An ileostomy surgically attaches the small intestine to an opening, or stoma, in the abdominal wall. An ileostomy bypasses the large intestine, or colon, either because it’s been removed or is damaged. An ileostomy may be a temporary procedure, to allow the bowel to rest and recover after surgery or other trauma, or may be permanent. Because much of your body’s nutrition is absorbed in the large intestine, having an ileostomy can cause nutritional deficiencies. Vitamin supplements help replace nutritional losses. In addition to vitamins, some people with ileostomies may also require mineral supplementation.
ADEKS stands for vitamins A,D, E and K, all fat-soluble vitamins normally absorbed in the ileum. If a large part of the ileum is removed or bypassed, fat-soluble vitamins aren’t absorbed. Adults and children with short gut syndrome, which occurs after removal of a significant portion of the ileum, often require ADEKS supplementation. ADEKS, given as pediatric drops or in tablets, supplies fat-soluble vitamins in a water-soluble form so they can be absorbed. ADEKS multivitamins also contain water-soluble vitamins such as B-complex vitamins and vitamin C.
Around 25 percent of all people who undergo ileostomy eventually develop a B-12 deficiency, the National Health Service of Great Britain reports. B-12 deficiency occurs when part of the intestine that normally absorbs B-12 is removed. Untreated, B-12 deficiency can lead to pernicious anemia, which causes fatigue, shortness of breath, headache, ringing in the ears, faintness and irregular heartbeat. It may take several years for B-12 deficiency to appear, so monitor B-12 levels regularly. Regular B-12 injections or tablets can treat B-12 deficiency.
In addition to vitamins, poor absorption of minerals may also occur in patients who lose a portion of the small intestine in addition to the large intestine. Poor absorption of calcium, iron, magnesium and zinc may occur, particularly during illnesses, which increase diarrheal output from the ileostomy, according to Brizee.