After ostomy surgery

It is important to keep your skin healthy. Contact between stoma output and skin causes skin irritation that can affect how well the barrier on the appliance sticks to your body. This creates a vicious circle of more leakage and even more irritated skin – which is important to avoid.

Keep your skin healthy
These six steps will help you keep your skin healthy: 

1. Make sure your skin is clean and completely dry before applying the barrier
2. Adjust the hole in the adhesive so that it exactly fits around your stoma
3. Make sure that there is full contact between the barrier and your skin – use a bit of light pressure with your hand
4. Change your appliance as soon as you feel any discomfort or itching
5. Check the size of the stoma regularly, especially if you have a hernia
6. Make sure to use the stoma appliance and accessories most appropriate for your body profile 

Use the right type of appliance
There are many different types of stoma appliance, so make sure you choose one that fits your body profile.

Learn about Brava Accessories

Introducing our line of ostomy accessories designed to reduce leakage and take care of your skin.

You can choose between different pouch sizes, application systems, colors, barrier types and many other features to suit your lifestyle. See the product finder for more details.

Use the right accessories
Coloplast also offers a wide range of accessories to make wearing a stoma pouch even more comfortable. These can help improve sealing, prevent skin problems and reduce smell.

You can see more detailed instructions on changing and draining a stoma pouch in our instructional videos.

When you wake up after the operation you’ll be wearing your first pouch. This will probably be a clear one so that your nurses can check on your new stoma easily. You may also have drips and drains attached to your body. This is perfectly normal and they will be removed with very little discomfort when appropriate.

Your stoma
Your stoma will be moist and pinkish-red in color and should protrude from your abdomen (though it's also common for a stoma to remain flush with the skin surface). It may be quite swollen to begin with but will reduce in size over time – usually 6 to 8 weeks after surgery. Your stoma is a mucous membrane, just like the mucous membrane inside your mouth. There is no sensation in the stoma, so it is not at all painful to touch.  The stoma can bleed a little when being cleaned, especially in the beginning, but this is normal and should stop shortly afterwards.

Your stoma will begin to work shortly after your operation, usually within a few days. At first the output will be a watery liquid and may be strong-smelling as your bowel hasn’t been working for a while. Don’t worry, though, the consistency will thicken slightly and the smell will diminish as you resume a more balanced diet. Your doctor will advise you when you will be able to eat and drink as usual.

Initially, it’s also likely that a certain amount of noisy gas will come from the stoma – again this is perfectly normal. It is not uncommon to have an urge to use the washroom, as how you felt before having the surgery. This is normal and should reduce with time. If your anus is still present, there may be some mucus discharge from it.

Urostomy
If you have a urostomy, the stoma will begin to work immediately after your operation. The tubes -- called  "stents" -- placed in the urostomy will be left in place for seven to ten days. At first, your urine may be slightly red, but it will soon return to its usual color.

After your operation, your stoma care nurse will focus on helping you become confident in taking care of your stoma. It will help to have a close relative or spouse with you for this training.

Your nurse will help you with:

• Learning how to care for your stoma, including what to watch out for
• Re-ordering stoma pouches and accessories
• Your rights regarding reimbursement and other economic support relating to your stoma
• Other practical aspects of living with a stoma, e.g. food and drink, your social life, travelling and your intimate relationships
• Who to contact when you have questions
• Ostomy association support groups in your area

Ask questions
There will be a lot of new information to take in at once; it may even feel a bit overwhelming. Take your time and ask all the questions you need, as many times as you need to. The more you ask and try things out, the better prepared you will be once you are back at home.

Before you leave the hospital, your enterostomal therapy nurse will likely make arrangements for follow-up care to make sure you feel confident caring for your ostomy.

Overcoming challenges
Once you are home, you may experience some challenges caring for your stoma. But remember that your ET nurse, as well as our Consumer Support Specialists, will be more than happy to help you with any issues.

To contact our Consumer Support Team, please call 1-866-293-6349 or email casupport@coloplast.com

Sports

Exercise is good for everyone. What you can do now really just depends on what you did before. Swimming and walking are both great low-impact ways to keep fit and keep your energy levels up. Just remember that taking up sport again should be a gradual process. Talk to your ostomy nurse for advice on how to reduce the risk of getting a hernia.

Swimwear tips:

• Try before you buy. There is specialist swimwear available, but it should not be necessary

For women

• A one-piece swimsuit with detailing or patterns can help hide the ostomy pouch
• Swimwear with a panel across the stomach can provide extra support.
• Sarongs are great for covering up on the beach

For men

• Layering a pair of lycra or stretch material swimming trunks underneath shorts will help hold your stoma pouch in place.
  Sunbathing tip:

• Apply suntan lotion only after you’ve applied your pouch, as creams and oils may affect the prevent the barrier from sticking properly.

Diet

You don’t need to follow a special diet, but just like anyone else, some foods may cause gas or just not suit you.

If you think a particular food is causing problems, try cutting it out for a while – then reintroduce it into your diet later. If you do this three times with any suspect food, you’ll know if it’s really causing an issue.

