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Colostomy Care

WHAT YOU NEED TO KNOW:

What is colostomy care?

Colostomy care is how to change, empty, or clean your pouch system. You and your family will be taught colostomy care before you leave the hospital.

How do I empty my pouch?

  • Wash your hands. Put on medical gloves.
  • Empty the pouch when it is ⅓ to ½ full and before you change the system. Do not wait until the pouch is completely full. This could put pressure on the seal and cause it to leak or spill.
  • Hold the pouch up by the bottom end. If the pouch has a clamp system, remove the clamp. You may need to roll the end back to keep it from getting soiled.
  • Drain the pouch. Place toilet paper into the toilet before you empty the pouch to reduce splash back. Drain the pouch by squeezing the contents into the toilet.
  • Clean the end of the pouch. Use toilet paper or a moist paper towel. You may also rinse the pouch but it is not necessary. Keep the end of the pouch clean.
  • Close the end of the pouch. Unroll the end of the pouch. Replace the clamp or close the end of the pouch as directed.

How do I change my pouch system?

How you change your pouch system depends on the type you have. Your healthcare provider will give you specific instructions on how to change your system. The following is general information about how to change it:

  • Ask how often to change your pouch system. The type of system you use affects the amount of time it can be worn. Some pouch systems can stay in place for 3 to 7 days. Others can last 1 to 3 months and the pouch is changed more frequently.
  • Wash your hands. Put on medical gloves.
  • For a one-piece system:
    • Remove the pouch. Empty the pouch before removing. Gently remove the pouch by pushing the skin down and away from the adhesive skin barrier with one hand. With the other hand, pull the pouch up and away from the stoma.
    • Gently clean the skin around your stoma. Use mild soap and water. Do not use soaps that have oil or perfumes. Pat your skin dry.
    • Use a pouch with the right size opening. Use a pouch that has an opening that is ⅛ of an inch larger than your stoma. You may need to cut the opening to fit around your stoma. If the opening is too large, bowel movement can leak onto your skin and cause irritation.
    • Use skin barrier products to help reduce irritation. These products can help protect your skin and keep it dry.
    • Use slight pressure to place your pouch. Center the pouch over the stoma and press it firmly into place on clean, dry skin. It may be helpful to hold your hand over the new pouch for 30 seconds. The warmth of your hand can help stick the adhesive skin barrier into place.
    • Dispose of the used pouch correctly. If the pouch is disposable, place the old pouch in another plastic bag and throw it in the trash. If you use a reusable pouch, talk to your healthcare provider about how to clean it.
    • Remove gloves and wash your hands.
      Handwashing
  • For 2 piece systems:
    • Remove pouch and faceplate. Empty the pouch before removing. Gently remove the faceplate by pushing the skin down and away from the adhesive skin barrier with one hand.
    • Gently clean the skin around your stoma. Use mild soap and water. Do not use soaps that have oil or perfumes. Pat your skin dry.
    • Use a faceplate with the right size opening. The opening needs to be ⅛ of an inch larger than your stoma. You may need to cut the opening to fit around your stoma. If the opening is too large, bowel movement can leak onto your skin and cause irritation.
    • Use skin barrier products to help reduce irritation. These products can help protect your skin and keep it dry.
    • Use slight pressure to place your faceplate. Center the hole in the faceplate over the stoma. Press it firmly into place on clean, dry skin. It may be helpful to hold your hand over the new faceplate for 30 seconds. The warmth of your hand can help stick the adhesive skin barrier into place.
    • Dispose of the used pouch correctly. If the pouch is disposable, place the old pouch in another plastic bag and throw it in the trash.
    • Remove gloves and wash your hands.
      Handwashing

How do I care for my skin?

Look at the skin around your stoma each time you change your pouch system. Your stoma should be pink or red and moist. You may have a small amount of bleeding when you clean your stoma. This is normal. Your stoma will get smaller and become its normal size in about 8 weeks.

What types of foods can I eat after a colostomy?

  • Eat a variety of healthy foods. Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, and lean meats. Do not eat foods that give you cramps or diarrhea.
  • Limit foods that may cause gas and odor. These include vegetables such as broccoli, cabbage, and cauliflower. Beans, eggs, and fish may also cause gas and odor. Eat slowly and do not use a straw to drink liquids. Yogurt, buttermilk, and fresh parsley may help control odor and gas.
  • Drink liquids as directed. Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. This may help reduce constipation.

What are some problems that can happen with a stoma?

Most stoma problems happen during the first year after your surgery.

  • Stoma retraction happens when the height of the stoma goes down to or below the skin level. Retraction may happen soon after surgery if the colon does not become active soon enough. Retraction may also happen if you gain weight. The type of pouch you use may need to be changed to fit the stoma shape.
  • Peristomal hernia happens when a part of your large intestine bulges into the area around the stoma. A hernia may be more obvious when you sit, cough, or strain. Hernias may make it difficult to create a proper pouch seal or irrigate. You may need to change the type of pouch you use or wear a hernia belt. You may need surgery to repair the hernia.
  • Prolapse happens when a part of your bowel pushes out of your stoma. The stomal prolapse may be caused by increased abdominal pressure. Surgery may be done to fix the prolapse.
  • Stenosis is the narrowing of your stoma. Your healthcare provider may be able to stretch your stoma if it has mild stenosis. Severe stenosis can cause blockage and surgery is usually needed.

Where can I find support and more information?

  • United Ostomy Associations of America, Inc.
    P.O. Box 512
    Northfield , MN 55057-0512
    Phone: 1- 800 - 826-0826
    Web Address: http://www.ostomy.org
  • Wound Ostomy and Continence Nurses Society
    15000 Commerce Parkway
    Mount Laurel , NJ 08054
    Web Address: www.wocn.org

Call your local emergency number (911 in the US) if:

  • Your bowel movements are black or bloody.
  • Your stoma is bleeding and you cannot stop the bleeding.
  • You are too weak to stand up.
  • You have severe abdominal pain.

When should I call my doctor?

  • You have a fever.
  • You have a foul odor coming from your colostomy bag or stoma that lasts longer than a week.
  • Your skin around the stoma becomes red and irritated.
  • You have nausea, vomiting, pain, cramping, or bloating.
  • You do not have regular bowel movements through your stoma.
  • The size of your stoma changes.
  • You have questions or concerns about your condition or care.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© Copyright IBM Corporation 2018 Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or IBM Watson Health

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

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