Ostomy

All the answers to the 10 most frequently asked questions of people with stoma

common questions about stoma

The diagnosis of a disease can find you unexpectedly. Whether you are a patient or a relative, your world has suddenly turned upside down. And somehow you will have to undergo an ostomy operation and you will definitely have countless questions about it.

Without warning, you need to understand illnesses and possible treatment options, make complex decisions with long-term impact, change habits and completely reorganize your daily life, deal with fears and anxieties, and accept or support and encouragement.

At such times, it is important to have honest, easy-to-understand information to guide you through and after this difficult time. Below you will find useful patient experiences and information about products and treatments in the case of colostomy and ileostomy, which we hope will help you make the right decisions for your case.

Table Of Contents

Is it possible for my stoma to move inward or outward in an unusual way?

Both can happen, but they are not always serious. It is normal for the mucous membrane to move slightly inward and outward due to the peristaltic movement of the bowel. The phenomenon of an ostomy showing an unusual fall inwards is called an retraction, while when the ostomy shows an outward fall it is a complication that can reach the stage of prolapse.

You should immediately adjust the ostomy materials you use to avoid the risk of leaks and, consequently, skin irritation. Only in some cases may it require surgery to reposition the bowel.

In any case, contact your doctor or Traumacare nursing staff.

Retraction

The ostomy usually protrudes slightly above the level of the skin. It depends on whether you have a colostomy or ileostomy (ileostomies tend to protrude more) and the size of your bowel. In the case of a retraction, the stoma is at or below the surface of the skin.

Retraction can be problematic, as it can prevent the stoma bag from fitting properly and cause leaks, which in turn can lead to pain and irritation.

The retraction can be restored using:

  • A bag with a curved flange to push the stoma out
  • An ostomy belt to support the area
  • A protective barrier paste to protect the skin

Only in very extreme cases can your doctor suggest repositioning the stoma.

Prolapse

In this case the stoma extends too far outwards and if left untreated is more susceptible to abrasions or infections.

Prolapse is more common in loop colostomy but can also be caused by other reasons such as:

If you have a prolapse it is important to watch your stoma carefully for changes in size and color as it can affect the blood supply to the area. Another important side effect is to clog the stoma making it impossible for stool to pass.

Seek immediate medical advice in the event of either. No need to worry as you will usually just need to change your bag to fit the extended stoma.

Again, your doctor may decide to reposition your stoma if and only if he or she deems it absolutely necessary.

My stoma shows changes in shape. Is it normal?

Yes! The change in shape is a normal development in both new and established stomas. In fact, in the beginning your stoma will be swollen and may grow in size during the postoperative period. Unfortunately, no one knows how much the stoma will swell immediately after surgery, but neither how big it will finally be when the swelling subsides in about 6 weeks after surgery.

Regularly measuring the base of your stoma is very important in these 6 weeks, so use the right size for the flange of the stoma bag. Traditionally the flange should be 3-4 mm larger than the stoma. The right size of the flange helps to prevent irritations of both the skin and the stoma itself.

However, changes in the size and shape of a stoma can occur over time for a variety of reasons. Gaining or losing weight by 4.5 kg or more, pregnancy, aging, hernia development need attention, requiring a re-evaluation of the ostomy supplies you use.

What kind of stoma bag should I use?

Immediately after the surgery and in the first days until you leave the hospital, you will use the ostomy bag chosen by the nursing staff. As usual, these are transparent bags, so that the medical team can evaluate the progress of the treatment but also you can get used to how the bag is changed.

But when you leave the hospital you can choose from many types of stoma pouches from different manufacturers.

It’s a matter of trial and error as one type of bag may suit you in the first few weeks and then not. First of all, the diameter of your stoma will shrink over time while you can use different bags depending on the activity such as when you travel, exercise, have sex, etc.

If you are not satisfied with the colostomy, ileostomy or ureterostomy bag you are using, you can always try something else for free.

Just fill in your details and we will contact you immediately or call us for more information.

Get free samples of colostomy & ileostomy bags and products through EOPYY



    I often have stoma leakage problems. What can I do?

    Depending on the type of stoma and the type of waste, the consequences of these leakage problems will vary. Knowing the cause behind the leak will help you and your doctor find the best solution. The skin around the stoma is not always smooth but often shows folds where their number and depth vary from person to person.

    If the skin around your stoma is completely healthy, it should look like the skin in the rest of the abdomen. If it is redder, it hurts or itches, there can be many causes but in the case of leaks the most common is moisture as the uneven surface of the skin can prevent the proper application of the bag resulting in leaks under the glue that lead in skin irritation even when the folds are very small in size.

    Check the glue for signs of leakage, as well as the condition of the skin around your mouth when removing the bag.

    One solution may again be a protective paste to smooth out wrinkles on the area as well as a protective skin spray with silicone to prevent skin damage caused by moisture and abrasion.

    In general, in case of irritation, it is recommended that the self-adhesive bags be changed at least once a day, while the 2-piece ostomy systems should be changed every other day, but the flange should be changed daily.

    Make sure the flange of your stoma has the right size. If it doesn’t fit properly, it may be time to try a stoma pouch with a soft, curved base.

    As a leakage problem is a big hassle, know that there are many reasons behind a leak. If the problems persist or you have any doubts about the condition of the skin you should immediately contact your doctor or Traumacare Nursing staff to determine the true cause of the leak and treat it immediately.

    Can my stoma be blocked?

