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Stoma Problems to Expect If You Have a Colostomy

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I didn't realise there are common problems (some embarrassing) all ostomates have - leaks, noisy flatulence, pouch ballooning, and the like.


If you have a colostomy, there are some challenging situations you must expect. Some of them are quite funny, some embarrassing, and a few, disastrous. Even though this may appear worrisome, they are not really serious issues and therefore not worth worrying about.

With this article, you will know the major problems to expect, how to manage them, and even how to overcome them.

Being an ex-ostomate myself, I can tell you about the situations I had to face and conquer, and the ones that gave me some concern, and also let you know how I managed and eventually overcame them.

  1. Flatulence
  2. Loose stool
  3. Colostomy bag leaks
  4. Discomfort in the rectum
  5. Face-plate absorbing water
  6. Pancaking

1. Flatulence

This is a funny one. Personally, I found that passing gas into my colostomy bag was a comic relief of sorts. Why do I say this? Because gas passing out through the stoma is hardly ever silent. It can be quite noisy.

For some strange reason, it always reminded me of a burbling baby, something that sounds like blowing bubbles, quite cute but noisy.

Before the gas is expelled, you will get a funny feeling in your tummy, a 10 to a 15-second warning to let you know it’s on its way. Finally, the gas will erupt noisily into your bag. Learn to recognize this pre-farting feeling.

The not-so-funny side is that the sound IS loud enough to attract anyone within earshot, or someone sitting on the sofa across from you., but to handle this problem, I just had to approach it with some sense of humour.

How did I overcome this? If I am within earshot, which is usual, I simply chuckle or start to speak when the warning signs approach. I’ll say something like "sorry about this. I recently had a surgical procedure and I don't have much control over this bubbling sound for now". Surprisingly no-one visitor or stranger has ever asked about the sound, and if they did wonder, I will never know which was good enough for me.

A good solution is to lay off the fizzy drinks. They are an absolute disaster if you take some when you go visiting, to a party, or go out with friends.

2. Loose Stool

You will soon discover that foods with high levels of roughage like some fruits, cereals, and salads, for instance, are among the most efficient foods and produce the least amount of stool by ostomates. If you have to go out, these are good foods to eat before venturing out anywhere, or to a function. With these type of foods, your bag won't fill up unexpectedly and you won't need to go back and forth to the toilet for a change, a bag drain.

On the other hand, junk food like fast foods, rich restaurant dishes, beans, and such tend to produce the most waste in relation to consumption. So, watch what you eat before you go on an outing, to school, or to work.

Try to study your system to know which foods take a long to process in your digestive system, and which ones don't. What I did was to keep a mental note of my observations and adhere strictly to some a colostomy diet and made it a routine.

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At the time, a fellow ostomy patient told me this, "you don't want to eat pork and beans five hours before you go to a quiet church service, neither would you want to eat a fast food lunch if you were planning to travel a long road trip".

Loose stool will fill your colostomy bag in no time, so, plan your meals according to your daily lined up activities especially if you an individual who is always on-the-move. This way, you will avoid embarrassing situations, and you will be able to keep your inconveniences to the barest minimum.

3. Bag Leaks

This one is nasty and is one mishap you don't want to encounter, especially when you are outdoors. When bag leaks happen, faeces seep out through an open bubble in the colostomy bag's faceplate, and the very first thing you will notice is a slight whiff of faecal matter. You won’t miss that tell-tale odour.

Immediately you smell something, go and change your bag and replace the waxy faceplate if you are using a two-piece appliance. Never, ever dismiss this because it will gradually, within seconds, get worse and the odour will spread before you know it.

To avoid the embarrassment, use a seal ring. With a seal ring fitted, you can be doubly sure there' will be no leakages and no seeping odour. With seal rings, you can take a long bubble bath without worrying about a swelling face-plate causing leaking of gas or faeces.

I barely had any bag-leak problem and because I can detect smell faster than a bloodhound, I'm up and off to the loo before anyone notices. When I am far away from a public or private toilet, which is unusual, I know I'm in deep you-know-what, and so will you, so, take extra care to ensure your bag’s face-plate is firmly secured. If you are lucky, you won’t be in that situation often. I was fortunate not to be.

