What is Colostomy?
A colostomy is not a disease; rather it’s a diversional surgery to free the patient from the troubles that come with the disease.
A colostomy is a surgically created opening into the colon, diverting stool from its normal route. Medical conditions that may require bypassing or removing part of the colon include: diverticulitis, cancer, trauma, inflammatory bowel disease, or birth defects. A colostomy may be temporary or permanent, depending upon the reason for surgery.
What is a stoma ?
The surgically created opening to dispel the stools is known as a Stoma. The word Stoma comes from the Greek word for mouth στόμα pronounced Stoma.
Generally, a stoma will be pink and moist (like the inside of our mouths). A stoma will initially be swollen after the operation but this will reduce after 6-8 weeks. There are no nerves in a stoma so there are no sensations when touching it. Everyone’s stoma is different in size or shape.
Will I be able to lead a normal life after surgery ?
Like in any other surgery, once your strength returns, you can go back to your regular activities. Most people can return to their previous line of work; however, you will need to be in touch with your doctor regarding your daily routine so that any issues you face or fear facing, they can help you address them so that normalcy is restored at the earliest.
The surgery should not limit your sporting activities, though being careful in contact sports is adviced, avoid any direct blow to the Stoma, otherwise you can resume your activities without any worry.
Just as in any other surgeries, there are a few Dos & Don’ts. Weightlifting may result in a Hernia, Continous fast sprinting may result in stoma trauma, jogging is recommended. However, swimming, water sports etc. are all possible post surgery. Consult your doctor, he is your best guide in this matter.
Can I be socially active post surgery ?
Though the “Stoma” is created as a Life Saving measure, the loss of natural control and the change in physical appearance can leave a deep psychological impact often more severe than the reaction of patients who have undergone any other type of surgical excision. The fear of offending others because of malodorous secretions can make ostomates avoid social contact with friends and even their own family. However, these are all unfounded fears.
A colostomy patient will need to empty his bag/irrigate as many times as he would have prior to surgery. Normally, its just once a day, or maybe two or three times on some days.
An Ileostomate & Urostomate can empty their bags no sooner they get filled, just as prior to surgery, while the bag cannot replace the bladder in specification, the basic chore of emptying the bag is as simple as urination, except that here the bag has a tap to be turned on/off.
So there is no need to worry, just socialize as before without any worry.
You need not feel you have to explain your surgery to everyone who asks. Those who are just curious need to know only that you had abdominal surgery, or that you had part or all of your colon or bladder removed.
If you are considering marriage, thorough discussions with your future spouse about life with an ostomy and its affect on sex, children, and family acceptance will help alleviate misconceptions and fear on the part of the spouse.
If you have children, answer their questions simply and truthfully. A simple explanation will be enough for them. You may want to confide in your employer or a good friend at work because keeping it a complete secret may cause practical difficulties.
What about bathing, Should I bathe with or without my pouch?
You may bathe with or without your pouching system in place. If you wish to take a shower or bath with your pouch off, you can do so. Normal exposure to air or contact with soap and water will not harm the stoma, and water does not enter the opening. Choose a time for bathing when the bowel is less active. You can also leave your pouch on while bathing or use a bathing belt
What about my diet, should I be making Changes ?
There may be some modifications in 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 create potential for blockage problems (i.e., corn, coconut, mushrooms, nuts, raw fruits and vegetables).
There are no eating restrictions as a result of urostomy surgery. Urostomates should drink plenty of liquids each day following the Doctor's recommendations.
Will I be able to wear the same clothes as before?
Whatever you wore before surgery, you can wear afterward with very few exceptions. Many pouching systems are made today that are unnoticeable even when wearing the most stylish, form fitting clothing for men and women.
Depending on your stoma location you might find belts uncomfortable or restrictive. Some people choose to wear higher or looser waistbands on trousers. Cotton knit or stretch underpants may give the support and security you need. Some men finds that jockey type shorts help support the pouch.
While swimming, women may want to choose a swimsuit that has a lining to provide a smoother profile. Stretch/Lycra undergarments help support and smooth out any bulges or outlines. Men may prefer to wear a sleeveless vest with trunks if the stoma is above the belt line.
What about sex and intimacy? Will I be able to get pregnant after surgery?
Sexual relationships and intimacy are important and fulfilling aspects of your life that should continue after ostomy surgery. Your attitude is a key factor in re-establishing sexual expression and intimacy. A period of adjustment after surgery is to be expected. Sexual function in women is usually not impaired, while sexual potency of men may sometimes be affected, usually only temporarily, unless the prostate is affected, in which case your Doctor would give you the best possible advise.
In women, the ability to conceive does not change and pregnancy and delivery should be normal after ostomy surgery. However, if you are thinking about becoming pregnant, you should first check with your doctor about any other related/unrelated health problems.
