No. You should dry the skin only with a dry towel, or if you have time, allow it to air dry. You may possibly damage the skin with something flammable so you should avoid using that.
A problem with adhesion may be caused by the large amounts of gels used in routine ultrasound scanning which seeps into the adhesive tape or skin wafers. It is, therefore worthwhile changing the pouch after such scans, cleaning the skin beforehand to make sure that all traces of gel are removed.
Ultrasound scans may be complicated for women with urinary stomas by the absence of a bladder, which helps to give a clear view of the baby in early pregnancy.
Later, scans may be complicated by the position of a baby in relation to the stoma. When the baby's head is directly beneath the stoma, which is not uncommon, measurement of his or her head is not easy. As an alternative to abdominal scanning, you may be offered a vaginal scan which is also useful in detecting any early pregnancy problems.
Yes. Breastfeeding offers many advantages for both baby and mum. It is your choice.
Yes. You are advised to use a pouch when swimming in a pool or lake. Larger swimsuits or a T-shirt will cover the pouch.
Yes. You can bathe your baby with the pouch on or off. Water will not go into the stoma. If your child has a urinary stoma, check with your child’s physician before allowing the water to cover the stoma.
If you decide to leave the pouch off while bathing, don’t be surprised if the stoma functions when your baby is in the tub. After the bath, do not use any oily soaps or lotions around the stoma that may interfere with the barrier adhering to the skin.
Only give medications to your baby that have been prescribed by their physician. When starting a new medication, you may notice a change in his or her output. When filling a new prescription, tell your pharmacist that your child has an ostomy.
If that is the way they prefer to sleep and it is okay with your child’s paediatrician, it will not hurt the stoma. Empty your baby’s pouch before a nap or bedtime.
A special diet may be required by other medical conditions, but not because of the stoma.
New foods can be added to your baby’s diet as recommended by their physician. When a new food is added, it may change the colour or consistency of your baby’s stool or result in more gas. This is normal. Watch how they react to any new food. If it causes a problem with their output, consult your child’s physician.
You don’t need special clothes, but make sure waistbands don’t rub against the stoma. Some two-piece outfits may slide down and pull the pouch off, but they do make it easier to empty the pouch.
There seem to be few problems with urostomies during labour. Some women who have had an ileostomy or colostomy worry if the loss of a rectum means that they will not be able to have a vaginal delivery, but removal of the rectum is normally only a problem if damage has been caused to the nerve supply.
How much or how little they are told and whether or not you show the stoma to them really depends on how the family interacted before surgery and also how old the children are. All children have questions and will more than likely want to ask them. They will want to know the reason for the operation and what has happened. Honest and simple explanations are both important.
Before embarking on a pregnancy it is important to check with your doctor or surgeon as to whether you are now fit to go ahead. You may be asked to visit a gynaecologist for pre-pregnancy counselling to discuss any possible difficulties before pregnancy occurs. Once your doctor or surgeon says you are fit enough to embark on pregnancy, there is no reason why you should not do so.
This will vary from person to person. Always check with your doctor before starting any exercise program. As recovery progresses after surgery, it’s usual to feel occasionally tired and to have little desire for exercise. But it’s important for overall health and well-being to start moving around, even just a little bit at a time. Generally mild exercise like walking can start in the first few weeks after surgery and then you can build up your stamina and endurance.
Depending on your type of surgery, you may have some nerve pathways affected by the surgery. There are solutions. For dryness, a lubricating jelly can be used. If your partner wears a lubricated condom, this may help. If penetration is painful, there are alternative sexual positions to try. If the rectum has been removed, the missionary position (the female lying on her back with her partner on top of her) may be uncomfortable. One option is for the man to enter the vagina from behind, the female kneeling with her knees apart while the man kneels behind her. Another way is for the woman to sit astride her partner while he lies on his back, and she guides his penis into her vagina. Don’t forget that one of the largest sexual organs is the brain. If you are feeling tense, this may be also contributing significantly to the issue. Communication is always key. Discuss any concerns with your partner.
