A Colostomy is created when a portion of the colon or the rectum is removed and the remaining colon is brought to the abdominal wall, thus creating a stoma. Types of Colostomy:
Temporary Colostomy
Allows the lower portion of the colon to rest or heal. It may have one or two openings (if two, one will discharge only mucus).
Permanent Colostomy
Usually involves the loss of part of the colon, most commonly the rectum. The end of the remaining portion of the colon is brought out to the abdominal wall to form the stoma.
Sigmoid or Descending Colostomy
The most common type of ostomy surgery, in which the end of the descending or sigmoid colon is brought to the surface of the abdomen. It is usually located on the lower left side of the abdomen.
Transverse Colostomy
The surgical opening created in the transverse colon resulting in one or two openings. It is located in the upper abdomen, middle or right side.
Loop Colostomy
Usually created in the transverse colon. This is one stoma with two openings; one discharges stool, the second mucus.
Ascending Colostomy
A relatively rare opening in the ascending portion of the colon. It is located on the right side of the abdomen
The following guidelines will make care of
your colostomy easier. Keep this information
close by for quick reference.
Helpful hints
Eat a well-balanced diet including vegetables
and fresh fruits. Eat on a regular
schedule. Drink at least six to eight
glasses of fluids daily.
Eat slowly in a relaxed atmosphere. Chew
your food thoroughly. Avoid chewing
gum, smoking, and drinking from a straw.
This will help decrease the amount of air
you swallow, which may help reduce gas.
Eating yogurt or drinking buttermilk may
help reduce gas.
To control gas at night, do not eat after
8 p.m. This will give your bowel time to
quiet down before you go to bed.
If gas is a problem, you can purchase
Beano. Sprinkle Beano on the first bite of
food before eating to reduce gas. It has
no flavor and should not change the taste
of your food. You can buy Beano over the
counter at your local drugstore.
Foods like fish, onions, garlic, broccoli,
asparagus, and cabbage produce odor.
Although your pouch is odor-proof, if
you eat these foods you may notice a
stronger odor when emptying your
pouch. If this is a concern, you may want
to limit these foods in your diet.
Applying the pouching system
To apply your pouch, follow these steps:
1. Place all your equipment close at hand
before removing your pouch.
2. Wash your hands.
3. Stand or sit in front of a mirror. Use
the position that works best for you.
Remember that you must keep the skin
around the stoma wrinkle-free for a good
seal.
4. Gently remove the used pouch (one-piece
system) or the pouch and old
wafer (two-piece system). Empty the
pouch into the toilet. Save the closure clip
to use again.
5. Wash the stoma itself and the skin around
the stoma. Your stoma may bleed a little
when being washed. This is normal.
Rinse and pat dry. You may use a wash
cloth or soft paper towels,
mild soap,
and water. Avoid soaps that contain perfumes
or lotions.
6. For a new pouch (one-piece system) or
a new wafer (two-piece system), measure
your stoma using the stoma guide provided
in each box of supplies.
7. Trace the shape of your stoma onto the
back of the new pouch or the back of the
new wafer. Cut out the
opening. Remove the
paper backing and set it aside.
8. Optional: Apply a skin barrier powder to
surrounding skin if it is irritated (bare or
weeping), and dust off the excess.
9. Optional: Apply a skin-prep wipe to the skin
around the stoma, and let it dry. Do not
apply this solution if the skin is irritated
(red, tender, or broken) or if you have
shaved around the stoma.
10. Optional: Apply a skin barrier paste
around the opening cut in the back of the
pouch or wafer. Allow to dry for 30 to
60 seconds.
11. Hold the pouch (one-piece system) or
wafer (two-piece system) with the sticky
side toward your body. Make sure the
skin around the stoma is wrinkle-free.
Center the opening on the stoma, then
press firmly to your abdomen. Look in the mirror to check if
you are placing the pouch, or wafer, in
the right position. For a two-piece system,
snap the pouch onto the wafer.
Make sure it snaps into place securely.
12. Place your hand over the stoma and the
pouch or wafer for about 30 seconds.
The heat from your hand can help the
pouch or wafer stick to your skin better.
13. Add deodorant to your pouch. Other options
include food extracts such as vanilla oil
and peppermint extract. Add approximately
10 drops of the deodorant to the
pouch. Then apply the closure clamp.
Note: Do not use toxic chemicals orcommercial cleaning agents in yourpouch. These substances may harmthe stoma.
14. Optional: For extra seal, apply tape to
all four sides around the pouch or wafer,
as if you were framing a picture. You
may
use any brand of medical adhesive tape.
15. Change your pouch every five to seven
days. Change it immediately if leakage
occurs.
16. Wash your hands.
If you are wearing a two-piece system, you
may use two new pouches per week and
alternate them. Rinse the pouch with mild
soap and warm water and hang it to dry for
the next day. Apply the fresh pouch. Alternate
the two pouches like this for a week.
