In general stoma pouches are usually changed every 1–3 days, however this can be different for ileostomists, colostomists and urostomists. The output is more corrosive for urostomists and ileostomists, and so may require more regular changing.
A stoma looks like a small `spout’ and is deep pink in colour, similar to the inside of the mouth. In the first 6-8 weeks post-surgery, your stoma will gradually shrink and may reduce in size. Check it weekly with a measuring guide to make sure the hole in your stoma pouch is a snug fit. If you are unsure of the right size for you, contact your healthcare professional for advice.
Bleeding from your stoma is normal when wiping and cleaning , however, if blood is present in your stoma pouch then please discuss this with your healthcare professional. Additionally, if the edge of your stoma is tender, painful and/or bleeding please contact your healthcare professional for a clinical review.
When a stoma is brought out to the surface it must pass through the muscles of the abdominal wall, thus a potential site of weakness is created. In the ideal situation, the abdominal wall muscles form a snug fit around the stoma opening. However, sometimes the muscles come away from the edges of the stoma creating a stoma hernia where there is no muscle.
This is sometimes referred to as a parastomal hernia. Factors that can contribute to causing a parastomal hernia include coughing, being overweight, or having developed an infection in the wound at the time the stoma was made
The development of a parastomal hernia is often gradual, with the area next to the stoma stretching and becoming weaker over time. This weakness, or gap, means that straining, coughing, sneezing or standing up can cause the area of the abdomen next to the stoma to bulge, or can cause the whole stoma to protrude as it is pushed forward by the rest of the abdominal contents behind it. As with all hernias, the size will increase as time goes by
Regardless of inconvenience or pain, hernias are evidence of a weakness in the abdominal wall and should not be ignored simply because they might not be painful. If you have concerns regarding a possible hernia, talk to your healthcare professional.
Your pouch may be fitted with a filter which should prevent most of the odours. If you notice a smell from your pouch you should check it, as there may be a leak under the flange and the pouch will need changing. If you are concerned, speak to your healthcare professional and they can advise on ways of dealing with odours.
If there is no leak present, preventing sore skin can be managed with short term use of skin barrier products. Sore skin associated with pouch leaks can be caused by wearing a stoma pouch that exposes more than 1-2 mm of skin surrounding the stoma. To ensure an accurate fit, you may want to stand in front of a mirror to apply the stoma pouch.
It is very rare to have a reaction to a stoma pouch, as the materials used in their manufacture are constantly tested and evaluated for skin friendliness. If you have suffered from a skin reaction, the first thing you should do is check that you have not used something different in your normal routine e.g. change of soap or barrier wipe. If there is no difference in your normal procedure, you may need to change your product. If you are concerned, speak to your healthcare professional.
Pancaking happens when a vacuum occurs in the stoma pouch and the pouch sticks together preventing the contents from reaching the bottom of the pouch. Faeces remain at the top of the pouch and the filter may become blocked. In some cases, the pouch may also be forced off the body. One tip is to blow air into the stoma pouch before you fit it, which will help to prevent a vacuum from occurring. A drop of baby oil opposite the opening can also sometimes help the output to slide to the bottom of the stoma pouch. Some people also find that rolling up toilet paper to form a tight cylinder and dropping it into the stoma pouch helps to avoid the problem.
Stoma pouches can be disposed of in many ways. If you have a drainable pouch, this should be emptied before removing. Wrap the entire soiled stoma pouch and dispose of it in a refuse bag for waste disposal. Some district councils have a clinical waste collection team, so you should check with them.
When reintroducing a more varied diet following ostomy surgery , it is a good idea to begin slowly, depending upon your recovery and/or other medical complications, adding back one new food at a time.
Most ostomists can eat a very varied diet, leaving out only the things which cause problems for them as individuals. However, as a rule, ileostomists should avoid foods that could cause blockage, such as sweetcorn, mushrooms, celery and nuts.
If you can tolerate spicy foods through your digestive system, the stoma is tough enough to tolerate spicy foods too. However, you should be aware that following a spicy meal your stoma output may increase.
Wind is a problem that most ostomists experience at some time or other. There are a number of foods you can eat which can help settle down flatulence, such as natural yoghurt, charcoal biscuits, fennel tea and peppermint oil capsules.
Yes, it is fine to swim whilst wearing a stoma pouch . In fact, many ostomy products are designed to be particularly suitable for use whilst bathing or swimming. If you use a stoma pouch with a filter, a patch can be placed over the charcoal filter to protect it while you are in the water.
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