If you are single and meeting someone with the idea of marriage or a sexual relationship, the stoma will not remain invisible, so be prepared to talk about it openly and honestly. Honesty, particularly in this matter would be the best policy. It’s always possible that a prospective partner might not want to continue the relationship when he or she learns about your stoma. This is the kind of experience no one wants. If it happens, remind yourself that people without stomas are rejected for all kinds of reasons as well. In fact, if a potential partner loses interest, it may not be because of your stoma at all.
While travelling, it’s sometimes tempting to try to reduce the stoma flow by altering usual eating and drinking habits. But experience shows that it’s generally not advisable to vary normal routines. On the other hand, a fresh change into a new pouch before leaving gives extra confidence and provides maximum security from the possibility of leaks.
For most of us, insurance is a prerequisite for international travel, but it’s important to look closely at the policy’s small print to check whether age limits have been applied or exclusions added for pre-existing medical conditions. Such clauses could mean that the level of coverage may be insufficient. So if you have any doubts, just check with the insurance agent, broker or travel agent.
First, you should never notice odour while your pouch is intact. If you do, check your pouch seal for unwanted leakages. There are a variety of pouch additives that destroy odours in the pouch so odour is less of a problem when emptying. You may find some foods do increase odour; again, this will depend on the individual.
Below are some foods that people frequently associate with odour.
Foods that may help reduce odour are parsley, yogurt, and buttermilk, as well as orange or cranberry juices.
One of the first things to consider talking about with close family — particularly those sharing the same home — is that although the surgery is over, recovery takes time, and it can be a while before relative normality is restored. Some allowances will need to be made for this. Take it one step at a time and let your family know your goals.
Select a time when there will be peace and quiet in the bathroom or toilet. Make sure that everyone in the home knows that these areas may be busy for a certain period, and that this is extremely important. Knowing the right time to change your pouch will take a little practice.
Obtain a letter from your doctor or Stomal Therapy Nurse explaining your stoma and the fact you need to wear and carry with you certain medical supplies at all times. If they are insistent on searching you physically, request a private area with a medical person to verify your requirements for these items.
Unless you know that you or your partner are infertile or one of you has been sterilised, if you are sexually active and do not wish to get pregnant, it is always advisable to use contraception.
Generally no. What you will need to do is check that the place to which you are travelling has a safe water supply. Introducing suspect water straight into your stoma may cause you some problems. If in doubt, use bottled water for drinking, irrigating and even cleaning your teeth. It might be wise if you normally only wear a stoma cap, to take along some regular pouches (either closed or drainable) in case you have an episode of diarrhoea from either the food or water.
Yes. Just like a person without a stoma, constipation can be a common problem. A person with a colostomy, not ileostomy, is most likely to suffer from constipation.
Increase the amount of water you drink if not on a fluid restriction diet. Foods that help naturally with constipation include:
Yes, a blockage is serious, but fortunately it is not very common.
If you have an ileostomy and it stops working from its usual routine for several hours or so, and you have any swelling or pain in the stomach, chances are you have a blockage. If this happens, seek advice from a healthcare professional.
If you have a colostomy, it might be constipation. This is of less concern but still should be monitored. There have been some foods in the past associated more frequently with blockages, but this does not necessarily mean it will always happen.
Remember to always chew your food thoroughly and have an adequate fluid intake.
Below is a list of foods most commonly associated with this problem. Not everyone with an ileostomy who eats these foods gets a blockage!
First, be sure that you are not sick. If your stoma is too active, that is, if you need to empty your pouch once or twice every hour, you may be losing far too much fluid. If this suddenly occurs and it lasts 24 hours or more, you should seek medical attention.
If diarrhoea is infrequent, a simple change to your diet may fix or help the situation. Some foods are known to reduce stool output and others increase stool output.
Foods known to increase stoma output are fibrous foods such as stone fruits (plums, peaches, cherries, mangoes, etc.), raw fruit and vegetables, spicy foods, high fat foods, caffeine, nuts and corn.
