Ostomy Care, Adult

About this topic

An ostomy is an opening from the belly to the outside of the body. It lets you get rid of the bodys waste products. The opening is called a stoma. If the opening is coming from the small bowel, it is an ileostomy. If it is coming from the large bowel, it is a colostomy. Sometimes, the opening comes from the bladder and then it is a urostomy. A special pouch attaches over the opening to catch body waste. ‚
This procedure is done to treat: ‚

Blockage in the bowel and removal of part of the bowel
Cancer
Crohn's disease
Diverticulitis
Injury that goes through the bowel
Kidney failure
Removal of the bladder for reasons other than cancer, such as birth defects
Ulcerative colitis

You may have an ostomy for just a short time. This is often needed when the bowels or bladder need to heal. If part of the bowel or bladder was taken out or there is a serious disease, the ostomy may be long-lasting. ‚
Having an ostomy may be a challenge to accept. It may be hard to deal with. Learn how to take care of your ostomy. This may help you adjust to your condition. Then, you will be able to get back to a more normal life. Talk with a family member, friend, or counselor if you feel very sad about your ostomy. ‚

General

Normally, your urine or stool will empty directly into a small plastic pouch that is worn outside your body. The pouch protects you from odor and wetness. You will need to learn how to care for the pouch and your skin. ‚
Taking Care of the Pouch ‚
Empty the Pouch ‚

Pour out the contents of the pouch when it is 1/3 to 1/2 full. Avoid emptying the pouch when it is near full.
Wash your hands before and after touching your pouch.
Sit on the toilet and place the pouch between your legs. Remove the opening clip of the pouch and empty the body wastes into the toilet. Sometimes, it is easier to sit facing the back of the toilet.
Clean the end of the pouch with a moist paper towel or baby wipe. You may also rinse the pouch with water and drain the water. Close the end of the pouch by replacing the clamp.
For urostomy, it is suggested to empty your pouch first thing in the morning. Do this before you drink anything in the morning.

Change the Pouch ‚

You will need to change the entire pouch system every 3 to 5 days. You may need to change it more often if there is leakage around the site.
Gather all your supplies and wash your hands.
Gently take off the old pouch and any protective barriers.
Look at the stoma. It should be red and moist looking. Gently clean the skin around it with warm water and pat dry.
The new barrier will not stick if your skin is moist. If needed, apply a small amount of skin barrier powder.
Use your measuring grid to measure the shape and size of the stoma. This will be used to mark the opening into the pouch barrier. The size should be just where your skin and stoma meet.
Trace the correct size opening on the pouch barrier. Use scissors to cut an opening in the pouch barrier. Take extra care not to cut the pouch.
Center the new opening of the pouch over the stoma. Make sure it fits well on all edges. Trim the barrier if needed.
Remove the protective backing. Place the barrier on the skin around the stoma and press down for 30 to 60 seconds. You may want to save the protective backing as a template for the next pouch change.
Close the bottom of the drainage bag with a clamp.

Take Care of Your Skin ‚

Wash your hands before and after touching the stoma. Clean the stoma and skin around it with warm water. Do not use products with oil or perfume to clean the stoma.
It is normal for the stoma to bleed slightly when you clean it.
If the skin around the stoma becomes sore, remove the pouch and clean the skin.
Dry the stoma before replacing the pouch.
Your doctor may suggest other creams, powders, or different bags if you are having problems with leaks.

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Will physical activity be limited?

Exercise regularly. Talk to your doctor about the right amount of activity for you. ‚

What changes to diet are needed?

Once your doctor says it is OK, you may go back to eating the foods you like. Keep in mind, the foods you had problems with before will still cause you problems. For example, foods like broccoli, cabbage, or beans that caused gas will still cause gas. Foods that will help soften your stool, like fresh fruits and vegetables, will continue to do the same.
Drink 6 to 8 glasses of water each day to prevent too much fluid loss.

What foods are good to eat?

Eat soft foods that are easy to digest like: ‚

Boiled eggs
Yogurt
Cheese
Soft crackers
Cooked vegetables and fruits
Oatmeal
Whole-grain breads
Cereals

Your doctor may want you to eat foods with a lot of fiber to help prevent hard stools, or trouble making bowel movements. Examples of foods with a lot of fiber are: ‚

Baked potato
Bran muffins
Brown rice
Oatmeal
Prunes

What foods should be limited or avoided?

These foods may cause blockages if they are not chewed well: ‚

Nuts
Apples
Grapes

Limit or avoid drinking beverages with caffeine. ‚

What problems could happen?

Skin irritation
Hernia
Crystal formation around the stoma
Bleeding
Infection
Ostomy suddenly stops working or becomes blocked

When do I need to call the doctor?

Signs of infection. These include a fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain or numbness, redness and pus at the wound site.
Belly pain that keeps you from eating or sleeping
Change in skin color of the stoma
Rash or sores around the stoma
Stoma leaks more than usual
Very hard stools
Bowel movements suddenly stop
Black, tarry, or bloody stools
No urine or stool coming out
You are not feeling better in 2 to 3 days or you are feeling worse

Helpful tips

Join support groups to get to know other people who have coped with the condition.
If you are going to travel, bring extra supplies to avoid problems.

Teach Back: Helping You Understand

The Teach Back Method helps you understand the information we are giving you. The idea is simple. After talking with the staff, tell them in your own words what you were just told. This helps to make sure the staff has covered each thing clearly. It also helps to explain things that may have been a bit confusing. Before going home, make sure you are able to do these: ‚

I can tell you about my condition.
I can tell you how I will take care of my ostomy.
I can tell you what I will do if I have a rash or sores around my stoma.

Where can I learn more?

American Cancer Society ‚
http://www.cancer.org/acs/groups/cid/documents/webcontent/002870-pdf.pdf ‚

Consumer Information Use and Disclaimer

This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚

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