You are here: Home Looking After A Stoma
Everyone is different, and we will all have different ways of looking after a stoma. These are the notes that are relevant to me.
Emptying a bag.
People with Stoma's have strong stomachs - we need to - as the smell that comes from a bag comes from Satan's bottom himself. It's not very pleasant.
You should empty a bag if possible when it is about a third full - the contents are often very watery, and the last thing you will want is a leak, which trust me, is nasty!.
There are several different types and styles of bags on the market - but I will only concentrate on drainable ones here as these (in my opinion), offer more flexibility.
Most of the drainable bags come with a velcro connector - so it is simply a case of disconnecting the velcro whilst the bag is hanging over the loo (or else watch your feet), and pouring the contents down the toilet, watching out for splash backs (I speak from experience!).
I have found it easier to kneel on the floor and hang the pouch over the toilet rim before putting some toilet paper into the bowl - I do this as the contents are sometimes very "sticky", and tend to cling to the bowl. They also "stain" very easily.
Have some soft non-woven wipes and a wet wipe handy - they will help you clean up the bag exit slots. Once the bag is empty and you have cleaned up, fold the ends of the pouch again until the velcro snaps into place.
Changing a bag.
There are two distinctly different types of bag on the market - a one piece and a two piece - both have advantages and disadvantages between eachother.
Obvious, but empty the bag first!
I have found it easier to remove the old pouch using a adhesive remover spray - this dissolves the glue holding the bag on the body, and is a less painful way of removing than just warm soapy water! Spray a tiny bit onto the flange of the pouch and pull it away gently from the skin. You will find that once removed, remnants of glue may remain on the skin. If this is the case, adhesive remover is also available as a wipe.
Using a combination of wet and dry, non-woven wipes, clean the stoma of excrement that covers it, and take time and care to include the area around the stoma itself.
I used to use a barrier wipe - this is a wet wipe that contains a thin layer of cream which you place against your skin to protect you against the burn of excrement, but nowadays, I use a stoma cap - this covers the stoma and surrounding skin and helps protects it. Either way, apply cap/wipe. Leave for a minute or two to dry. Peel off the protective plastic from the flange, then place the stoma through the hole in the flange, pressing firmly against the skin to help adhesion.
That's all you need to do for one piece, but remember to seal the bottom of the bag using the velcro, otherwise your shoes will get dirty!
Depending on which manufacturer you are using, simply unclip the bag from the flange - then dispose of the bag in the clinical waste bag (you do have a clinical waste collection?). The flange will stay on the skin.
Cleaning around the stoma is a little more trickier with the flange attached, but using wet and dry wipes, clean the stoma gently. I have found it easier to clean the inside edges of the flange with a cotton bud.
Once clean, snap on a new bag, and as before, remember to seal the bottom!
If replacing the flange as well, follow the method described for one piece bags.
There are many accessories on the market today that can help an Ostomist - some are available free on the NHS (for those of us in the UK), others not. The few items I have here are part of a huge list, but I have only included items I use on a regular basis.
So, how do these help ? .....
Now you have a stoma, you may find (as I have) that some foods that were previously inaccessible are now digestible. However, you need to be aware that some foods can now cause you problems. Foe example ....
Foods that can cause excess wind
Foods that may loosen stools
Foods that can thicken stools
Foods that can cause nasty smells
Foods that can help control smells
Foods that may pass through undigested
Potassium And Sodium
These two minerals are lost every day with the fluids that appear in your bag - you can help replace these by eating one of the following foods that are high in potassium .....
and these are high in Sodium .....
The main thing is that all this is trial and error - everyone is different, and some people have higher tolerances than others. Also, you must remember to chew your food well, so that is broken down into smaller pieces. This helps the digestion and allows your body to absorb as much goodness as is possible.
Also, as you no longer have a large intestine, you must drink a great deal more to compensate. Two litres a day is considered average.