Wash your hands before and after caring for your stoma. The best way to clean the skin around your stoma is to use warm water and a washcloth, or soft paper towels. The use of gauze or gloves is not needed.
The easiest way to clean your stoma site is to gently wash it with warm water using the dry wipes provided and then pat dry thoroughly using a clean dry wipe. Avoid using paper towels as these can get stuck to the stoma, always use dry cotton wipes.
Clean around the stoma with warm water and a soft washcloth each time you change the pouch. Water does not harm the stoma. You can even take a bath or shower without your pouch if you choose: There are no nerves in the stoma, so there is no feeling.
The best soap to use is anything that is unscented and has no oils or moisturizers because they interfere with adhesives and will cause your ostomy pouch to not stick as well. After your skin is totally dry, apply the skin prep in a thin and even layer around your stoma.
If skin is open, irritated, broken, raw or weeping:
To treat affected skin around the stoma you can use Stomahesive powder under the ostomy appliance. The powder is available from a medical surgical supplier.
Wash and dry your skin well, try not to use wet or baby wipes as they might prevent your pouch from sticking well.
You can bathe and shower as normal with your stoma and, unless you have been specifically advised otherwise, you can do so with the stoma bag on or off. It won't fall off in the water if you choose to keep it on and if you bathe with the stoma bag off, soap rinsing over the stoma isn't a problem.
Normal exposure to air or contact with soap and water won't harm the stoma. Water will not flow into the stoma. Soap will not irritate it, but soap may interfere with the skin barrier sticking to the skin. It's best to only use water while cleaning the skin around your stoma.
Clean the pouch
Wipe the inside and outside of the tail with toilet paper. This helps prevent any odor. Check both sides of the pouch for tears or holes. If you find any, put on a new pouch.
You may wish to keep your clothing loose for the first couple of weeks, because your tummy may feel uncomfortable. But the good news is that in a few weeks, you should be able to wear your usual clothes. Wearing tight-fitting clothes will not affect your stoma.
Skin irritation around your stoma is usually caused by leakage from your ostomy pouch and the output from your stoma getting underneath the adhesive and onto your skin. It is uncomfortable and can stop your pouch from working well.
Once home, avoid strenuous activities that could place a strain on your abdomen, such as lifting heavy objects. Your stoma nurse will give you advice about how soon you can go back to normal activities. At first you will pass wind through your stoma and then, usually within 2 or 3 days, you poo through it.
How often it needs to be changed depends on which type of bag you use. Closed bags may need changing 1 to 3 times a day. There are also drainable bags that need to be replaced every 2 or 3 days. These may be suitable for people who have particularly loose poos.
Also, it is normal to smell your ostomy output and gas when you are changing your ostomy bag. As you would if you went to the toilet the standard way to poo, it's natural for it to have a smell... After all, it is waste from your digestive system!
If you have higher fluid losses than the average person, it's best to drink the recommended 6-8 cups of fluid a day plus choose saltier foods and hydrating foods. Occasionally when someone has loose bowel movements, drinking more fluid can make them more dehydrated.
Sleeping on your back is a safe option, especially in the days and weeks after surgery. If you are sleeping on the same side as your stoma, you may feel a little vulnerable and worry that it may either hurt or you might roll onto your stoma and even your pouch. The mattress will support the ostomy pouch as it fills.
Change or empty your stoma bag before you go to bed
Always make sure you're going to bed with either a fresh or an empty stoma bag, depending on the type of stoma bag you use. This can help to reduce any anxiety you may have about leakages, as well as making sure your ostomy bag doesn't overflow throughout the night.
Sleeping positions with a stoma
Laying on your stomach may increase the chance of leaks if the stoma becomes active and the bag begins to fill up. There's not really a way around this. Ostomates usually know when the stoma is generally going to be active if they eat and drink at the same times every day.
In many cases, warm soapy water will be sufficient to remove a sheath or stoma pouch but, when it comes to particularly stubborn or residual adhesive, its always good to have medical adhesive removers to hand, to aid in the removal process.
Unlike a protruding stoma, a flush stoma does not protrude beyond the skin of the abdomen. A flush stoma, as the name suggests, is flush with the skin covering the abdomen. Flush stomas may be the result of a surgeon's chosen technique, or may occur over time, even though a protruding stoma was originally created.
Soap and water will not flow into your stoma or hurt it in any way. Here are some helpful tips: You can shower or bathe with your pouch on or off – the choice is yours. However, removing the pouch from a two-piece system before showering may weaken the skin barrier adhesion.