Chewing your food really well before swallowing aids digestion. In addition, charcoal tablets from the pharmacy can help avoid gas, as can peppermint and fennel tea. Yogurt and yogurt drinks can help some people too.

Foods that can cause gas include broccoli, cauliflower, cabbage, spinach, beans (green and baked), onions, garlic, Brussels sprouts, cucumbers, sweet corn and peas.

Drinks
As before your surgery, how much fluid you drink will affect the consistency of your output. It’s very individual, but many people find fizzy drinks and beer tend to cause gas. Water, squash and fruit juice are better than tea and coffee, which can be dehydrating. As for alcohol, you can still have a drink as long as it doesn’t interfere with any medication.

Have a chat with your doctor or ostomy nurse if you have any concerns. 

Constipation
If you are suffering from constipation, adapting your diet will help. Everyone’s is different so you know what is normal for you. If you are passing gas, your stoma is working. Increasing your fluid intake will help with constipation, but if you have any discomfort or concerns please contact your specialist stoma nurse or pharmacist. If you haven’t passed stool for 3-4 days, they may recommend a laxative.

Diarrhoea
Occasionally, just like everyone else, you may suffer from a bout of diarrhea or loose stool. Don’t be too alarmed about this. A one-off episode of diarrhea may be caused by something you ate and will often resolve itself. However, three or more consecutive loose stools are a cause for concern as you risk becoming dehydrated. At this point, you should consult your ostomy nurse.

Dining out
Once you have a better idea of the types of foods that suit you, there’s no reason not to enjoy eating out again.

Start with a familiar restaurant and keep it simple – something like a pizza. When ordering, you don’t have to be too over-cautious, just sensible. Order what you want but be aware that rich foods and sauces may cause a problem.

If you’re concerned about particular types of food, try them out at home first so you know how you’re going to react, and then add them to your diet gradually.

If you normally have a drink at home, start with a smaller version of your usual, e.g. a small beer rather than a large one. This will help your body build up your tolerance to alcohol again.

Socializing
Whether it’s a quiet drink in your local bar, a meal out with your partner or going out with friends, nothing should stop you from enjoying all the social events that you were doing before your operation.

It may be helpful to set yourself small targets to start with. It could be something as simple as using a public restroom for the first time, visiting a restaurant or relative or planning a day away. Before long, you will be thinking about booking a holiday or even going out dancing.

When you meet new people, you don’t have to tell them about your condition, unless you are comfortable doing that. It’s entirely up to you.

Intimate relationships
Having any type of operation can affect how you look and feel about your body. Try and accept that it will take time to adjust. It’s not just about your stoma but your whole body.

Sexual activity doesn’t put you at risk of damaging your stoma and most people are able to resume a healthy sex life. It is natural to feel nervous so only do what feels comfortable, take your time and talk to your partner.

There are small ostomy pouches that can be used during intimate moments. Call Coloplast Consumer Care to discuss options for intimacy, or explore sample options online.

Whatever you decide to do, the most important thing is that you are comfortable with your decision. You may want to explain that you had major surgery because of a serious illness and now wear an ostomy pouch. This often leaves few other questions to be asked and people will see that you have a straightforward attitude towards your condition.

Family and friends
Being open and honest with the people close to you can help you get back to the life you had before your stoma surgery. In the beginning, it’s important for the people closest to you to understand that although you are back home, recovery from major surgery will take time.

Children
If you have young children or grandchildren you may feel that they are too young to understand. However, children tend to cope well if they are given the information in a simple way. Children will often pick up on secrets and hiding the truth from them can sometimes make them think a situation is more serious than it really is.

At work
Many people are concerned about telling work colleagues. And just like with family and friends, who you tell and what you tell them is entirely up to you. However it’s usually advisable to ensure that at least one person knows you have an ostomy. Then, in case there are any problems or issues, you will have someone to talk to. 

To help you better understand your ostomy system and discuss your needs with your enterostomal therapy nurse, here is a glossary of commonly used terms.

Baseplate: The part of an ostomy pouching system that attaches the appliance to your skin while you are wearing it. The adhesive must ensure close contact with the skin surface and protect it so that output from your stoma does not touch the surrounding skin.

Coupling system: This attaches the barrier to the pouch in a two-piece appliance, allowing the pouch to be changed without changing the barrier. It can either be mechanical, or adhesive.

Convexity: A specially shaped baseplate with an oval shell that puts light pressure on the skin around the stoma. It is designed to accommodate a stoma that is difficult to manage, for example, a retracted stoma that lies below the skin.

Extended wear adhesive: An adhesive that can be worn for a longer time period, or if there is “aggressive” output from your stoma. Some types of ileostomy or urostomy can have output that breaks down standard adhesives too quickly. Extended wear adhesives are generally used with two-piece appliances.

Filter: From time to time, your stoma releases gas. The filter included in the appliance has a deodorizing action which helps ensure there is no odor, one of the things that people often worry about. It also controls the release of the deodorized wind, so that your bag doesn’t inflate (which is also called ‘ballooning’).

Non-return valve: Urostomy appliances have a non-return valve to stop urine from flowing back to the stoma and help prevent urinary infections.