This article is going to help you learn about ileostomy and colostomy care:
An opening that is created surgically that allows the feces to leave the body through the abdominal wall is called a stoma and this whole process is known as Ostomy. Usually, the stoma looks very red and moist just like your mouth. The stoma will get shrunken after 6 to 8 weeks but in the beginning, it looks swollen. There is no pain and pressure inside and around the stoma. There is no nerve ending present in stomas that is why you can’t have any sensation.
There are two types of ostomies. Some are temporary and some are permanent. It depends on your condition which one will be yours.
Your life changes suddenly and dramatically due to an Ostomy that is why we have written this article to help out people with ileostomy and colostomy in order to help them and make them more comfortable with their ostomies.
Main Types of Ostomies:
A surgeon may use a small intestine (ileum) or a colon (large intestine) to make an Ostomy. If a portion of the ileum is used it is called ileostomy and when the colon is used it is called a colostomy.
The consistency of the feces after an Ostomy depends on the fact that which part of the intestine was used to create an Ostomy. Feces can liquid, soft and hard, or solid.
The most occurring types of ostomies are:
Ileostomy:
The ileum is used for the creation of the Ostomy
The stool is loose, pasty, liquid.
A stoma is formed usually on the right side of the lower abdomen.
Ascending colostomy:
Made from ascending colon
The stool is watery, pasty, or loose
A stoma is on the right side of the lower abdomen.
Descending Ostomy:
Involves descending colon
The stool is mostly soft
A stoma is mostly on the left side of the lower abdomen
Sigmoid colostomy:
Evolves from the last portion of the colon
The stool can be soft and hard
A stoma is on the left side of the lower abdomen
Loop ostomy
Can be created from any part of the ileum or colon
It has two 2 openings in the stoma. But mostly only one opening is visible. This is a temporary ostomy.
Before leaving the hospital you will be referred to an Ostomy nurse or any certifies ostomy expert. They will teach you that how to take care of your stoma and many other recovery tips.
Pouching system:
You need to wear a pouching system on your stoma, following ostomy surgery. All the pouching systems are water and odor-proof. The pouching system consists of a skin barrier (wafer) and a storage pouch. They come in different sizes and varieties. Some are one-piece systems in which the barrier is attached permanently with the pouch and the other one is a two-piece pouching system with a separate skin barrier and pouch. In both systems, you need to attach the pouch to the abdomen with the help of a skin barrier and it allows the feces to leave the body through the stoma. A skin barrier is a good option for avoiding leakage.
You can ask your ostomy nurse to help you find the best pouching system for you. With the changing size of your stoma, you need to change your pouching system.
Some people use waterproof mattress and bed pads in order to avoid any accidental leakage.
Emptying your pouch:
Your ostomy nurse will teach you how to drain your bag properly. It is recommended to empty the bag when it becomes 13 or ½ filled. Avoid overfilling the pouch.
You can easily empty out the liquid feces. Pasty and thick feces are difficult to drain out in the toilet. You can squeeze the pouch it will get thin and then you can empty it out. Don’t compress all of the air out. If you do so then the feces will stick at the side of the pouch. You can also apply lubricants in case of thickened stools.
Changing pouching system:
It is taught by an ostomy nurse that how to change the pouching system. It is advised to change the pouching system every three to five days. In case of leakage, you should change it immediately. This will avoid any kind of irritation and discomfort around your stomal skin. In case of prolonged leakage or irritation for more than a week you can talk to your doctor.
Main Concerns:
Body flaws and depression
People start to see their bodies in a different way when they get to know about their cancer. They have the effect of chemotherapy and radiotherapy on their mind and emotions. In the case of ostomies, patients feel the same way. They get frustrated over the loss of their body part or they get upset by looking at the stoma. Ostomy brings many negative thoughts. With the passing days as you get used to your stoma, you will eventually start to feel better for your body. The mentioned tips may help you to face it in a better way:
Looking at your stoma many times a day so become comfortable with it
Remember that ostomy has saved your life.
Seek out other people with ostomies
You can get help from a therapist or a counselor
Nutrition:
Your doctor will explain to you briefly about your diet, following the surgery. You can also seek help from a dietarian.
In the case of ileostomy you can follow the guidelines mentioned below:
Keep yourself hydrated
Drink 8 to 10 glasses of water or any liquid every day
Avoid alcohol and caffeine.
Avoid high fibers food
Avoid more sugary foods
If you notice any of the following symptoms you should consult your doctor
Dry mouth
Loss of hunger
Weakness
Decrease in urine output
Foul-smelling in urine
Dark color urine
Fainting
Cramps in legs or muscles
Changes in feces consistency
Some foods can cause gas in your stomach and it will cause discomfort. These food items are;
Cabbage and capsicum or broccoli
Carbonated drinks
Using a straw for drinking
Chewing gums
In case of an issue with a lot of gas assembling in the pouch, you can use pouches with a charcoal filter. They will keep your pouch. You should avoid the following things;
Don’t rub your pouch too hard it will destroy the odor the filter inside the pouch
Don’t scrub the pouch with water.