Ensure you carry along with you at least two spare colostomy bags and one faceplate (if you use the two-piece appliance) AT ALL TIMES. I usually had double that number with me. You can never be too careful. If a leak or blowout occurs, having enough spares will be a real lifesaver.

4. Discomfort in the Rectum

I vividly remember the first time I had discomfort in my rectum. It was a weird feeling of wanting to go to the toilet to defaecate and it was least expected because that area is supposed to have been sealed shut in my abdomen. It was so alarming that I had to call my doctor.

He calmed me down and told me that such was expected with some colostomy patients, but it is not a common occurrence. It can happen to some ostomates and not happen with others. He claimed that once in a while, I may eliminate rectally when I get this feeling. He recommended I use a very mild suppository and I did.

That is how I learned that the rectum will still produce mucus and when it accumulates, you’ll feel the I-need-to-go feeling. It has to be eliminated when it accumulates but the good thing is that if it happens at all, it only happens once in a while for most ostomates and what finally pops out is hardly larger than a grape.

If you experience this, don’t panic; it is normal. If it doesn’t pop out if you bear down gently, use a very mild suppository.

5. Face-Plate Water Absorption

The wax-like face-plate of a colostomy bag is fine if you shower or swim. Because you only spend a short time showering and it doesn’t absorb water fast, and if you plan to take a swim, as long as you don’t frolic in the pool for longer than half-an-hour or so, it will not absorb water and lift from your abdomen. The bag itself is waterproof.

When the face-plate absorbs moisture, it swells, becomes a pale white, and begins to lift off from where it has been attached on the stoma. The absorption starts at the edge and slowly, the wax starts to soften, becoming almost putty-like. Eventually, it spreads in towards the centre while losing its stickiness. At this point, the face-plate and bag will start to come off, or, the plate will start to form loose pockets.

How can you avoid this from happening? Swim for no longer than 45 minutes and ensure you change the whole bag if it is a disposable colostomy bag, or the face-plate piece if it is a 2-piece system.

6. Pancaking (or Patty-Caking)

An occurrence that many ostomates don't see as a problem but is an annoying one nonetheless is pancaking. It occurs when stool collects around the stoma instead of going right into the colostomy bag. This stool forms a 'cake', the shape of a pancake and thickens around the stoma, pushing its way underneath the flange or faceplate as it accumulates.

This can cause irritation problems if you are sore around the stoma and may cause an infection. Pancaking also causes unpleasant odour or leaks as it pushes and lifts part of the flange off from the abdomen.

But why does pancaking occur?

It is caused by one of two things. It is either your stool has a sticky or thick consistency, or the appliance's filter is over-effective, meaning it lets out gas too quickly, causing the bag to lay like it is ironed flat against the abdomen.

This problem can be tricky to resolve, but here are the ways I was able to resolve my pancaking issues whenever it occurs.

  • I increased my fluid intake: This is the #1 remedy and it is absolutely important because if you drink enough fluids, preferably water, your waste will not become hard or sticky.
  • Alter your diet slightly: Do this by increasing your fibre intake. This will help to alter the consistency of your stool.
  • Blow a bit of air into the colostomy bag: Before fitting on your appliance, blow some air into your bag. This helps to prevent it from flattening against your tummy.
  • Use filter stickers: Sometimes, the filter system can be over-effective so to avoid this, place a sticker (round white stickers that come with your colostomy supplies) over the filter hole. This way, the bag doesn't look 'sucked-up' and it will allow the gas that precedes stooling create more space for the stool to move freely down the bag.

Remember that your stoma is like an alien stuck to your abdomen and needs extra care and attention if you wish to avoid (or keep to the barest minimum) unforeseen situations or colostomy bag mishaps.

My Inspiration

This great book - I'd Like to Buy a Bowel Please - that I purchased a few weeks after my surgical procedure gave me a glimpse into the daily challenges to expect as a colostomy patient. What I loved most about this book was the incredible spirit and sarcastic humour woven into it, with examples from ostomates on how they coped and soon moved on with their lives.

The author's wit was a great inspiration to me and I'm sure it will be for many others living with a temporary or permanent colostomy.

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2015 Alobeda

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