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What is an Ileostomy?
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Ileostomy is a surgical operation in which the end of the small intestine, the ileum, is brought out through an opening in the abdomen. The contents of the intestine, unformed stool, are expelled through this opening into an ostomy bag .The stoma is moist, pinky-red in color, and protrudes slightly from the abdomen. However, there is no sensation in the stoma and it is not painful.
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When is an ileostomy needed?
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An ileostomy is needed when the large intestine (colon) cannot be used and must be by-passed or removed.
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What kind of an ostomy bag should be used for ileostomy?
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An ileostomy bag or open bag is often used for ileostomy as the waste products of an ileostomist are often relatively liquid and produced in a continuous flow. If you empty the ileostomy bag you do not need to change the appliance so often and it can protect your skin.
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What is colostomy?
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A colostomy is an incision (cut) into the colon (large intestine) to create an artificial opening or "stoma" to the exterior of the abdomen. This opening serves as an alternate pathway through which the intestines can eliminate waste products until the colon is healed or other corrective surgery is done. The stoma is moist, pinky red in color and protrudes slightly from the abdomen. However, there is no sensation in the stoma and it is not painful.
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Why would you need a colostomy?
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A colostomy is needed for conditions such as "necrotizing enterocolitis" (an acute inflammatory disease of the bowel), "imperforate anus" (absence of anal opening) or Hirschsprung's Disease (a condition in which the nerves controlling bowel function are abnormal).
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What kind of a stoma bag should be used for colostomy?
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A colostomy bag or closed bag should be used for colostomy due to the firm consistency of the waste products and because there is no need to empty the bag. The colostomy bag is usually with a carbon filter so that intestinal gases can pass without leaving any smell.
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What is a urostomy?
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Urostomy is an abdominal opening from the urinary tract. The stoma for a urostomy is often built from a short length of ileum conduit and may look nearly the same as an ileostomy. But the difference is simple - if it flows urine then it is a urostomy and, if it flows digestive waste then it is an ileostomy.
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Why would you need a urostomy?
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Urostomy, or a urinary diversion, is needed when the bladder is not working properly. There are four major reasons for performing a urinary diversion, the most common being bladder cancer.
Others are birth defects, neurological dysfunction or chronic inflammation of the bladder.
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What kind of a bag should be used for Urostomy?
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Urostomy bags or open bags with an anti-reflux valve preventing the urine from flowing back towards the stoma are often preferable. There are 1-piece and 2-piece systems available: - 1-Piece Systems: In 1-piece systems the adhesive and urine bag are welded together. The advantage of using a 1-piece appliance is that it is easy to apply and the bag is flexible and soft.
- 2-Piece Systems: In 2-piece systems the bag and adhesive are two separate components. If your skin is sensitive, the 2-piece system might be preferable as you do not need to remove the adhesive frequently. The adhesive can stay on for several days while the bag can be changed as required.
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Will bathing or taking a shower require me to take off my ostomy pouch?
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No, there are no concerns about that. You can shower with the pouch on or without it. The stoma can be exposed to soap and water without causing any problems.
Water will not enter the stoma so you need not be concerned about that. Or you can keep the pouch on when bathing or showering.
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Do I continue with the same size and type of ostomy bag throughout?
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No, it is not necessary that you will be wearing the same ostomy pouch throughout after surgery. As the healing process occurs, the stoma may shrink in size and therefore, you might need to change the size of your pouch. And after the initial period of recovery, you might need to go back to a regular lifesyle, going back to work, etc.
In that case you might need to change the type of pouch you are wearing, in order to adapt to your present needs. Your caregiver might help you in selecting the change.
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What should alert me to change my stoma bag?
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When the area around the ostomy skin barrier begins to itch or burn, then this may be an alert for you to change the wafer. You have to be careful when you change and how frequently because too much or too little change may damage the skin. Usually, a ostomy pouch might need wearing between 3 to 7 days without change. It will also depend on the adhesiveness and sturdiness of the pouch.
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Should I shower with the ostomy pouch on or off?
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You can do either. Soap and water from the shower will not harm the stoma. If showering with it off, it is best to choose a time the stoma is least active, such as in the morning before eating or drinking anything. Water will not compromise the pouching system, however, if you have a pouch with a filter, you will need to place the sticker provided in the box over the filter. Once the filter gets wet, it does not work properly. Some will cover the pouch with plastic and medical tape to keep it dry.
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Do I need to use skin barrier film before placing my ostomy wafer/pouch?
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Stoma nurses have differing opinions on this. You should keep the peristomal skin healthy and use the skin barrier. It sets up the skin to accept the adhesive. Choose one without alcohol. If the skin becomes red or breaks down, it won’t burn.
