How to Care for Your Stoma After Leaving the Hospital: My Advice
Taking care of your stoma is a procedure you need to master once you are out of the hospital. While in hospital, the nurses are there to walk you through every step of your stoma care and their kind and encouraging words are what kept you going, helping you gain more confidence in yourself and your condition.
However, we are all different. While some are a bit more confident and can easily take off from where the nurses left, it's not that easy for others.
The days that follow your colostomy procedure can be confusing and challenging and there appears to be so much to learn about your new condition, one of them being how to take proper care of the stoma.
As a colostomy patient, you need to know the importance of taking care of your stoma, the pink cherry-like 'soft button' that’s your connection between your intestine and the outside, the opening through which faecal matter is expelled.
You need to familiarize yourself with the simple tasks associated with stoma care before you walk out of the hospital and one of the most important things you need to learn next to wearing a colostomy bag is ensuring that the stoma and its surrounding area (the pancake) is kept clean AT ALL TIMES.
The 3 Types of Stomas
Let me first mention that there are three types of stomas and they are either temporary or permanent, depending on the reasons for your colostomy procedure.
- Colostomy stoma - This type of stoma is usually on the left side of the abdomen and is an outlet for solid harder waste.
- Ileostomy stoma - The ileostomy opening is for softer faeces.
- Urostomy stoma - This type is a conduit for passing out urine.
All three are located in the abdomen.
Ileostomy and colostomy surgery may be temporary (reversible) or permanent (irreversible). A urostomy is always a permanent procedure.
How to Clean Your Stoma
Because the stoma acts as an opening through which human waste (faeces and urine) is expelled, it requires gentle cleaning at all times. In actual fact, it’s best to clean it every time you change your ostomy bag.
Cleaning around the stoma is no hard task.
If you are a mother caring for your young child, or a caregiver taking care of a spouse or an elderly relation with challenges, the patient's stoma nurse will teach you everything you need to know - how to use ostomy supplies, how to deal with/watch out for ostomy-associated mishaps, how to be encouraging to the patient by lifting their spirits if need be, and how to generally take care of a stoma.
First, I must mention that the basic requirement you’ll need for cleaning it is lukewarm water. Because the stoma has no nerve endings or pain sensors, if it comes in contact with very hot water whilst showering or bathing, for example, you won’t feel any scalding pain. However, that is bad for a stoma.
The following ways are essential for proper stoma care:
- When you take off your ostomy bag, gently but thoroughly clean the stoma perimeter with the wipes that come with your supplies. Ensure you clean the crevices in case bits of faeces is stuck there.
- Clean the skin around the stoma. It's the pancake area where the bag's faceplate adheres to. Use a fresh sheet of wipes to do this.
- You can shower without your ostomy bag if you wish but remember, If you have to do that, use a shower guard. If you don't, expect waste to be expelled at any point in time while showering. A bit unpleasant for some.
- If you experience any faecal leakage on your skin, wipe it off and clean thoroughly with dampened wipes. Leakages will cause irritation and are harmful to the stoma.
- Care for your stoma these ways, a minimum of three times a day.
Always make sure that you have ample supplies of ostomy products at all times. It would be inconceivable to run out of supplies suddenly. You won’t like the consequences!
What You Should Know About Your Stoma
Though a stoma may look raw, moist, and sensitive, it has no sensory nerves and is devoid of nerve endings. However, it will bleed easily if it is accidentally bruised, scratched, or pinched.
Even though the bleeding, which is usually slight, is no cause to get alarmed, if this does happen, ensure that you clean it gently but thoroughly with your wipes so as to guard against infection.
Remember, your waste passes out through this opening, so it's good to take care not to bruise your stoma in any way that will allow bruised spots come in contact with faecal waste.
Necessary Ostomy Supplies
Ostomy bags – This, of course, is essential and comes first. When you've had the procedure, as soon as you come round after surgery, you’ll find that the bag is already fixed in place.
Wipes - You'll always need these. A lot! Every time you change your bag, you will use wipes to clean around the stoma. If leaks occur (they don’t happen often, but they do occur), you need wipes. Ensure you dampen with clean warm water before wiping gently around the stoma. Check for caked waste in the case of a colostomy stoma. Clean the 'pancake' area with mild soap.
The wipes are dry and serve as washcloths, but they should NOT be reused.
Ostomates must avoid using any form of paper towel or tissues to clean the stoma. They leave little bits of tissue stuck on the moist stoma.
Soap - Mild, non-perfumed soap is best to cleanse the stoma and the surrounding area if it is visibly soiled, or if bits of faeces is caked around the perimeter. It's best to purchase your soap with your ostomy supplies and not use just any available bath soap you may have at home. If you have to, check the ingredients in the soap before use.
Avoid harsh skin cleansers that include alcohol because they will irritate your stoma and the skin around it.
Deodorant - You want to have a canister of this as well. While changing or emptying your ostomy pouch, you may want to spray a bit of this.
What I do is spray a couple of spurts around my abdomen before opening to empty or changing. Then after completing whichever it is that I'm doing, l spray just a bit around the bathroom. This takes care of lingering odour, especially if it’s a public toilet, like when you visit the mall or go to a restaurant!
Faceplate hole - This is of particular importance when caring for the stoma. It's the cut-out hole in the adhesive faceplate of the ostomy bag. The hole is meant to fit fairly snug around the stoma but many Ostomates cut this opening too small.
Holes cut out too small squeeze the stoma and this, in turn, causes bruising and slight bleeding. This will certainly trigger an infection if care is not taken.
On the other hand, if the hole you cut out is wider than the stoma, the surrounding skin will become exposed to clumps of human waste. This will cause irritation and/or become infected.
Ostomy bag change - Excessive changing of ostomy bags, and pulling, tugging or yanking the faceplate off the skin, may pull out the fine hairs of the abdomen, especially if you are hairy. This constant pull and tug will cause skin irritation for some. If you have a hairy abdomen, it is advisable to shave the area occasionally.
Shower protector - If you prefer to shower with your pouch off, it's good to consider using a stoma shower protector. This will protect your stoma from perfumed shower gels or bubble bath soaps. Also, for instance, if your stoma is emptying a bit whilst showering, it keeps waste from leaking into your body or into the shower tub.
What to Do Asides Caring for a Stoma
Once you start to get the hang of it, you can care for your stoma and manage it successfully. Like I mentioned earlier, taking care of a stoma is not complicated,
Asides proper management, take gentle exercises, like walking. This is good for you. And whenever you feel ready, you can gradually increase your activities, which will, in turn, encourage and improve circulation. Also, ensure you pay attention to your diet and avoid some foods that will upset your digestion and excretion of waste.
When you finally become more comfortable with having an ostomy and managing your stoma, you must resume your normal daily activities and start living your life once again.
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