by Betzy McMaster RN, WCC, OMS, Wound Care Solutions
An ostomy is a surgical procedure that diverts a portion of the intestines to the outer abdominal wall to create a stoma that expels stool. It is estimated 450,000 people in the U.S. have an ostomy. It is a new way of living and with modern medicine, patients can experience a full life again.
Changes caused by weight loss, weight gain, sitting, standing or lying down can all change your abdomen’s contours around the stoma. Choosing the right pouch can be overwhelming because pouches collect the stool in a variety of methods. They come in one piece, two piece, flat, convex, cut to fit, pre-cut, transparent, opaque, Velcro closure, clip closure or a closed system. A new stoma will naturally decrease in size the first two months and cutting the pouch to fit correctly can be a key to limiting leakage.
A patient’s ability to measure their stoma will help fit the pouch around the area correctly. A stoma can be inverted, flat to the abdomen, protruding, round or oval. Another issue can be the stool that comes from the stoma can be too runny or too thick and that can cause the pouch to leak or be pushed off.
It’s also important to consider that the pouch placed on the patient in the hospital may not be the right pouch once they are home. The movement of daily living can change the pouch’s fit and cause leaking. Being able to empty your pouch is also essential to daily care. Because opening the pouch needs to be an easy process, it’s important to consider finger dexterity when making your selection.
There are products to help with less leaking, skin prep, strip paste, barrier rings, ostomy belts and outer pouch barriers. With a new ostomy, one should introduce food in small doses to see how their body reacts to it. Eating small meals throughout the day can help the body digest food more easily. It is common for post-ostomy patients to experience depression, which can lead to a decrease in appetite, changing the fit of the pouch. Additionally, depression can lead to the patient avoiding touching, looking at or caring for the ostomy, which can also cause leaking.
Accepting that this procedure saved your health or life comes slowly. However, life with an ostomy can be manageable once the patient, pouch and waste are all in sync.