Can you bathe and shower? Do you have to wear the appliance while doing this? What about hot tubs?
Yes, of course you can bathe and shower. You can take the entire appliance off if you want to (remember that you can’t re-use the flange; a fresh one must be applied). You won’t hurt your stoma with direct shower spray, but if it is sensitive, you can protect the skin with your hand. All ostomates can go in a hot tub, but you may want to tape the edges of the flange so it’ll hold. You may need to change the flange if it melts down too much.
Can you swim, snorkel and dive?
Yes. If you have a filter on your appliance, this should be taped so water doesn’t damage the filter. You don’t necessarily have to buy special swim suits. One piece or two-piece suits that are high enough to cover the appliance work well for women. There are ostomy companies that make custom clothing if what you’re wearing doesn’t work. Ostomy appliances are also made that fit like a shower cap over the flange.
What if the appliance makes a noise in public?
There is no way to stop your ostomy from expelling gas. Ileostomies and colostomies can and will emit gas, which may not be audible to others. Snug clothing can help muffle a noisy stoma, as can a hand or forearm pressed over it. Stoma noises often sound like a rumbling stomach so people often assume it’s just your stomach if they notice at all. If it embarrasses you, consider cutting down on gas producing food or drink.
Sometimes the stoma bleeds – What do I do?
Stomas will bleed if cleaned too roughly, if the appliance is improperly applied, or if you accidentally scratch it with fingernails or cloth. This is normal and looks like spotting. It should stop soon if you dab the spots with tissue. Some stomas will bleed more easily than others, and certain medications (such as aspirin) can increase the likelihood of bleeding. Prolonged bleeding may indicate other problems and should be reported.
Nothing has come out all day – Is something wrong?
Just as people with an intact set of bowels can get constipated, so can you if you have an ostomy. So long as you feel well otherwise, periodic inactivity doesn’t mean anything is wrong. Drink grape or prune juice if things haven’t moved in a 24 hour period. Give your body a chance to sort itself out before resorting to laxatives, and if you do, take such products sparingly. Prolonged lack of output from an ileostomy is NOT normal and should be reported to your doctor or nurse.
What can I eat? - Will I need to change my diet?
There may be some modifications to your diet according to the type of ostomy surgery. People with colostomy and ileostomy surgery should return to their normal diet after a period of adjustment. Introduce foods back into your diet a little at a time and monitor the effect of each food on the ostomy function. Chew your food well and drink plenty of fluids. Some less digestible or high roughage foods are more likely to cause blockages (i.e., corn, coconut, mushrooms, nuts, raw fruits and vegetables.)
I am an ostomate with a hernia. Are appliances available to help me?
It is not uncommon for ostomates to suffer from hernias. This can complicate the fit of ostomy appliances. Ostomates with curves or bulges can suffer similar problems as devices may not adhere as well as they do on flat surfaces. Suppliers make an effort to design appliances to help with this problem, but Coloplast has recently put out a product designed specifically for patients with this issue. The Sensura Mio Concave is designed to fit the curve of bulges and hernias. For more information go to www.coloplast.ca.
When can I return to work?
Your doctor will be the best judge of when you are fit to resume work. If your job involved heavy lifting, you need to let your doctor know so he or she can recommend any changes to your duties. In most cases, patients can resume their work with no problems. It can take months to regain former strength and stamina, however, so you should discuss shorter hours or part-time shifts with your employer for the first few weeks. It’s also best to explain that you may need to take longer bathroom breaks than before.
I’m having leakage under my pouching system?
There are a variety of reasons why you may be having this problem. If you are not preparing your skin properly before you put the flange on, it could cause adherence problems. Where is the leakage occurring? If it’s always in the same area, evaluate the area for any creases or uneven surfaces such as scar tissue, incisions or your abdomen; even your belly button could cause an uneven surface under the area where the flange is to be applied. If this is the problem, you might try a barrier ring as a filler to even out the surface area. In any case, make sure you do not leave any skin exposed between the barrier and the stoma.
My skin around the stoma is irritated and weepy?
