An ostomy is a life-saving surgical procedure that creates an opening in the abdomen, known as a stoma, to allow waste to leave the body. While adjusting to life with an ostomy can feel overwhelming at first, learning the basics of care can help you regain your independence and confidence. This guide provides a straightforward look at how to manage your ostomy, maintain skin health, and navigate daily activities with ease.
Understanding Your Ostomy
There are three main types of ostomies, and knowing which one you have is the first step in proper care. A colostomy involves the large intestine, an ileostomy involves the small intestine, and a urostomy is for the diversion of urine. Each type may require slightly different supplies and maintenance routines based on the consistency of the output.
Regardless of the type, the stoma itself should look moist, pink, or red, similar to the inside of your cheek. It is normal for the stoma to bleed slightly when cleaned, but it should not cause pain, as the stoma lacks nerve endings. Monitoring the size and color of your stoma is a vital part of your daily routine.
Essential Ostomy Supplies
Having the right supplies on hand makes the management process much smoother. Most people use a pouching system that consists of a skin barrier (the part that sticks to your skin) and a collection pouch. These systems come in two main varieties: one-piece and two-piece systems.
- One-Piece System: The skin barrier and the pouch are permanently attached as a single unit.
- Two-Piece System: The skin barrier and pouch are separate, allowing you to change the pouch without removing the barrier from your skin.
- Measuring Guide: A tool used to ensure you cut the opening of your skin barrier to the correct size.
- Skin Prep Wipes: Used to protect the skin and help the barrier adhere better.
- Adhesive Remover: Helps gently remove the barrier without irritating the skin.
- Ostomy Belts or Wraps: Provide extra security and support for the weight of the pouch.
How to Change Your Pouching System
Changing your ostomy pouch is a skill that becomes easier with practice. Most people change their system every three to five days, though this varies based on personal preference and the type of ostomy. It is often best to change the pouch in the morning before eating or drinking, when the stoma is less active.
- Prepare your supplies: Lay out everything you need on a clean surface. Cut your new skin barrier to fit your stoma, leaving about an 1/8-inch gap around the base.
- Remove the old pouch: Gently peel the barrier away from the skin. Using an adhesive remover wipe can help prevent skin stripping.
- Clean the area: Use warm water and a soft cloth or paper towel to clean the skin around the stoma. Avoid using soaps with oils, perfumes, or lotions, as these can prevent the new barrier from sticking.
- Dry the skin: Pat the skin completely dry. The barrier will not stick to damp or wet skin.
- Apply the new barrier: Center the barrier over the stoma and press firmly for about 30 seconds. The warmth from your hand helps the adhesive create a secure seal.
- Attach the pouch: If using a two-piece system, snap the pouch onto the barrier ring. Ensure the bottom of the pouch is closed or clamped.
Maintaining Healthy Peristomal Skin
The skin surrounding the stoma is called the peristomal skin. Keeping this area healthy is the most important part of ostomy care. If the skin becomes irritated, red, or broken, the pouching system may leak, leading to further discomfort and skin damage.
To prevent irritation, ensure your skin barrier fits snugly around the stoma. If the opening is too large, waste can sit on the skin and cause chemical burns. If the opening is too small, it can cut or bruise the stoma. Check your stoma size regularly, especially in the weeks following surgery, as the stoma will shrink as it heals.
Managing Odor and Gas
Many people worry about odors, but modern ostomy pouches are designed to be odor-proof. Odor should only be noticeable when you are emptying or changing the pouch. If you notice a smell while the pouch is closed, check for leaks or a loose seal.
Gas is a natural part of digestion and can cause the pouch to inflate. Many pouches come with built-in charcoal filters that allow gas to escape while neutralizing the odor. You can also manage gas by avoiding carbonated drinks and foods known to cause gas, such as beans, cabbage, and onions.
Diet and Hydration Tips
For most people, a return to a normal diet is possible after a period of healing. However, it is important to introduce new foods slowly to see how your body reacts. Chewing your food thoroughly is essential to prevent blockages, particularly if you have an ileostomy.
Hydration is another critical factor. Because an ostomy can change how your body absorbs water, you may need to drink more fluids than you did before surgery. Water, broth, and electrolyte-rich drinks are excellent choices. Watch for signs of dehydration, such as dark urine, dizziness, or extreme thirst.
Physical Activity and Clothing
Having an ostomy should not stop you from being active. Once your doctor clears you for exercise, you can participate in almost any sport, including swimming. Special waterproof tape or covers can help secure your pouch while in the water. For contact sports, protective stoma guards are available to prevent injury.
In terms of clothing, there is usually no need for a completely new wardrobe. Most ostomy pouches are discreet and sit flat against the body. Many people find that high-waisted pants or leggings provide extra support and help conceal the pouch. Patterned clothing can also help mask any small bulges.
When to Contact Your Healthcare Provider
While minor skin redness can often be managed at home, certain symptoms require professional medical attention. Contact your doctor or a Wound, Ostomy, and Continence (WOC) nurse if you experience any of the following:
- A stoma that changes color significantly (turning very dark or pale).
- Severe skin irritation, sores, or weeping skin.
- No output from the stoma for several hours, accompanied by cramping or nausea.
- Frequent leaking that occurs shortly after a pouch change.
- A stoma that seems to be pulling back into the abdomen or protruding significantly further out than usual.
Living with an ostomy is a significant adjustment, but with the right information and routine, it becomes a manageable part of daily life. By focusing on skin health and proper pouching techniques, you can continue to enjoy your favorite activities and maintain your quality of life. For more practical advice on health and home management, explore our other helpful articles on SearchAndHelp.com.