Cover your filter with any sticker or waterproof item
Medication
There are some medicines that can’t be digested by the body following an ileostomy. This happens because the bowel is altered and it takes some time for the medicines to absorb in the lower part of the intestines. It happens mostly when:
Enteric-coated pills
Sustained-release or extended-release medication
If you feel that it’s hard for your bowel to absorb any specific tablet or medicine contact your doctor.
It’s recommended not to crush the medicine until or unless your doctor allows you to do this.
Exercise:
Following the surgery, you can do a few exercises. Mostly walking and stretching (light) are recommending following a few weeks after the ostomy. You are allowed to lift a weight equal to a water kettle after some weeks of the ostomy.
Avoid pushups and sit up it may cause pressure on the stoma and develop the chances to have a hernia.
Moreover, you can consult your WOC nurse or doctor for more instructions.
Odor:
Some Ostomy deodorizing products are used to reduce or remove odor. Most of them come in bottles, but they are also present in tablet form such as Parthenon’s chewable tablets. Order must only spread out of the Ostomy pouch while you are changing or draining the bag. If there is any odor in any other situation then this is a sign of leakage or any mishap with your ostomy bag.
Ostomy bag deodorants are used to eliminate the odor within the Ostomy bag. You can get a scented deodorant, but you also have a choice of odorless products that are used to target odor-producing bacteria.
Lubricating deodorants are also available that avoid the feces to pile up at the top portion of the Ostomy bag. The drainage can become easier by using lubricating deodorants
You just need to add some drops of the deodorant to your Ostomy bag while changing or draining it. Every brand instructs its products and their usage.
Sexual Activities:
You can engage in sexual activity following surgery. It may take some time to continue it due to the ostomy. Discuss the things with your partner. Clean your pouch. Seal the pouch properly. You can use ostomy belts or cummerbunds in order to hold your pouch in place.
The most worrying part for people is to share their ostomy with the person whom they are dating. Some people immediately tell everything to their mates. Do what you feel is right for your relationship.
Showering or bathing:
It's your choice to wear the pouching system while showering or not. In the case of ileostomy, most people prefer to keep on their pouch because it enables bowel drainage during the shower. It is recommended to use waterproof stickers or tap at the edges to avoid any water from entering into the pouching system.
Work:
It would take some time in healing and recovering from your ostomy, but you would be able to join your work eventually. You can ask your boss for some time relaxation.
In case if you are a laborer, and have to do a lot of lifting, the doctor will give you many advices for the protection of the stoma.
Don’t panic or don’t get nervous. If you will continue your job it will divert your mind and will help you to restart a normal life ignoring the bad experiences in your life.
Travel
You should keep extra ostomy supplies with you while traveling. If you feel any anxiety you can think about any other thing. This is not the first time you are traveling, you can avoid the anxiety easily.
Double-check the following things in your handbag or pouch
Pouches
Wafers
Clamps
Tissue or paper towels
Look for your doctor if you have the following signs
Vomiting
No feces output for 3 days following a colostomy
No bowel movement for 3 to 6 hours following an ileostomy
Abdominal pain
Dry mouth
Loss of appetite
Weakness
Urge to change ostomy bag frequently
FAQs
What is irrigation?
This is a method that is similar to enema and it helps you to predict your bowel movement. The people who use this method only wear a stoma cap rather than wear completing the pouching system. It can be done daily or every second day. It is strictly mentioned that people with ileostomy can’t use this method because it can be a reason for dehydration.
Irrigation can’t be performed when:
In case of any bulge or hernia around the stoma
During chemotherapy
During radiation therapy
What is the color of the stoma?
Mostly the stoma is dark pink and red color throughout the time. But during bowel movements, it can change in its color for a few seconds. In case if you notice its color turning to dark red, black, brown, or grey you should see your doctor immediately.
Is bleeding normal while touching or changing the pouch?
Peristomal skin has many blood vessels around it. So it is very common if the blood comes out during irrigation or changing of the pouching system. This bleeding should stop in few minutes. If your blood is thin you can take an aspirin. But in case of prolonged bleeding apply pressure on the stoma and call your doctor immediately.
Is the bulge around the stoma normal?
If you have a hernia or notice any curve around the stoma this means that the abdominal wall has very weak muscles.
Surgery for a hernia is not crucial until or unless it got complicated or it cause intestinal obstructions.
How to wear a belt over a stoma?
You should wear the belt above or below the stoma. If it is placed directly on the stoma then it can be the reason of:
Irritation
Bleeding
Tissue overgrowth
Is there any need to wear gloves while changing the pouching system?
This is your choice. There is no seen risk of the infection. But most people wear to avoid the touching of feces.
Is it normal to pass mucus or stool from the rectum after ileostomy?
It depends on your surgery. But you should apply zinc ointment and wear a pad in order to avoid irritation around the anus
What is needed to be done if I get admitted to the hospital?
You should bring extra appliances with you. Because there are chances that you don’t like the pouching systems provided over there or you may run short of them.
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