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I feel rectal pressure or I had a bowel movement from the rectum. Is this normal?
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It is normal to pass mucous and/or stool from the rectum when you have an ostomy. One of the functions of the colon is to secrete mucous to keep things lubricated. This is still occurring even though you are diverted. If your surgery was emergent and you did not do a bowel prep to clean the colon prior to surgery, you will eventually pass what was remaining in the colon. If you have a loop colostomy or a loop ileostomy rather than an end ostomy, stool can travel down the part of the stoma that is still connected to the lower end. This allows the waste to travel the normal route.
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How often should I change the ostomy pouch?
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If you have a colostomy, the wear time of the colostomy pouch can be up to 7 days. It is important to keep the peristomal skin healthy and it is recommended to change the pouch every 5 days. If you have an ileostomy, wear time is 3-4 days. The output is more acidic from digestive enzymes and can breakdown the material of the barrier more quickly. Don’t wait for the system to leak before changing. You can be in control.
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Will people see my ostomy pouch under my clothes?
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Stomas placed in the lower right or left abdomen will usually be below the waist and sit underneath pants. This makes them less noticeable. For stomas placed in the upper abdomen can be a little more challenging. Wearing loose fitting shirts is helpful. Consider a pouch cover. For women, wearing a longer top will conceal the bottom of the pouch. For men, also wearing long shirts and avoiding tucking into the pants are a good idea. You may want to consider looking into a Wrap. This is an undergarment that men or women can wear around the portion of the abdomen where the stoma is. It minimizes the bulk of the pouch and has a pocket to support the pouch as it fills. Check out our ostomy support garments on Shop Ostomy Supplies website.
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What are the different types of ileostomy bags?
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There are 1-piece and 2-piece systems available: - 1-Piece Systems: In 1-piece systems the bag and the adhesive are attached together as one component. The advantage of using a 1-piece appliance is that it is easy to apply and the bag is flexible and soft.
- 2-Piece Systems: In 2-piece systems the bag and the adhesive are two separate components. If your skin is sensitive, the 2-piece system might be preferable as you do not need to remove the adhesive frequently. The adhesive can stay on for several days whereas the bag can be changed as required
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What are the different types of colostomy bags?
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There are 1-piece and 2-piece systems available: - 1-Piece Systems: In 1-piece appliances the adhesive and the bag are welded together. The advantage of using a 1-piece appliance is that it is easy to apply and the bag is flexible and soft.
- 2-Piece Systems: In 2-piece systems the bag and the adhesive are two seperate components. If your skin is sensitive the 2-piece system might be preferable as you do not need to remove the adhesive frequently from the skin. The adhesive can stay on for several days while the bag can be changed as required.
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What is the best way to take care of the skin around my stoma?
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Managing peristomal skin is one of the most important things. Although, some people feel one does not need to use a skin barrier film for protection, one should be “pro-active” in keeping the skin in good shape. It is recommended to use one. It is also recommended to clean the peristomal skin with water. Soap can leave a residue and most soaps have moisturizers in them. Adding moisture to the skin can hinder the adhesive for your next pouching system. Avoid using “baby wipes” or flushable wipes as many of these have moisture additives as well. If you develop skin redness or a rash, consider discussing with an ostomy nurse or your surgeon.
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Should I use a drainable pouch or a closed end pouch?
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An ileostomy pouch needs to be emptied multiple times day since the output is loose. A closed ended pouch is not appropriate. Insurance will cover 2 pouches per day. If you choose to go this route, it will be costly as you would need to pay out of pocket. If you have a colostomy and have 1-2 BMs per day, the closed ended pouch is economical and a good choice. Flushable liners are available and can be used for either ileostomies or colostomies but you will need to use a 2-piece system.
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How do I know which manufacturer to use?
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Hollister, Coloplast, ConvaTec, Nu-Hope, Micro-Skin all offer 1- and 2-piece pouching systems, flat or convex. Each manufacturer offers different options. As an example, some of the Coloplast lines are firmer than others. These feel more secure to some. While others like the flexibility of Micro-Skin. Velcro closures are different on each of these manufacturers'' products. Some may have a skin sensitivity to one brand, but not to others. Nu-Hope makes special molds for special needs. Coloplast offers deep convexity for those stomas that retract deeply when sitting. They also offer a “convex flip” for parastomal hernias. Once you are comfortable with managing your ostomy, it is recommended to request samples of others to see what features you may like better.
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My peristomal skin is red, raw or has a rash. What should I use?