    Your stoma output can be slowed down or even stop working completely, ie there may be a stoma blockage. There are two types of obstruction:

    • Partial obstruction of the stoma when liquids and gases pass during bowel movements but most solids are blocked.
    • Full obstruction of the stoma where nothing passes.

    In the case of a colostomy, the blockage may not be noticeable from the beginning as it may take several days for it to form until you feel constipated. In the case of ileostomy, the blockage usually occurs quickly without any feeling of constipation and you will notice it when your pouch remains empty when it should have been full.

    Symptoms of ostomy blockage

    • Reduced output
    • Cramps
    • Abdominal pain
    • Swollen abdomen
    • Constipation
    • Nausea
    • Swelling or discoloration of the stoma area
    • Stoma dryness
    • Reduction of urine production
    • Vomiting (only in severe cases)

    What to do in case of blockage

    Many times the blockage can be due to food debris. Rinsing the stoma with a solution of warm water and salt (salt solution) can address the problem. However, if the blockage is due to stenosis, then the stoma will be colorless and swollen. In this case we advise you to contact your doctor without further delay.

    • Stop eating solid foods
    • Increase fluid intake
    • If the stoma is swollen, replace the bag you are using with a larger one
    • Take a warm bath to relax your abdominal muscles
    • Massage your abdomen
    • Pull your knees toward your chest and move from side to side
    • Call your doctor if the pain is severe or you have symptoms of dehydration, even if the symptoms have not lasted for 8 hours.
    • Ask someone to take you to the doctor or hospital
    • Do not use laxative or any other medicine without consulting your doctor
    • Do not drink or eat anything if you vomit or not passing stool at all or both
    • Do not insert anything into the stoma unless instructed to do so by your doctor
    • Don't wait too long to call your doctor

    As suggested by Gwen B. Turnbull (RN, BS, CETN), IA (Ileostomy & Internal Pouch Association)

    Is there a risk of skin irritation around the stoma?

    If you simply follow the daily care of your stoma area, the risk of irritation is signigicantly lower. Keep in mind that the adhesive part of the flange or the one-piece stoma bag also acts as a skin protector, which means that its role is on the one hand to adhere to the skin, but on the other hand to protect it.

    However, there are ways to reduce the risk of irritation to a minimum:

    • Use lukewarm water to cleanse the skin
    • Avoid products that contain fragrance
    • If you have watery stools that cause itching, you can cover the exposed skin with a protective paste such as B.Braun Superfiller

    After colon cancer, I should start chemotherapy. Will there be changes in my stoma and digestion?

    During chemotherapy, changes are expected. Your stoma may become more sensitive and swollen as even the slightest friction can cause light bleeding. Although this is nothing alarming, you should be even more careful in taking care of your stoma.

    Stools may also become more fluid and irritate the skin around the stoma. Make sure you cut your flange or bag correctly. Sometimes you may need to use adhesive paste for extra protection to prevent fluid from leaking out of the stool.

    That is, once again you will need some products for the best possible protection of the skin around the stoma.

    It is also recommended that you use bags that can be emptied during chemotherapy if the stool is fluid to avoid over-frequent changes.

    Finally it is necessary to adjust your diet accordingly.

    I have gas and I feel awkward. What can I do?

    It is a common concern in people who live with an ostomy, but you don’t need to worry. Modern colostomy and ileostomy bags have a special filter that allows gases to escape automatically, without odors. It is effective for at least 12 hours. However, this filter can be saturated or moistened. In this case your bag will swell from the gas. This can happen if you wear the bag continuously after 12 to 24 hours or at the end of the night.

    Under no circumstances should you puncture the bag, as it will allow odors to escape. Remember that it is important to close your filter when bathing (or while swimming, water sports, diving), by applying a sticker on the filter. You will find these stickers in the purchase boxes of your bags. Remember to remove the sticker after the end of the activity so that the filter starts working again automatically.

    For your own comfort, you can reduce the daily amount of gas produced by following a few simple diet tips:

    • If you have watery stools that cause itching, you can cover the exposed skin with a protective paste such as B.Braun Superfiller
    • Have lunch at regular intervals
    • Eat moderate meals
    • Chew food well and eat slowly
    • Carefully monitor your mouth health
    • Prefer eating foods, such as whole grain breads, and high-fiber cereals, bananas, and peeled vegetables.
    • Drink at least 1.5 liters of fluid a day (eg water or tea)

    Check with Traumacare nursing staff about foods that can help you reduce gas.

    Note: If you have a left colostomy, there are solutions that can mask gas noises. You can use a stoma plug, in combination with an irrigation or a vaseline cap to stoma opening.

    Does a stoma smell?

    The ostomy materials used today don’t allow any odors to leak. At first you may think you can smell the stoma, but don’t worry. This is something that passes over time as you get used to it.

    If there is indeed an odor coming from your bag, change it. For added safety, you can also use B.Braun’s DeOdour product, which eliminates all odors of bacterial origin in ostomy bags. A small sachet per bag offers hours of confidence.

    Do I need to talk to my children and relatives about my ostomy?

    Children need confidence, so you should talk to them and explain the situation in plain words. They should not feel that you are hiding something from them and in this case what they imagine is often much worse than reality.

    Just because someone has a stoma doesn’t mean he/she have to show it! As far as relatives are concerned, it is up to you to decide if it is necessary to talk about it. You are the one who lives with the ostomy, so it is your choice whether to do it or not. It may be natural for you to talk about this comfortably with some people, and less so with others.

    It would definitely be better to talk about your stoma with your significant other calmly and openly so, both get rid of any fears you may have.

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