- There are many kinds of pouches for use with an ostomy. With time, individuals can decide what type works best. The individual will need to empty the pouch four to six times a day if they have an ileostomy, and one or more times a day if the individual has a colostomy. For both types, individuals need to change the pouch every four to six days, and clean it if it is reused. Individuals also have to care for the stoma and the skin around it. An enterostomal therapy nurse (ETN) or a doctor will instruct the individual how to care for the stoma and skin. Individuals may want to join a group that can offer them and their families support and information about ostomies.
- Emptying the pouch: Healthcare professionals recommend to empty the pouch when it is a third to half full. The individual will probably need to empty the pouch four to six times a day.
- It is best to sit on the toilet with the pouch hanging between the legs, or to sit on a chair next to the toilet with the pouch opening aimed into the toilet.
- It is best to point the opening of the pouch into the toilet and remove the clamp that keeps the pouch closed. Slide the fingers down the outside of the pouch to squeeze the contents out of the pouch. Clean the inside of the pouch opening with a piece of rolled-up toilet paper.
- After emptying the pouch, the individual may rinse it out with room-temperature water. To do this, use a rubber ear syringe to squirt water inside the pouch. Tip the pouch to get the water up into the top. It can be emptied and rinsed again.
- The pouch can now be deodorized using specialized deodorants. The clamp can now be placed back onto the pouch to close it and the patient may wash their hands with soap and water. Gloves are also recommended by healthcare professionals.
- Skin and pouch care:
Ostomy pouches come in many styles: one-piece, two-piece, disposable, reusable, cut-to-fit, and pre-cut, for example. Some individuals prefer an opaque white or beige pouch to a clear one. An ETN or doctor can help the individual decide which type is best.
- When changing the pouch, the stoma and the skin around it should be checked. The surface of the stoma is mucous membrane that is pink or red and moist-looking. The stoma tissue has many small blood vessels, and may bleed when cleaning and wiping it. The bleeding should not be of concern unless it fails to stop. The stoma may get smaller during the first weeks after surgery.
- The part of the pouch that sticks to the abdomen is called a skin barrier wafer. The wafer opening for the stoma must fit snugly around it. Use the measuring guide that comes with ileostomy supplies to check the size of the stoma. As it gets smaller, the individual will need to reduce the size of the opening cut in the skin barrier wafer. If the skin wafer is too small, intestinal contents will leak and irritate the skin.
- Irritated skin may also mean that the wafer has been left on too long. If the stoma becomes red or irritated, it is recommended to let a doctor know.
- Cleaning and changing the pouch regularly will prevent unpleasant odors. The individual may also want to try different pouch deodorants. It may be best to change the pouch in the morning, before having anything to eat or drink, or at another time of day when the stoma is unlikely to be active. After time passes, the individual will probably get to know when to expect a bowel movement. If one is not on the way, the individual can take off the pouch and bathe or shower before putting on a clean replacement.
- The length of time that the pouch stays tightly secured to the abdomen depends on many factors, such as the size and shape of the stoma and the shape of the belly. Large amounts of watery bowel movement will shorten the wearing time. If the pouch stays on for only one or two days, it is recommended to let an ETN, or doctor, know about the problem.
- Changing disposable pouches: First, it is recommended by healthcare professionals to wash hands with soap and water. Use the measuring guide or pattern, trace the correct opening onto the skin barrier of the new pouch, then cut out the opening that was traced. Take off the paper backing that covers the adhesive on the skin barrier of the new pouch. Lay the pouch near with the adhesive side up.
- Empty the old pouch into the toilet. Remove the pouch by pushing down on the abdomen with the fingers of one hand and peeling off the pouch with the other hand. Remove the clamp from the old pouch and save it for use with the new pouch. Put the used pouch into the plastic bag and throw away.
- It is recommended to wash thoroughly around the stoma with mild soap and warm water. Do not use soaps that contain baby oil, cold cream, or perfumes. Rinse and dry the skin with a dry soft cloth. Do not leave any stool or wafer residue on the skin. The individual may want to shave or clip hairs around the stoma.
- Next, center the pouch opening over the stoma. Press the skin barrier wafer onto the abdomen. Make sure there are no creases or wrinkles in the wafer. Squirt some pouch deodorant into the bottom pouch opening. Move the deodorant around the inside of the pouch with the fingertips. Use a piece of toilet paper to wipe deodorant off the opening. Put on the clamp that was removed from the old pouch. If the deodorant causes skin irritation, contact a healthcare provider.
- Alerting medical care: A doctor should be called if the individual with an ostomy is vomiting or has diarrhea. Individuals who have an ileostomy can quickly get dehydrated. Signs of dehydration include dry mouth or tongue, a dry stoma, failure to urinate as much as normal, and dizziness on standing up. A doctor should also be called or the individual should be taken to a hospital if: they have severe abdominal pain; they vomit more than three times in one hour; they are too weak to stand up; they feel as though they are going to pass out; they cannot stop the stoma from bleeding; or they have an ileostomy and nothing has come out for several hours. This may mean that the intestines are blocked.
- American Academy of Family Physicians. www.aafp.org.
- American Gastroenterology Association. www.gastro.org.
- American Society of Colon and Rectal Surgeons. www.fascrs.org.
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- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). http://digestive.niddk.nih.gov.
- Natural Standard: The Authority on Integrative Medicine. www.naturalstandard.com.
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Copyright © 2011 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.