10):1173-1190. Journal
• Messaris E, et al. Dehydration is the most common indication for readmission after diverting ileostomy creation. Dis Colon Rectum. 2012. PubMed
• American Gastroenterological Association. AGA Clinical Practice Update on Management of Ostomies. AGA
• American Cancer Society. Ileostomy Care. ACS
• NIDDK (NIH). Complications of Ostomy Surgery of the Bowel. NIDDK