Ostomy is major surgery and it brings a lot of changes in your life. Initially, you feel very disturbed and frustrated due to this dramatic change, but gradually you will learn to live with it.
Most of the patients complain about the following issues following a surgery:
- Red and annoying skin
- Dysfunction of stoma
- Adhesion problems
- Loss of water or dehydration
- Stomal problems i.e. bleeding prolapse, retraction
- Emergency conditions
In this article, we will discuss these problems and their solution so that you can easily handle your Ostomy.
Annoying or red skin:
You may notice that the skin around your stoma is turning red and irritated. This is the most common issue among Ostomy patients. The main reasons for this condition are pulling off tape and barriers roughly, feces contact with the skin.
What should you do about this?
- You should observe your skin each time you change your pouch. You can look all around your stoma by using a mirror.
- You should always measure your stoma and cut the barrier according to it.
- You should not wear it on the flange for a long time. The recommended time is three to five days. Pouch wearing time is dependent on
- Frequency of your pouch changing
- Sweating rate
- Physical activities
- Body physique
You can use skin-friendly powder if you feel irritation or wetness in your skin. Apply a little powder and remove the excess by using a brush. Then you can apply a skin barrier (pouching system).
If you notice that the feces is in contact with the skin or skin fold, you can use stoma paste or foldable rings to conceal the gaps.
If you have any questions do not hesitate to ask. If you delay any of your issues it might worsen your condition. You can take help from an ET nurse.
Determining some common skin issues
It may be a very difficult task to determine the cause of the skin problems. Given below are some common skin issues and how can you treat them. If you notice no betterment in next coming days, you should seek help. You can call your PCP and ET nurse.
Red skin above the stoma
If the barrier is not about the size of the stoma then you might notice redness above your stoma. Apply skin powder in case of wet and irritating skin and then apply skin barrier. You will observe that the stoma will look better in the coming 3 to 5 days.
Itching and red skin around the all-around stoma
In the case of sensitive skin and pulling off skin barrier roughly this condition takes place. You should remove the tape gently and slowly. You may use a remover (adhesive remover) or you have the option to try another pouching system.
Skin infections due to fungus
This happens mostly in wet and moist areas like under the flanges or skin folds. Initially, it becomes red and forms a bulge, and then it becomes hot red. Occasionally there is a white lining around the stoma. You may experience itching and soreness. You can seek help from your doctor or apply any anti-fungal ointment.
Hair follicle infection
This situation occurs nearby the entrance of the hair. Your skin under the flange should be completely dried before you apply the flange because wetness is the main reason for hair follicle infection. You should trim the hair nearby the stoma. You can use a scissor and electric shaver as well.
Do not shave over the wet skin.
Difficulty in adhesion of the skin barrier
The type of your pouching system depends on the type of your stoma. Some of the stomas are flat with the skin, some move inward and some outwards. Your Et nurse or stomal expert can help you to the best one for you.
How can you overcome this issue?
- If there is an adhesion problem then you should follow the below-mentioned steps:
- You should use a wet towel to clean your skin. You should was your skin properly after using any soaps or wipes ensuring that there is nothing on your skin.
- Make 100% sure that your skin is completely dry
- You should warm up your flange before applying it.
- You should trim your hair around the stoma
- In case if you sweat a lot then you must use skincare powder and remove excess of it.
- You should empty your pouch every 3 to 4 hours and use an ostomy belt for support.
- If you experience a problem is an adhesion and you need to change your barrier two to three times a day. You should call your ostomy expert for further solutions.
Excessive loss of water
If your consumption of water is less than loose of water then there can be excessive loss of water and salts from your body. This condition is termed dehydration. If there is frequent vomiting or stool, you have a high chance to have dehydration. That’s why most ileostomy patients need to come back to the hospital.
How can you treat this condition?
You must drink eight to nine glasses of plain water.
Don’t eat spicy and oily foods that lead to diarrhea.
You should not take foods such as caffeine, alcohol, carbonated drinks.
You should keep a record that how often you need to drain or empty the pouch.
Some common symptoms of dehydration:
- Feeling thirst
- Arid mouth
- Less urination
How to avoid diarrhea
You should increase the consumption of water. You can try supplement drinks, for example, broth, electrolytic drinks.
You should eat foods that result in thickened feces for example whole grains, pasta, bananas, bread, and peanut butter.
Your ET nurse and doctor can properly guide you about how to take oral replacements.
Dysfunction in stoma
Typically a stoma is always active. In case of nausea and cramps, you may feel blockage or you may experience zero output. These conditions are:
For the 4 to 6 hours after the ileostomy
24 to 36 hours after the colostomy
It might be because of food particles’ adhesion or blockage.
How can you treat this?
- You should chew your food properly. Avoid eating high-fiber foods like whole grains, raw veggies, and fruits, celery, skins, and corn.
- You should massage your abdomen near the stoma if food is the reason for the blockage.
- Blood from stoma
- You may notice some blood on your stoma while changing and emptying your pouch. The reason is that the stoma is very rich in blood supply. So there is nothing to worry about this.
How can you treat this?
- You should make sure that after changing the pouch the bleeding must be stopped. It may take few minutes.
- You should use a damp cloth or towel and apply gentle pressure for about 60 seconds.
In this condition, your stoma protrudes out, elongating the stoma.
How can you treat this condition?
- Until or unless the stoma is moist and red, there is nothing to be worried about. There is no emergency.
- If you are worried you can ask about this condition from your doctor and nurse.
- If you notice the shrinking of the stoma or if you feel your stoma is slipping inward this condition is termed stoma retraction.
- If your feces output is normal as before there is nothing to be worried about.
- You can seek help from your nurse and doctor and tell them about your condition. It may disturb the adhesion of your pouching system. Your ostomy nurse or team can help you in placing the pouching system properly.
- You should visit your ostomy nurse or doctor without wasting any time, if:
- There is a major cut in the stoma
- You notice the change in size, color, or orientation of your stoma. This could indicate there is an inadequate supply of blood to the stomal tissues.
- There are almost four tablespoons of blood in your pouch.
- Frequent vomiting and nausea
- Diarrhea and loss of water
- Intense skin problems (breakdowns)
- Obstruction in stoma output for almost four to six hours.