Ann Johnson is a professional trainer working with Smith + Nephew, teaching nurses current techniques in wound care. She worked for years as a Certified Would, Ostomy and Continence Nurse (CWOCN), during which time she dedicated herself to both caring for ostomates and empowering ostomates and their families to continue care at home. In an effort to address frequent patient concerns, Ann compiled a list of questions and answers that she included in a handout for new patients.
From general questions about activities and pouch maintenance to more specific issues of supplies and travel, the list covers a range of key challenges faced by both new and seasoned ostomates. We are providing this ostomy Q&A below in hopes that it can benefit even more ostomates, as well as educate the public on the myths and realities of living with a stoma.
If you have questions about ostomy care for ileostomy, colostomy or urostomy, consult the Q&A below. If there’s anything else you’d like to know, contact us and we’ll include your questions (anonymously) in the list!
Q: Will I be able to do the same activities as I did before surgery?
A: Yes. Having ostomy surgery does not usually affect your lifestyle. There are few exceptions such as heavy lifting (usually during the first three months after surgery) and contact sports. There are devices available to protect your stoma from possible trauma. Ask your ostomy nurse about these. If you have specific questions about lifting restrictions, ask your surgeon.
Q: Will my stoma hurt if I touch it?
A: Stoma tissue does not have pain sensors that respond to touch. You may feel pressure, but not pain. Pain is sometimes felt immediately after surgery due to the closeness of the incision line to the stoma and tenderness of the abdomen in general.
Q: Why is my stoma red? Will it always be this color?
A: Stomas range in color from beefy red to pink. The stoma is this color because this is what the lining of the intestine looks like. It should remain this color due to the rich blood supply it receives.
Q: Should I bathe or shower with my pouch on or off?
A: This is up to you. There is no health reason why you cannot bathe or shower with the pouch off. Soap and water do not harm the stoma. Remember that stool or urine may drain out while you are washing. If this is undesirable, bathe or shower with the pouch on, or pick a time when your stoma is least likely to release output. When coming out of the bath or shower be sure the skin is cool and dry before applying your pouching system. The skin barrier may not adhere well if your skin is too warm or if you use cleansers with lotion or oils.
Q: How often should I empty my pouch and what about rinsing it out?
A: You should empty the pouch when it is one-third full or urine, stool or gas. By keeping the pouch emptied you will not be as likely to see it under clothing or have it get so heavy that the barrier adhesive seal breaks. It is not necessary to rinse the pouch every time you empty it. Most manufactures do not recommend rinsing. If you wear a two-piece system you may remove the pouch and rinse with tepid water. If you rinse with hot water you may lose the odor proof capability of the plastic.
Q: My stool is thick and sticks around the top of my pouch. What should I do?
A: This can be very frustrating. First, make sure you are drinking enough fluids and eating and balanced diet which include fruits and vegetables. Second, you may want to use a lubricant in your pouch. There are commercial varieties which include a deodorizer as well. You place drops in your pouch which helps the stool to release from the top and move toward the tail. Also, before applying the pouch you may want to pull the pouch apart and allow air to reside in the pouch. By leaving air in the pouch there is room for stool to drop toward the tail.
Q: How can I control embarrassing odor?
A: Odor can be wearisome. Make sure the tail of the pouch is clean on the inside and out. Make sure the Velcro is free from waste if you have this type of closure. Check for leakage at the skin barrier. If you use a two-piece system be sure both pieces are securely fitted together. Take time to look over your diet. Is the food you eat a strong odor producer? Is there a food you could eat to combat odor? Many ostomy supply companies make deodorants you can add to your pouch or to the toilet when emptying the contents. There is also an odor reducing pouch cover on the market which works well. Room sprays help too. Ask your ostomy nurse about product specifics and where to obtain.
StomaCloak ostomy pouch covers are also an excellent tool to help you control embarrassing odors from your ostomy bag. The material of our covers actually changes the molecular structure of odor molecules, rendering them harmless and unnoticeable.
Q: When I empty my pouch I get splashed. How can I avoid this?
A: When emptying your pouch, place toilet paper in the bowl first. Get closer to the bowl by either standing directly over the water, or try sitting. Flush toilet while emptying. By doing these things there will be less splashing.
Q: How do I avoid the pouch popping off and resulting embarrassing mess?
A: Empty your pouch when a third full. Change your pouch at regular intervals. Avoid overuse of accessory products such as paste and adhesive removers. If using a two-piece system try using an ostomy belt. This usually extends the wear time of the system. Empty your pouch before going to bed. If you have a urostomy, use a night drainage system. Always carry a complete appliance change when you are away from home.
Q: Why do I need to bring supplies to the hospital?
A: Most hospitals carry ostomy supplies, but as there are many sizes and types the likelihood of having your exact appliance is slim. The hospital may have something similar that will work, but if you like your own or are particular with your own care be sure to bring a supply for your hospital stay.
Q: Help me! It is Christmas Day and I have run out of pouches. What do I do?
A: Never run out of supplies. Durable medical equipment companies are not open on holidays. Plan ahead by placing extra supplies in a backup area and then periodically rotate out into your current stock and place new supplies in the backup area. Always order when a few pouches are left. You cannot plan for the weather, which can delay supply delivery. It is best to keep a list of the equipment you use along with order numbers, sizes and manufacturer name. Let a family member know where the list is kept so they can access it in the case of an emergency.
Q: I am going to be traveling. Any special tips?
A: Traveling can be fun, but at times stressful. Try not to let yourself become too tired. Take care to inspect your appliance each day for potential issues such as slight leakage. Take twice the amount of supplies you usually would use, just in case. Research a list of retail suppliers and ostomy nurses available in the area before embarking on your trip.
Do you have any other questions for the ostomy nurse? Contact us with your questions and we’ll add the answers to our list. Every submission makes you eligible for a discount on StomaCloak ostomy bag covers!