It is important not to have skin breakdown, broken wounds, or a rash under the barrier. Try using stoma powder to absorb moisture from the broken skin around the stoma, which may result in the barrier sticking more effectively. You will need to pinpoint the reason for the problem to find the best solutions. For example, where exactly is the skin breaking down, how long has it been a problem, have you had leakage or was the barrier removed too quickly, and what product are you using to prepare your skin for the barrier?
I am noticing an odor and I’m worried that others will too?
Odours can be caused by leakage or it can be associated with emptying your pouch. A lubricating deodorant is a great choice for neutralizing the odour of the stool when the pouch is emptied. You might also consider a pouch that has a filter, to neutralize the gases in the pouch. Make sure no stool drainage gets on the outside of your closure system. If the odour is not a result of these problems, the barrier might be starting to lift off the skin which can allow odour to escape and can be the beginning of leakage.
My pouching system is not staying on- What do I do?
It may be a problem with your barrier seal. Make sure you have one that you can count on. A good rule of thumb is to determine how many days you can rely on the product to provide a secure seal without leakage problems. Watch the back of the barrier when you change the pouching system. If you see stool or urine from the stoma that has leaked under the barrier, it’s a sign that the barrier seal is compromised and you can lose your seal to the skin. At that point, it’s time to change the barrier. You should be careful to change your appliance routinely, rather than trying to extend the life of the pouch to an extreme. The condition of your skin and stoma drainage under the barrier are the best indicators of the need to change.
What kind of discreet pouching systems are out there? I don’t want to be wearing something that is unsightly.
When a pouch fills with gas or drainage, it will start to balloon out and might show under clothing. You can burp the pouch by breaking the seal near the top and allowing gas to escape; it is easy to reseal the pouch. However, a pouch with a filter can help release the gas. Consider emptying your pouch when it’s a third to half full to avoid weightiness on the barrier. This can cause leakage. There are a variety of pouching systems out there from ostomy suppliers such as Hollister, Coloplast, and Convatec. There are both one- and two-piece systems. For a person with an ileostomy or a colostomy, there are drainable and closed-end pouches in various lengths. There are also options for transparent pouches, ultra clear and beige pouch films. There are also good choices for those with urostomies.
Is it normal to have discharge from a rectal stump?
In many cases, a person with a stoma still has a rectum, even though it is closed off. Sometimes, there can still be discharge from the bottom, where the rectum and the anus are, even though a stoma has been created. In many cases, this is a normal and expected occurrence and is nothing to be worried about. However, if the discharge from the bottom is bloody or smelly it should be discussed with a doctor.
My stoma is inward rather than outward and I have difficulty getting a tight seal with my flange.
A retracted stoma normally occurs when scar tissue pulls the stoma inward. However, there may be some cases where the stoma did not protrude immediately following surgery. In some cases, there may be a need for surgical repair, but to get a tight seal, you will need to find an appliance with a convex insert to help control the stool from slipping under the wafer. The convex design will help fill the gap.
I have a temporary ostomy. How long will I have to wait to have it reversed?
That depends on a number of factors. A reversal will only be done when you are in good health and have fully recovered from the effects of the initial surgery. This can occur within 12 weeks of surgery, but the timeframe may vary depending on factors such as whether you have taken chemotherapy and how well you have recovered from surgery.
The initial estimates from your doctor about the potential date of the reversal, may have to be extended because of your condition. There is no time limit for reversals and some people live with their ostomies for years before it is possible to reverse it.
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Nothing contained on this website should be considered medical advice. Medical advice can only be provided by an individual’s doctor or medical professional. A variety of excellent and accessible resource materials are available to answer these and other questions:
- The Ostomy Handbook includes a series of questions and answers, along with tips and tricks on how to deal with commonly experienced problems. http:/www.ostomytoronto.com/handbook.asp.
- The United Ostomy Associations of America Inc. have a wealth of useful material and answers for ostomates at www.ostomy.org.
- Many of the suppliers have good on-line resources to answer common questions and provide help. Hollister is a good example www.hollister.ca/en-ca/ostomycare/ostomycarelearningcenter/ostomyfaqs