Ostomy gas
Gas can be caused by the foods you eat. It can also be the result of swallowing air. Drinking carbonated beverages, smoking, chewing gum and chewing with your mouth open can all increase the amount of air you swallow. If you are concerned about gas, you can use a pouch with a filter.
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.
Sometimes carbonated drinks may help. Massage your tunny around the area and also your stoma to try and encourage the blockage to work its way out. Lie on the floor, on your back and roll from side to side with your knees up to your chest. Try a hot bath for 15-20mins to help relax the muscles in your tummy.
Food and drinks such as carbonated beverages, beer, onions, milk, melons, cucumbers, chewing gum, or drinking through a straw can cause gas in the bag. Try to avoid having more than one of those during a single meal.
Air from the stoma causes the bag to expand and detach from the skin (ballooning) Ballooning occurs when air from the stoma inflates the bag and cannot escape through the filter. The resulting air pressure can cause the adhesive to detach from the skin.
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. This should start to improve as your bowel recovers from the effects of the operation.
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. The skin around your stoma should look similar to the skin on the rest of your body.
An overfilled or overweight pouch causes undue strain on the base plate attached to the skin, which could lead to leakage. Tips: Base your wear time on personal preference, your unique stoma, and your output. Change your pouch on a regular basis before it gets too full and leaks.
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.
Emptying your pouch before going to bed:
It's always a good idea to empty or change your stoma bag before you go to bed as it will help to prevent your bag from filling up too much overnight and disturbing your sleep.
The best position to sleep in when you have a stoma is on your back, or on your side. If you prefer to sleep on your stomach, this will be fine at the beginning of the night but increases the chances of leaks as the night progresses and your bag fills.
This most often takes at least 6 to 8 weeks. But in some cases it can take up to 12 months. Your bowel and anal muscles need to be working for the reversal to work well. The doctor rejoins the ends of the bowel that were separated.
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.
Ileostomy output will be liquid or pasty depending on your diet. You will need to empty your pouch about 6 –8 times per day. Never let a pouch become more than half full. It is best to empty the pouch when it is 1/3 full.
Taking a Skin Break
Many people enjoy leaving their skin uncovered for 15 to 30 minutes after taking their pouching system off. This is called a skin break. Taking a skin break can help with irritation or keep it from happening. You can decide if you want to take a skin break.
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.
Raw vegetables, including salad e.g. lettuce, celery, raw bell-peppers and spring onions. Hard to digest vegetables, including beans like butter beans or green/runner beans, sweetcorn, peas, mushrooms, cabbage, brussel sprouts, spinach, kale and spring greens.
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. If you're showering without your pouch, remove the skin barrier too. Try to create a routine that coincides with when you're due for a pouch change.
Especially right after surgery, you may lose some fluid due to the relatively large amount of stool (750-1300 ml). Thus it's recommended that you drink at least 2 litres of water per day plus the equivalent of what you lose via the stool.
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.