Key facts. A stoma is a small opening in the abdomen which is used to remove body waste, such as faeces and urine, into a collection bag.
Some people have a permanent colostomy or ileostomy. When you have a stoma, you need to wear a bag to collect your poo or urine.
If you have an ileal or colonic conduit, you will drain urine continuously into a bag attached to the stoma (called an ostomy bag). If you have a continent urostomy, you will have scheduled times that you need to drain your pouch with a plastic tube called a catheter.
Open the Velcro closures or remove the clamp and set it aside. Slowly unroll the tail, or spout, over the toilet. Bend over the toilet to help prevent splashing. Slide your fingers down the pouch to push out all the stool.
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.
Many ostomates worry about odour. If the stoma bag fits well there should be no smell except when changing it. If you do notice a smell from your bag, you should check it as there may be a leak under the flange and the bag will need changing.
If you have a colostomy, ileostomy or urostomy, a pouching system is used to collect stool or urine from the stoma. The system may have 1 or 2 pieces. They can also be closed-end or drainable.
You can drink alcohol. Alcohol can cause dehydration, so make sure to drink enough water. Remember to consult with your physician before using alcoholic beverages as alcohol may not mix well with your medication.
Change your pouch every 5 to 8 days. If you have itching or leakage, change it right away. If you have a pouch system made of 2 pieces (a pouch and a wafer) you can use 2 different pouches during the week. Wash and rinse the pouch not being used, and let it dry well.
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. Prior to swimming, make sure your seal is secure.
Ileoanal pouch surgery
Stool and gas will leave your body through your anus, as they did before surgery. At first, you will have more frequent bowel movements, up to 15 per day. You may have mild bowel control problems and may need to wake up from sleep to pass stool.
Instead of going to your bladder, urine will go outside of your abdomen. The part that sticks outside your abdomen is called the stoma. After a urostomy, your urine will go through your stoma into a special bag called a urostomy pouch.
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.
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.
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.
Cleanliness is one of the most important aspects when adjusting to life with a stoma. Once you've pushed the stool into the toilet, take some toilet paper and clean the inside and outside of the opening. Flushable wipes are very good to use in this instance, as they'll help eliminate any unsightly odor.
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.
Cleaning the stoma
Water does not harm the stoma. Clean and dry the stoma gently. Because the stoma has no sensory nerves, you could injure it without feeling any pain. The stoma may bleed a little when you clean it.
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.
Outsmart Gas
After getting an ileostomy, gas tops many patients' list of worries, Holder-Murray says. Gas may be worst right after surgery and get better over time as swelling in your abdomen goes down. “Most pouches contain a filter so gas can empty and keep your pouch relatively flat,” she says.
Passing wind with a stoma
When you have a stoma, there are only two options for gas. It has to come out of your stoma, or out of your mouth. From your stoma, gas usually leaks very slowly into your stoma bag.
Lifting weights can put a strain on your healing tissues after your surgery. If you want to resume weight lifting, talk to your doctor or ostomy nurse about a binder or hernia prevention belt to support your abdomen while you lift. Sit-ups and crunches can be uncomfortable with an ostomy bag, also called a stoma bag.