We are continuously monitoring the situation, taking guidance from Public Health England (PHE), and are mindful of the concerns this raises for people with an ileostomy or internal pouch.
If you are at particularly high risk of getting seriously ill with coronavirus, the NHS will contact you from Monday 23rd March 2020 with specific advice about what to do. Do not contact your GP or healthcare team at this stage – please wait to be contacted.
We are being asked many questions about this pandemic and having an ileostomy, and have created a series of FAQs below.
Does having an ileostomy affect our immune system, due to our risk of dehydration and possibly anaemia due to poor absorption from our diet?
There are several issues within this question: ’’immunity’ ‘dehydration’ ‘anaemia’ and ‘poor absorption’ with some possible overlap.
Nutrients from food are absorbed through the wall of the small intestine in the same way as before surgery (removal of the colon), so provided that any disease of the bowel, such as Crohn’s, is well-controlled by medication, and you have a varied diet, your nutrition (absorption) should not be affected. There may be an ‘increased risk of dehydration’ because you no longer have a colon, where water and salt used to be reabsorbed, but the remaining small intestine adapts in time to absorb what the body requires. It isn’t simply an issue of drinking more water – management of ‘hydration’ as well as the issue of a ‘high output stoma’ are addressed in our factsheet Staying Hydrated, available from National Office (0800 018 4724; email@example.com).
You can avoid anaemia by eating a varied diet that contains iron-rich food. For example, eggs, green vegetables, meat (including liver), beans and pulses, and dark chocolate (70% cocoa solids and over). But if you are concerned about your diet, you should discuss it with either your Stoma Care Nurse or dietician.
The immune system is responsible for protecting against and treating infection and is made up of many organs and processes in the body, including the spleen and white blood cells (lymphocytes). Our immunity is influenced by diet, sleep, exercise and stress, amongst other things. The bacteria in the gut (including the small intestine) also play a part, and these can be influenced by eating a healthy diet including fresh fruit and vegetables (to boost vitamin C and anti-oxidants), fibre and vitamin D (particularly in the Northern hemisphere winters where there is reduced sunshine). This can be found In oily fish (salmon, mackerel) liver, eggs, cheese, and fortified foods. Getting seven or eight hours sleep per night, exercising (within personal limits) and avoiding stress can also help. People taking immunosuppressant medication, e.g. for inflammatory bowel disease or chemotherapy, should take extra care to avoid contact with infection.
Am I at risk if I am taking immunosuppressive/immunomodulating medicine?
People taking immunosuppressive/immunomodulating medicines are considered ‘vulnerable’ or ‘high risk’, which means they are more likely to encounter severe infection or complications from Covid-19 if they are infected.
What are the symptoms of coronavirus?
The symptoms of coronavirus are:
- A high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
- A new, continuous cough – this means coughing a lot for more than an hour, or three or more coughing episodes in 24 hours. If you usually have a cough, it may be worse than usual)
What should I do if I am showing symptoms?
If you develop symptoms associated with coronavirus, you should self-isolate and get in touch with the 111 online coronavirus service. https://111.nhs.uk/covid-19/
How long should I stay in self-isolation?
If you are showing symptoms, stay at home for SEVEN days. However, if you live with other people they should stay home for FOURTEEN days from the day the first person showed symptoms. After 14 days, anyone living with you who does not have symptoms, can come out of self-isolation.
More detailed NHS advice on self-isolation and what this entails, can be found here: https://www.nhs.uk/conditions/coronavirus-covid-19/self-isolation-advice/
Should I be requesting increased quantities of stoma supplies?
There is no need for you to do anything different when ordering or taking your medicines; continue with your ordinary repeat prescriptions. NHS England and the Department of Health have issued statements to reassure patients that it will be business as usual where your prescriptions and supplies are concerned.
The Department of Health have stated that there are no prescription medicine shortages as a result of Covid-19 and patients should order prescriptions and take their medicines as normal.
What can I do to lower my risk?
Everyone should do what they can to stop coronavirus spreading. It is particularly important for people who:
- Are 70 years or age or over
- Have a long term condition
- Are pregnant
- Have a weakened immune system
NHS advice is to:
- Wash your hands with soap and water often – do this for at least 20 seconds
- Always wash your hands when you get home or into work
- Use hand sanitiser gel if soap and water are not available
- Cover your mouth and nose with a tissue or your sleeve (not your hands) when you cough or sneeze
- Put used tissues in the bin immediately and wash your hands afterwards
- Avoid close contact with people who have symptoms of coronavirus
- Only travel on public transport if you need to
- Work from home, if you can
- Avoid social activities, such as going to pubs, restaurants, theatres and cinemas
- Avoid events with large groups of people
- Use phone, online services or apps to contact your GP surgery or other NHS Services
- DO NOT touch your eyes, nose or mouth if your hands are not clean
- DO NOT have visitors to your home, including friends and family
If you are worried about Coronavirus (Covid-19) the very latest information can be found on the Government or NHS England websites.
If you have concerns around your ileostomy or internal pouch, please contact the IA helpline on 0800 018 4724 or contact us via Facebook. Our teams will do their best to help as quickly as possible.
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