Foods known to decrease or thicken stoma output are bananas, rice, apples and pasta. Some people go on the BRAT diet for a short period if they have diarrhoea. This stands for Bananas, Rice, Apples and Tea. Some other foods to help thicken loose output are:
The answer is yes and no. Gas is normal for everyone, and some people produce more than others.
If you found that a particular food gave you gas before your operation, it more than likely will now as well. However, if you have an ileostomy, it is not necessarily the gas you make or even swallow naturally. Instead, it may be the contents of the pouch “fermenting” in the bag that causes excess gas. Many pouches these days have filters that can vent the bag and thus deodorise it. You may wish to select this option.
Another possibility is a two-piece pouch that you can “burp” when it is convenient. This is done by simply detaching the top part of the pouch and expressing the excess wind out. Be aware that burping the pouch can lead to unwanted odour.
Here is a list of common foods and beverages that have been known to increase gas. Again, these may affect some people differently.
Some people, such as those who have had rectal surgery as well, will have rather sore or tender bottoms for a good while after their operations. The solution can be simple: make sure the chair is comfortable or there’s a cushion to sit on. These problems with the 'perineal wound,' as it’s known, usually disappear after a few months. If they don't, consult a doctor.
As far as jobs which involve a lot of bending and stretching are concerned, two useful things can help. Wear a pouch that can be attached to a stoma belt while working. This can give added security. Wear loose fitting clothing if needed or avoid constricting belts and tight trousers. A common problem is sweating at the area where the pouch is attached to the skin which can reduce the effectiveness of the adhesive holding the appliance to the skin. The pouch may have to be changed more frequently in these circumstances. Alternatively there are more durable skin barriers available that cope better with perspiration than others.
It might possibly be a fungal infection and not a rash. It would be best to get your skin tested by a dermatologist to see if it’s indeed fungal. Sometimes cortisone cream can make this rash worse. If you are prescribed an anti-fungal cream, make sure it’s an oil-free preparation or your skin barrier may not stick.
No. This is generally not a good idea as the shaving can sometimes either nick the skin leaving it open to infection or the hairs grow back underneath the skin giving unusual bumps or pimples. Using a clipper would be better as this allows a small amount of ‘stubble’ on the skin that still allows the barrier to stick and avoid unnecessary pain on removal.
It’s quite possible that this is tape sensitivity but it may also be skin stripping. Make sure when you are removing your product that you’re doing so gently by pressing the skin away from the tape instead of pulling the tape straight off. Sometimes remover wipes can assist with a more gentle removal. If this persists, you can try a skin barrier without tape and see if this fixes the problem.
If a relationship is becoming serious, it’s worth discussing your stoma before the relationship gets physical. If this information is whispered in a moment of passion, this is one surprise that might make the situation awkward. Plan ahead by rehearsing a short explanation. It might be easiest to start with the fact that there was a serious illness that had to be treated surgically. The result is that a pouch now needs to be worn. Once the decision has been made about how to talk about this situation, it will be easier to find a comfortable time to explain to a potential new partner about the pouch.
Of course, it’s possible that a sexual relationship can occur soon after meeting someone, before there’s time to get to know someone well enough to discuss such matters. This does raise the risk level of surprising them, as well as the risks everyone faces with casual sex. It’s always possible that a prospective partner might not want to continue the relationship when he or she learns about your stoma. This is the kind of experience no one wants. If it happens, remind yourself that people without stomas are rejected for all kinds of reasons as well. In fact, if a potential partner loses interest, it may not be because of your stoma at all.
If you take it routinely, carry a copy of your prescription with a letter from your doctor with you at all times. Some countries have tight restrictions on certain medications, particularly codeine-based medications. It would be wise to investigate your destination's specific laws before traveling there.
You may need to consider several options. If you are wearing an ostomy belt, that may be causing too much pressure. You could try wearing the product without the belt. Also some convex products cause a lot of pressure, you might want to try another manufacturer. It might be wise to see your Stomal Therapy Nurse as well. A simpler solution may be a seal or ring on a flat product to stop the leakage.
