Leakage, sore skin, and the first months

These are filed under concerns rather than complications, and the framing is deliberate: they are common, expected, and mostly temporary.

Leakage

This may be motion or mucus, and can happen in the early post-operative period, mainly at night. As you get stronger, leakage should cease; if it persists, see your doctor or stoma care nurse. It may also occur if you take strenuous exercise. Regular Kegel — pelvic floor — exercises can help reduce it. The practical tip is unglamorous and effective: wearing a small pad or panty liner will let you overcome soiling and give you confidence.

Sore skin

This sometimes occurs around the anus. When possible, wash the area after opening your bowels, using a soft cloth to pat dry; moist toilet paper is useful. Soothing or barrier cream used sparingly after washing can prevent soreness. Portable bidets for use on your toilet are available at moderate cost.

It is worth pairing that with the timeline: improvement continues over 12 to 24 months. Skin care is a long game rather than a first-fortnight job.

The rest of the list

• Frequent motions: frequency usually reduces as you recover and regain strength. If it continues, contact your doctor or stoma care nurse — it is usually remedied easily with diet or medication.
• Wind: due to an accumulation of wind, your bowel action may at times be explosive. This can be influenced by diet, or by delaying opening your bowels.
• Bleeding: not common, but may occur in the early days, or if you take anticoagulant medication such as aspirin or warfarin. Contact your doctor or stoma care nurse.

What the first weeks are actually like

The surgeons are blunter about the start than anyone, and it helps to know beforehand. Soon after the ileostomy is reversed, when the pouch begins to function, expect things to be a bit erratic. It is not uncommon for faeces to be very liquid and frequent, and you may feel you have little notice to reach the toilet. Control can be difficult, and you may experience some leakage of stool.

Then it changes: as your diet returns to normal over the following days, output begins to thicken, frequency decreases and control becomes better. You may experience some incontinence at first, particularly at night, and it can take time to get this under control.

Where to put the effort

Three of the things on this page respond to something you can do, which is worth separating from the ones that simply pass.

• Leakage responds to regular Kegel — pelvic floor — exercises, which can help reduce it. You can do them anywhere, any time, since no one knows you are doing it.
• Sore skin responds to washing after opening your bowels, patting rather than rubbing dry, and barrier cream used sparingly.
• Wind responds to diet, and to not delaying opening your bowels — both influence how explosive a bowel action is.

The rest — the frequency, the erratic first weeks — mostly improves on its own as you recover and regain strength. Which is why all of it is filed under concerns rather than complications.