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Firstly, check the fit of your skin barrier. The size and shape of your stoma can change with weight gain or loss, or the development of a parastomal hernia (a bulging around the stoma). If the skin is red but not moist, consider stoma powder and use a barrier film spray over the powder so your pouch will adhere well. If you develop a rash that is itchy, it most likely is a fungal rash from moisture (this occurs most often in warmer weather). Using an antifungal powder with each pouching change will help. Use a barrier film spray over the powder so your pouch will adhere well. Stop using it once the rash has resolved. If the skin is raw and moist, consider Marathon skin protectant (made by Medline). Once applied to the weepy skin, Marathon leaves a dry coating over the skin, allowing your pouching system to stick. Be sure to change the system in about 3 days to reassess the skin (you want to be sure it is healing).
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What is the difference between an ileostomy, colostomy ad urostomy?
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- With an ileostomy, the small intestine is brought up through the skin to create the stoma. The output is expected to be loose since the function of the colon is bypassed.
- With a colostomy, the colon is used to create the stoma. The output is based on where in the colon the stoma is created. A stoma closest to the rectum can have formed stool whereas the closer to the right side or small intestine, the stool becomes looser.
- A urostomy is made out of the small intestine. The ureters from both kidneys are connected to allow urine to drain from the body. This type of ostomy is placed when the urinary bladder needs to be removed.
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When is the best time to change the pouch?
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The best time to change is the time when the ostomy is least active. For ileostomies, this is usually the first thing in the morning before eating or drinking anything. Of course, if the pouch is leaking, it should be changed immediately. The same is true for colostomies. Urostomies are usually active most of the time.
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How often should I empty the pouch?
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It is recommended to empty the pouch when it is half full. The fuller the pouch, the heavier it becomes. The weight may cause separation of the barrier from the skin, causing leakage.
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How difficult is it to travel with an ostomy?
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Traveling with an ostomy is not difficult but requires some planning. Obtaining a TSA card from the United Ostomy Association is a good idea if you are flying. Carry supplies onboard in a carry-on bag in case your luggage is lost. Use disposable products when possible. Pack extra supplies, this way you can worry less about running out.
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Can you control a bowel movement with an ostomy?
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There is no sphincter muscle to stop the flow of stool from any ostomy. Ileostomies drain stool often. Urostomies drain urine often. Those with colostomies do not have control over stool output. However, if the stoma is in the sigmoid or descending colon and there is stool which has formed, irrigation is an option for controlling stool output.
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Can I swim with my ostomy?
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Absolutely! While pouching systems can get wet, there are many products available for “waterproofing” your system. Try barrier strips or occlusive/ transparent dressings placed around the edges. Try the Ostomy Secrets website for swimwear (for both men and women). It is recommended to keep an extra pouching system at hand just in case. Also, empty your pouch before jumping in.
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My stoma bleeds when I touch it. Is this normal?
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Yes, the stoma has many blood capillaries at the surface. They rupture easily when cleaning or touching the stoma. This should stop rather quickly. If the opening is too small and rubbing on the edge of the stoma, you may note more bleeding. If your pouch is filling with blood, contact your surgeon immediately.
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Does a stoma hurt?
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No. The stoma has no nerve endings and no feeling when touched or when it is draining air or stool. You should be cautious when wearing a seat belt or participating in contact sports.
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How will a Urostomy change my life?
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For most, a urostomy will improve your life. If you have been incontinent, you will no longer be worried about finding a bathroom.
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Can I work with a Urostomy?
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Yes, although it is recommended not to do very heavy lifting after a urostomy surgery.
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What about activities and sports?
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As long as your urostomy pouch is secure, you can participate in most activities. If you are involved with contact sports, it is advisable to wear a stoma guard (check out the Stealth Belt stoma guard).
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Do I need to change my diet?
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The only dietary restrictions are those needed for other health conditions. There are no restrictions or a specific diet for urostomy. However, it is important to keep hydrated.
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How will the urostomy affect intimacy or my social life?
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Sexual function is influenced by the reasons for which urostomy surgery is performed. If for cancer, more tissue is removed. With the many nerves found in the pelvis, the more tissue removed, the more nerves can be damaged, result in changes in sexual function. The urostomy itself should not interfere with normal sexual activity or pregnancy. A continent urostomy should not prevent one from dating and continuing relationships and friendships.
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How will the urostomy affect sleep?
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Our bodies drain urine continuously. Night drainage systems are available for connecting to your pouch, allowing you to sleep with urostomy night bag without having to get up to empty frequently.
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Will I need to wear different clothing?
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Most urostomates will need not change their clothing, including swimwear.
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