If your surgeon has given you the all clear, there is no reason why you can’t go back to your usual routine. Just remember to start off slowly and build up gradually. Also empty your pouch before you start any exercise and drink enough fluids to stay hydrated.
Recovery from a major operation takes time. People having stoma surgery are very likely to have been unwell before surgery, and this can slow the recovery process. Don’t expect to resume sexual relationships immediately after getting home from the hospital. Follow your doctor’s recommendations. Some people will start sooner than others. We are all individuals – so do what feels right for you and your partner.
Again, if the surgeon has given the all clear, then you can go back to your normal routine. Make sure your pouch is empty before starting. There are protective stoma guards in case you are worried about the stoma getting injured. Ask your Ostomy Association if they carry these.
To gain confidence that your pouch will stick, you can practice this at home. Just sit in a bathtub full of water for a while to assure yourself that the seal stays snug and leak-free. When diving into a pool, for added security, wear a snug bathing suit to help keep the pouch in place. Men can wear drawstring trunks, tightly fitted around the waist. Continual submersion in water may reduce the wear time of your pouch so avoid long swims and check the pouch when you leave the water.
Don't rush unnecessarily back to work. Going back too early is likely to cause more problems in the long run. Think of your return to work as a series of steps to be taken one at a time. The time it takes to get back into work varies from person to person depending on the severity of the disease, the reason for and type of surgery, recovery time, age and the type of job. It’s always a good idea to discuss this timing with your doctor or surgeon.
There are a few options. Firstly, empty the pouch before intercourse, it can then be folded up and secured with some tape. Some people find a cummerbund helpful as well as being discreet. In fact some men find that a cummerbund gives quite a slim line appearance and can be made to look quite sexy and discreet. You can also use a nice cotton pouch cover during sexual activity. There are many styles that can be specially ordered – some even made from black lace! Instead of using a transparent pouch, get one with a cover that hides the contents. There also are smaller activity pouches or caps which are discreet and can be worn just for these special occasions.
When you exercise you tend to sweat more. This excess sweat can affect your pouch adhesion. You may need to change your pouch more frequently or you could look for an extended wear skin barrier. These are designed to hold more moisture than a standard wear skin barrier.
This is very unlikely unless the cause of your ostomy is hereditary. There is no firm hereditary connection with either Crohn's Disease or Ulcerative Colitis.
Having a stoma makes absolutely no difference to the number of children you can have, although once any woman has had three Caesarean sections, doctors may advise against having any more children.
If you are planning to return to work, talk with your day care provider about your baby’s ostomy and make sure they have plenty of supplies. You should teach several people how and when to empty the pouch. Plan how a pouch leak will be handled when you are not there. Preparing for these situations in advance can alleviate anxiety and ensure that your child gets the best possible care when you are not around.
Yes. Planning ahead is important for any trip, but it takes on new meaning with a baby! Be sure you have plenty of supplies. If you are flying, take your baby’s ostomy supplies in your carry-on luggage. Changes in environment or routine may reduce the wear time of the pouch seal, so be sure to pack more than you think you will need. When in a car, your infant should always be in a car seat. Do not expose supplies to excessive temperature e.g. in a hot car.
As your baby becomes more active, there will be additional stresses placed on the pouch seal. This is frustrating, but normal. When they start to scoot, crawl, pull themselves up on furniture and walk, the pouch may come off more often. You don’t want to limit this healthy activity. Your child’s Stomal Therapy Nurse may have some tips to help improve the seal and to perhaps consider different pouches.
Children are naturally curious about their bodies and things around them. The pouch is no exception! It helps to dress your child in a one-piece outfit – even for naps. This can deter their exploration. A few toys in their crib can also help satisfy their curiosity.
For many, fatigue can be a real problem, even months after your operation. More often than not, people start back to work gradually, (perhaps a couple of mornings a week at first) before going back full-time. Unfortunately, it’s not always possible to do this in all jobs. It’s a good idea to check the employment and job rules at any place of work before requesting or receiving either time off work or reduced time.
