Most people will be able to feel their bowels move and know when poop is about to come out. But you won't be able to control it anymore. Unlike your anus, your stoma doesn't have a muscle system that allows you to close it at will. So pooping won't be the intentional action that it used to be.
With an end colostomy, 1 end of the colon is pulled out through a cut in your tummy and stitched to the skin to create a stoma. An end colostomy is often permanent. Temporary end colostomies are sometimes used in emergencies.
However, lots of stoma bags do have filters that stop there being any pong. From time to time, some people do experience fart-type noises from their stoma. Thankfully, this usually doesn't happen regularly.
Permanent ileostomy – the small intestine cannot be reconnected and closed back together. Regardless of whether the rectum has been removed, you may feel the need to have a bowel movement (phantom sensation). This is normal and should ease with time.
Some common complications of stoma include poor siting, parastomal hernia (PH), prolapse, retraction, ischemia/necrosis, peristomal dermatologic problems, mucocutaneous separation, and pyoderma gangrenosum. Each will be discussed separately in further detail.
Signs of Stoma Problems
The stoma is no longer beefy red or pink but pale in appearance. The stoma is no longer moist in appearance but seems dry. Your stoma turns dark red, purple, or even black in color. Your stool from the stoma is always watery or diarrhea.
This is usually due to the filter becoming wet or blocked from stoma output.
When the skin barrier isn't properly adhered to the skin to create a seal, your ostomy can leak odor, gas, and even stool or urine under the barrier.
What is pancaking? Pancaking occurs if the internal layers of the stoma bag stick together causing a vacuum which prevents the contents from dropping to the bottom. The stool remains at the top of the stoma bag which can potentially block the filter. The bag can also be forced off the body.
Many people worry that their colostomy will give off a smell that others will notice. All modern appliances have air filters with charcoal in them, which neutralises the smell. Most people will be aware of the smell of their colostomy because it's their own body.
For people who wear two-piece appliances, gas can easily be released by “burping” the pouch. Slightly separate the pouch from the flange at the top of the appliance (complete removal of the pouch is not required) to allow the gas to escape. Once the pouch is empty, reattach the pouch to the flange.
Eating and drinking directly before bed can cause your stoma to be more active overnight and will result in a full bag. If you find that, regardless of what you do, your stoma is very active at night, you can try taking something like Imodium to slow down your output.
You must still include fibre in your diet. Choose some foods from the following list daily: Wholemeal bread. High fibre cereal e.g. Weetabix, porridge.
If you allow it to get too full, the weight of the stool may pull the pouch away from the skin. A person with an ileostomy will need to empty the pouch about five or six times in a 24-hour period. If you have a colostomy, you will need to empty the pouch two or three times in a 24-hour period.
One major issue to watch out for with a stoma is the laxative effect of some chocolates. The caffeine and fibre within the chocolate can increase the rate of motility (which is the contraction of the muscles in the digestive tract that encourage bowel movements).
You can bathe or shower with or without wearing your pouching system. Normal exposure to air or water will not harm or enter your stoma.
Issues or problems with the skin around the stoma is probably the most common complication for ostomates. Not only is having sore skin extremely uncomfortable for the patient but it can also compromise the attachment of the bag to the skin causing leaks and leading to further skin damage.
A Parastomal Hernia (Stoma Hernia) is a weakness or protrusion in the muscle wall of the abdomen at the site of a Stoma which allows the abdominal contents to bulge out. The bulge often protrudes more when coughing or undertaking physical activity.
Make sure your clothes are not too tight around the bag.
You may need to be careful that waistbands do not rest below the stoma restricting ability to drain into your pouch. Depending on stoma placement, you may feel more comfortable with high- or low-rise waistband items, like underwear, jeans, or activewear.
If your current stoma bag has a filter and you are still experiencing ballooning problems, it may be suffering from excess wind. Spicy foods, some particular vegetables (onions, cabbages, peas, and beans) and fizzy drinks have been known to increase wind, so we would recommend avoiding these in your diet.
You can swim or be in the water while wearing your pouching system. Remember, your pouching system is water-resistant and is designed not to leak with the proper seal. Water will not harm or enter your stoma.
Will my bag 'inflate' on the plane? The cabin pressure on a plane shouldn't have any effect on your stoma or inflate your bag.
When you are first discharged from hospital after your stoma surgery, you will feel tired and find everyday tasks such as having a shower exhausting. This is normal and will improve over time.
Try several different body positions, such as a knee-chest position, or lie on the side of your stoma with knees bent, as it might help move the blockage forward. Massage the abdominal area and the area around your stoma. Most food blockages occur just below the stoma and this may help dislodge the blockage.