Can I travel ?
Travelling is no bar. In fact many people with ostomies travel extensively, from business/work related trips to camping trips to cruises to plane excursions around the world. Take along enough supplies to last the entire trip plus some extra, double what you think you may need. Checked luggage sometimes gets lost, carry an extra pouching system and other supplies on the plane with you. When traveling by car, keep your supplies in the coolest part, and avoid the boot. Seat belts, once adjusted comfortably will not harm the stoma.
When going overseas, apart from the obvious extra supplies, you may like to take referral lists for physicians and medical centers, and some medication to control any diarrhea and stop the fluid and electrolyte loss. When going through customs or luggage inspection, a note from your doctor stating that you need to carry ostomy supplies and medications by hand may be helpful. For more information, see Ostomates on the move
What about medications? Can I take vitamins?
Self medication is not advised. Body absorption may vary with individuals and types of medication. Certain drug problems may arise depending on the type of ostomy you have and the medications you are taking. Make sure to consult your doctor regularly and even if you are visiting your family doctor, do share information about your surgery so that he can take adequate precautions while prescribing medication.
Will I always be wearing the same size and type of pouch?
The type of pouching system that was used in the hospital may need to be changed as the healing process takes place. Your stoma may shrink and may require a change in the size opening of your pouch. Your lifestyle may necessitate a change of the pouching system after a recuperative period. Make an appointment with your ET to evaluate your condition.
How do I empty the pouch?
The pouch is attached to your body, so you will definitely feel the pressure of its filling from time to time. Check occasionally to see if it needs emptying before you go out. Avoid keeping it too full as it may lead to leakage necessitating a change. For Colostomates, most find the easiest way to empty the pouch is to sit on the toilet with the pouch between the legs. Hold the bottom of the pouch up and remove the clamp. Slowly unroll the tail of the pouch into the toilet. Clean the outside and inside of the pouch tail with toilet paper. Replace the clamp.
For Urostomates & Ileostomates, the pouch comes with a tap for on/off functions.
How often should I change the pouch?
The adhesiveness and durability of pouching systems vary. Anywhere from three to seven day is to be expected. Itching or burning are signs that the wafer should be changed. Changing too frequently or wearing one too long may be damaging to the skin.
What should I do if hospitalized again?
Take your ostomy supplies with you since the hospital may not have your brand in supply. If you are in doubt about any procedure, ask to talk to your doctor.
Ask to have the following information listed on your chart:
- type of ostomy or continent diversion,
- For colostomates, whether or not your rectum is intact,
- Describe in detail your management routine and list the ostomy products used.
- For urinary stomas, do not take a urine specimen from the urostomy pouch, use a catheter inserted into the stoma.
When should I seek medical assistance?
You should call the doctor or an ET when you have:
- Hard cramps lasting more than two hours
- a deep cut in the stoma
- excessive bleeding from the stoma opening (or a moderate amount in the pouch )
- continuous bleeding at the junction between the stoma and skin
- severe skin irritation or deep ulcers
- unusual change in stoma size and appearance
- severe watery discharge lasting more than five or six hours
- continuous nausea and vomiting;
- the ostomy does not have any output for four to six hours and is accompanied by cramping and nausea
Ostomates On The Move…..
- Pre-cut all pouches at home, as you may wish to avoid having scissors in your hand/checked luggage
- Pack ostomy supplies in at least 2 places – hand & checked luggage.
- Take extra supplies in case you are stranded where supplies may not be available.
- A statement from your Doctor/Hospital stating your need for ostomy supplies might be helpful.
- In case of overseas travel, it may be a good idea to have all your critical Ostomy information written in the language of the foreign country, this translation effort will be most useful if you are visitng non English speaking countries.
- The translated information may also include details/words that are specific to Ostomates, this also be helpful.
About carrying scissors, Liquids, Gel & Aerosols on board aircraft: Please refer updated IATA guidelines on www.iata.org
Full Body Scanners (Advanced Imaging Technology;: While early use of these scanners sometimes caused embarrassing incidents for ostomates, as of now, the awareness levels havegone up and Ostomates need not fear the scanner.However, it may be a good idea to empty your pouch before entering the security line, so there will be little to feel if a pat-down is done. The millimeter wave scanners are sensitive enough that even an empty ostomy pouch will usually be detected. Therefore, you should be prepared to state that you have an ostomy when you get scanned. You may be asked to wipe your hand over the outside of your clothing in the area of your ostomy, and your hand will be checked for explosive residue. The documents you carry will more often than not vouch for your authenticity and avoid any embarrassing moments.
All screening at airports must be conducted in a way that treats passengers with courtesy, dignity, and respect. You may request that any personal screening be conducted in a private area.