After a week, change the wafer and begin
with two new pouches. Place the old
pouches in a plastic bag, and put them in the
trash.
Applying your pouch
You may stand or sit to apply your pouch.
Keep the skin where you apply the pouch
wrinkle-free. If the skin around the pouch
is wrinkled, the seal may break when your
skin stretches.
If hair grows close to your stoma, you
may trim off the hair with scissors, an
electric razor, or a safety razor.
Always have a mirror nearby so you can
get a better view of your stoma.
When you apply a new pouch, write the date
on the adhesive tape. This will remind you
of when you last changed your pouch.
Changing your pouch
The best time to change your pouch is
in the morning, before eating or drinking
anything. Your stoma can function at any
time, but it will function more after eating
or drinking.
Emptying your pouch
Empty your pouch when it is one-third full
(of urine, stool, and/or gas). If you wait until
your pouch is fuller than this, it will be
more difficult to empty and more noticeable.
When you empty your pouch, either put
toilet paper in the toilet bowl first, or
flush
the toilet while you empty the pouch.
This will reduce splashing. You can
empty the
pouch between your legs or to one side
while sitting, or while standing or stooping.
If you have a two-piece system, you
can snap off the pouch to empty it. Remember
that your stoma may function
during this time.
If you wish to rinse your pouch after you
empty it, a turkey baster can be helpful.
When using a baster, squirt water up into
the pouch through the opening at the
bottom. With a two-piece system, you
can snap off the pouch to rinse it. After
rinsing your pouch, empty it into the toilet.
When rinsing your pouch at home, put a
few granules of Dreft soap in the rinse
water. This helps lubricate and freshen
your pouch.
The inside of your pouch can be sprayed
with non-stick cooking oil.
This may help reduce stool sticking to
the inside of the pouch.
Bathing
You may shower or bathe with your
pouch on or off. Remember that your
stoma may function during this time.
The materials you use to wash your
stoma and the skin around it should be
clean, but they do not need to be sterile.
Wearing your pouch
During hot weather, or if you perspire
a lot in general, wear a cover over your
pouch. This may prevent a rash developing
on your skin under the pouch. Pouch
covers are sold at ostomy supply stores.
Wear the pouch inside your underwear
for better support.
Watch your weight. Any gain or loss of
10 to 15 pounds or more can change the
way your pouch fits.
Going away from home
A collapsible cup (like those that come in
travel kits) or a soft plastic squirt bottle
with a pull-up top (like a travel bottle for
shampoo) can be used for rinsing your
pouch when you are away from home.
Tilt the opening of the pouch at an upward
angle when using
a cup to rinse.
Carry wet wipes or extra tissues to use in
public bathrooms.
Carry an extra pouching system with you
at all times.
Never keep ostomy supplies in the glove
compartment of your car. Extreme heat
or
cold can damage the skin barriers and
adhesive wafers on the pouch.
When you travel, carry your ostomy supplies
with you at all times. Keep them
within easy reach. Do not pack ostomy
supplies in baggage that will be checked
or
otherwise separated from you, because
your baggage might be lost. If you’re
traveling
out of the country, it is helpful to
have a letter stating that you are carrying
ostomy supplies as a medical necessity.
If you need ostomy supplies while traveling,
look in the yellow pages of the telephone
book under “Surgical Supplies.”
Or call the local ostomy organization to
find out where supplies are available.
Do not let your ostomy supplies get low.
Always order new pouches before you use
the last one.
Reducing odor
Limit foods such as broccoli, cabbage,
onions, fish, and garlic in your diet to
help
reduce odor.
Each time you empty your pouch, carefully
clean the opening of the pouch, both
inside and outside, with toilet paper.
Rinse your pouch one or two times daily
after you empty it (see directions for
emptying your pouch and going away
from home).
Add deodorant to your pouch.
Use air deodorizers in your bathroom.
Do not add aspirin to your pouch. Even
though aspirin can help prevent odor, it
could cause ulcers on your stoma.
When to call the doctor
Call the doctor if you have any of the following
symptoms:
purple, black, or white stoma
severe cramps lasting more than two hours
severe watery discharge from the stoma
lasting more than six hours
no output from the colostomy for three
days
excessive bleeding from your stoma
swelling of your stoma to more than
1/2-inch larger than usual
pulling inward of your stoma below skin
level
severe skin irritation or deep ulcers
bulging or other changes in your abdomen
When to call your ostomy nurse
Call your ostomy/enterostomal therapy (ET)
nurse if any of the following occurs:
frequent leaking of your pouching system
change in size or appearance of your
stoma, causing discomfort or problems
with your pouch
skin rash or rawness
weight gain or loss that causes problems
with your pouch
Disclaimer: The text presented on these pages is for your information only. It is not a substitute for professional medical advice. Please consult your healthcare provider if you have any questions or concerns.
