November/December 2002
Page 6


The Ten Most Frequently Asked Questions Following Ostomy Surgery

By Jennifer Dore, RN, CETN

These are some of the most common questions I'm asked by my patients following ostomy surgery. I have provided very general answers to these questions. Please remember to discuss your specific concerns/questions with your E.T. (Enterostomal Therapist) nurse or doctor as every person's ostomy experience is unique and individual.

1. What about showering and bathing, will soap hurt the stoma?

People with ostomies shower and bathe both with and without their appliances according to their personal preference. Normal exposure to air or contact with soap and water will not harm the stoma and water does not enter the ostomy opening. In the case of the ileostomate, you may want to choose a time for bathing when the bowel is less active.

2. What can I eat? Will I need to change my diet?

There may be some modifications in your diet, but in most instances you should be able to eat a varied and well-balanced diet. Any dietary restrictions are highly individual. It is important to introduce foods a little at a time with plenty of liquids. For ileostomates, some less digestible or high roughage foods such as corn, coconut, mushrooms, nuts, popcorn, dried or raw fruits, and some vegetables are more likely to create potential blockage problems. People with colostomies and urostomies generally have fewer or no restrictions. It is important to drink lots of liquids and to chew your food thoroughly before swallowing. Ask your ET for a list of recommendations before or soon after you leave the hospital.

Questions???? 3. Will there be odor coming from the pouch?

Generally there should be no odor coming from the pouch as it is designed to be odor proof. Depending on the type of ostomy you have and what you have eaten, you may have gas and odor when emptying the pouch. There are a lot of products that can be taken orally or placed in the pouch to combat odor. Some people like to use room deodorizers preventatively before emptying.

4. Will I be able to wear the same clothes as before? How about belts, pantyhose, girdles, tight clothes and swimsuits?

After ostomy surgery, many people wear the same clothes as before. Depending on your stoma location you might find belts uncomfortable or restrictive. Some people chose to wear higher or looser waistbands on trousers and skirts. Pantyhose, girdles, and tight clothes will not injure the stoma, but they could inhibit the normal flow from the stoma to the pouch thereby breaking the adhesive seal and creating a leak under the wafer. Often people will wait a number of hours after applying a new wafer and pouch before wearing tight clothing or going swimming to make sure the paste or cement has set. As for swimsuits, steer clear of white ones as the outline of the pouch may be visible when wet. Many women prefer patterned suits with an inside panel for extra tummy control. Recently underwear and bathing suits that contain a provision for a pouch have been introduced for both sexes.

5. How long can I or should I wear one appliance between changes?

The adhesiveness and durability of systems vary. Anywhere from three to seven days is to be expected, or whatever makes you and your skin comfortable. Specialists say that changing an appliance unnecessarily frequently, or wearing one too long, may be damaging to the skin. After a few months most people learn how long a single appliance will last.

6. How many times a day will I empty the pouch?

It depends of the type of ostomy, what you eat, and how quickly it passes through your system. For most ostomates two to six times a day is to be expected. Ileostomates must empty more often than colostomates. Urostomates will empty even more frequently.

7. Is there a correct way to empty an ileostomy or colostomy pouch?

Most people with a colostomy or ileostomy find the easiest way is to sit on the toilet with the pouch between the legs, although there is no right or wrong way. Make sure to hold the closing clip and bottom of the pouch firmly before opening. It is a good idea to place some paper in the bowl before emptying to prevent back splash.

8. Will I be able to continue my daily activities once I recover from surgery?

Yes. Generally after surgery you can gradually resume the daily activities you were doing before. You may need to plan on doing certain things in a different way. For instance, ileostomates and urostomates need to take in a good amount of liquids. Unless there is a specific problem, your ostomy should not restrict daily living. With some people, such as those who have suffered from ulcerative colitis, an ostomy can greatly enhance the quality of that person's life.

9 Will I be able to resume or maintain an active lifestyle if I choose? Travel, camp, swim, etc.?

Most people with an ostomy lead active lives. Indeed, some are professional athletes. Unless you have a particular problem, you can look forward to traveling, swimming and most other activities. You may have to plan ahead more carefully, such as making sure you have extra ostomy supplies with you when traveling. Some doctors recommend avoiding contact sports to prevent injury to the stoma and may prescribe a plastic protector cap for the stoma during some activities. It's common for people to reinforce the edge of the wafer with waterproof tape and/or wear an ostomy belt during physical activities such as running or swimming.

10. What about medications? Can I take vitamins?

Time-released and enteric-coated medications may pass through the system of ileostomates too quickly to be effective. Remind each of your doctors that you have an ostomy. Checking with your doctor is a good idea before taking any medication, vitamins included.

Via Edmonton OA's Mail Pouch, April 2002, via Inside Out On-line Nov/Dec 2002.

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