The pouch now becomes functional so that waste passes into the pouch, where it is stored. In most cases, the second surgery can be done at the ileostomy site without re-opening the first incision. The skin at the former ileostomy site is usually left to close on its own. There may be accompanying urgency and leakage of stool. All of these aspects improve over time as the anal sphincter muscles strengthen and the pouch adapts to its new function.
Stools become thicker as the small intestine absorbs more water.
In addition, medications to decrease bowel activity and bulk-forming agents to thicken the stool may be prescribed. Patients can help during this adaptation process by avoiding foods that may cause gas, diarrhea and anal irritation. Careful skin care around the anus will protect the skin from the irritation of frequent stools. After six months, most people can expect about five to six semi-formed bowel movements during the day and one at night. The pouch takes up to one year to fully adapt.