Ostomy Care

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Overview of Ostomy Surgery for Colostomy and Ileostomy

An ostomy in which the large intestine is connected to the abdominal wall is called a colostomy. When a piece of the small intestine is used, it is called an ileostomy. The purpose of both is to provide an alternate route for the bowel waste or gas to pass from your body when the bowel and/or rectum have been surgically immobilized. Colostomies and ileostomies may be permanent or temporary.

Reasons for having an Ostomy

The reasons for having an ostomy vary. These include:

  • Colorectal cancer (cancer of the bowels).
  • Severe or repeated diverticulitis (infection of small pouches in the colon).
  • Crohn’s disease (inflammation of the digestive tract).
  • Bowel obstruction (causing a risk of rupture, leading to infection and internal bleeding).
  • Trauma or injury to the colon (knife, gunshot wound, or traumatic ordeal).
  • Emergency (usually occurring during another surgery).
  • Bowel incontinence (inability to control bowel movements).
  • Familial polyposis (an inherited condition causing the formation of polyps in the colon and rectum).

Adjusting to Your Ostomy

Whether temporary or permanent, adapting to your ostomy may be challenging, particularly in the beginning. You may find yourself regarding your body in an unexpected manner, seeing the change as a “loss” of the person you once were.

Proper care and attention to diet and fluid intake will go a long way in letting you experience a full and active life. With the elimination of the underlying condition that instigated the procedure, you may find the negative emotional changes you experience tempered by the relief of the freedom you have gained by way of the surgery. Mastering new skills, reaching out to others for assistance, and maintaining a positive attitude will be instrumental in adjusting to your now unfamiliar anatomy.

The more quickly you can solve the problems unique to your new situation, the sooner you will be able to integrate your circumstances into a life that works for you.

Issues that will arise may include:

  • Learning how your appliance works and how to care for it.
  • Consequences of eating certain foods.
  • Skin irritation.
  • Physical activity.
  • Social situations.
  • Work.
  • Sexual activity.

Becoming Accustomed to Your Ostomy Appliance

Your ostomy appliance is comprised of an adhesive wafer that covers the soma and a disposable pouch/bag that catches your waste, then replaced or emptied as required.

Today’s ostomy appliances lie flat on the abdomen, making them less perceptible under clothing. When used correctly, the system is dependable and odor-free, causing accidents to be rare.

Before you leave the hospital, you will be given detailed instructions on how to care for your soma and the surrounding area. These will include the daily tasks of:

  • Keeping it clean. It is safe to shower or bathe. Using only water rather than soap will lessen the chance that the pouch has trouble sticking to your skin.
  • Keeping the area smooth. Hair growing around the soma can make it harder for the pouch to adhere properly, as well as increase your discomfort. There is a product made specifically for shaving there.
  • Changing the pouch each morning before eating or drinking, as well as before it becomes full.

Your Ostomy and Diet

Avoiding diarrhea and constipation requires maintaining a well-balanced diet. The number of occurrences and quantity of bowel movements you have is dependent on your prior numbers, the type of ostomy used, the method of surgery, and your dietary routines.

Although you may eat whatever you want if your physician has given you the go-ahead, you may find that some foods now affect your digestion differently than before the surgery, causing gas, constipation, diarrhea, and poor digestion.

Gas-causing foods and drinks include, among many others, onions eggs, cabbage, broccoli, beans, carbonated drinks and milk; skipping meals may exacerbate gas even more.

Rather than the standard three meals, break them into several lighter ones throughout the day. It may help to chew your food completely, as well as to stay well hydrated by drinking plenty of water (at least six or more glasses a day).

If you feel you might be nervous or self-conscious when eating in public, first test individual foods in private to ascertain the ones that cause problems.

Also, observe your reaction to your medications, as some may also be the cause of constipation or diarrhea.

Your Ostomy and Activity

Hobbies

Although you should avoid strenuous activity for two to three months, unless there is a risk of injury to the stoma (ex. rough contact sports) you should be able to resume most physical activities such as running, walking, dancing, swimming, rowing, aerobics, etc. after you have healed.

Make sure you check with your doctor about any that might pose a problem and how to reduce the possibility of damage.

Work

Unless you are in a line of work that primarily involves manual labor, returning to your job when you are feeling well enough will help you become accustomed to the change in your life, both socially and physically. Reestablishing a routine can be an important part of your healing process.

Sex

Your ostomy does not prevent you from having sex and intimate relationships. Side effects such as erectile dysfunction or vaginal pain are usually temporary, improving with time.

The important thing is that you and your partner are comfortable, both open and honest about your concerns. Being supportive and understanding will help put to rest any awkwardness during the adjustment.

Ostomy Support

Although you may feel isolated and lonely in the beginning, you are not the only person who has an ostomy. Reach out to others within your community or online for advice, camaraderie, and first-hand experience. These people, who have been where you are, may not only provide suggestions for coping but also make you appreciate that you are not as alone as you believe.

In turn, you may do the same for someone else later.

 

General Surgeons

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