Impotence can be both psychological and physical. Sometimes it occurs because the man believes or comes to believe that he’s unable to have an erection or reach a climax. This can become a vicious cycle of failure and loss of confidence. First, try and not stress too much as this can make the problem worse. There are several options to look at. The causes of impotence can be physical. For men, there’s a risk that the nerves governing erection and ejaculation can be damaged in surgery. Age can be an important factor too. You should talk with your doctor about tests to see if there are any physical reasons why this could be occurring. If there are, you can then discuss the right options for you.
It can be normal, depending on what you have been eating. Some foods and medicines can cause change in urine and stool colour, but if you have doubts, contact a healthcare professional. Here is a brief list of the most common culprits:
Pastes generally contain alcohol. If your skin is broken, the paste will sting on application but this usually goes away as the alcohol evaporates. There are lower-alcohol pastes available or you can try using a seal or ring instead of paste to fill in these uneven surfaces. These generally are alcohol-free.
There are a number of things that can affect the skin barrier. In warmer weather, the skin barrier may not last as long. Changes in diet or a new medication may impact its effectiveness. Often, as babies start teething, parents notice a change in the stool. This can cause the skin barrier to wash away and not last as long as before.
Most of these are temporary situations. If the problem persists, check with your child’s Stomal Therapy Nurse. They may be able to recommend a skin barrier that is more durable.
Occasionally, the colour of the stoma will change. Sometimes, when a baby cries, the stoma becomes almost white. If the colour change is temporary – less than a few minutes – it is usually nothing to be concerned about.
There should not be an odour when the pouch is on securely. If there is an odour, it usually means there is a leak in the pouching system or the spout of the pouch is not clean. Odour eliminators can help when the pouch is emptied or changed.
Gently clean the skin using something soft like a cotton ball, washcloth or chux cloths moistened with water. It does not need to be sterile. If you use soap, be sure to rinse completely. Most baby wipes add moisture to the skin which interferes with the barrier sticking well, so they are not recommended.
In Australia, your child will be joined to an Ostomy Association and be supplied with products needed for stoma care under a federally funded scheme with minimal costs. Your child's Stomal Therapy Nurse will discuss this with you and arrange application to an association.
If you had a normally functioning reproductive system before surgery, and your medical condition is under control, and surgery has not made a negative impact, chances are high you should be able to become pregnant. Having a stoma for many women has not made the slightest difference in the ability to conceive. However, it is always recommened to talk with a professional first before trying - such as a gynaecologist, to make sure.
Not necessarily. If it is the early days following surgery, you might find that some things don’t agree with you. However, in time, as your body readjusts, you may be able to go back to these foods.
Trial and error can help you determine what you can and cannot eat. First, test to see if the food will work for you. Always reintroduce slowly.
Certainly. The most important factors in successful breastfeeding are the correct positioning of you baby at the breast making sure that your baby is 'latched on'—and feeding your baby 'on demand', not by the clock. Make sure that you and your baby are comfortable before you start to breast feed and experiment with the position that suits you best—whether this is sitting up or lying down.
It is helpful to have an empty pouch before feeding as an active baby can dislodge a fullish pouch or cause it to leak.
Attending parentcraft classes is an important part of your ante-natal care and there is no reason why you should not take part in the exercises, although as your abdomen enlarges you may find certain exercises may cause the pouch to become loose and leak.
It may be advisable to let the person running the class know that you have a stoma if they are not already aware that you have one. Ask her for advice if necessary and remember to empty your pouch before the start of the class.
As your abdomen enlarges, your stoma may also change shape. It may often become more oval and may either become shorter or longer. As a result, it may be necessary for you to change your pouch type as it is vital to maintain an accurate fitting if damage to both the skin and the stoma is not to occur.
It is important to keep measuring your stoma from time to time and change the size of your pouch as necessary. Most women find that soon after delivery their stoma quickly reverts back to its original size.