Colostomy
Content
Colostomy Care Information for Patients
The following guidelines will make care of your colostomy easier. Keep this information close by for quick reference.
Helpful hints • Eat a well-balanced diet including vegetables and fresh fruits. Eat on a regular schedule. Drink at least 6 to 8 glasses of fluids daily. • Eat slowly in a relaxed atmosphere. Chew your food thoroughly. Avoid chewing gum, smoking, and drinking from a straw. This will help decrease the amount of air you swallow, which may help reduce gas. • Eating yogurt or drinking buttermilk may help reduce gas. • To control gas at night, do not eat after 8 p.m. This will give your bowel time to quiet down before you go to bed. • If gas is a problem, you can purchase Beano. Sprinkle Beano on the first bite of food before eating to reduce gas. It has no flavor and should not change the taste of your food. You can buy Beano over the counter at your local drugstore. • Foods like fish, onions, garlic, broccoli, asparagus, and cabbage produce odor. Although your pouch is odor-proof, if you eat these foods you may notice a stronger odor when emptying your pouch. If this is a concern, you may want to limit these foods in your diet.
Applying the pouching system To apply your pouch, follow these steps: 1. Place all your equipment close at hand before removing your pouch. 2. Wash your hands. 3. Stand or sit in front of a mirror. Use the position that works best for you. Remember that you must keep the skin around the stoma wrinkle-free for a good seal. 4. Gently remove the used pouch (1-piece system) or the pouch and old wafer (2-piece system). Empty the pouch into the toilet. Save the closure clip to use again. 5. Wash the stoma itself and the skin around the stoma. Your stoma may bleed a little when being washed. This is normal. Rinse and pat dry. You may use a wash cloth or soft paper towels (like Bounty), mild soap (like Dial, Safeguard, or Ivory), and water. Avoid soaps that contain perfumes or lotions. 6. For a new pouch (1-piece system) or a new wafer (2-piece system), measure your stoma using the stoma guide (Fig. 1) in each box of supplies.
(Fig. 1) continued
COLOSTOMY CARE
7. Trace the shape of your stoma onto the back of the new pouch or the back of the new wafer (Fig. 2). Cut out the opening (Fig. 3). Remove the paper backing and set it aside.
11. Hold the pouch (1-piece system) or wafer (2-piece system) with the sticky side toward your body. Make sure the skin around the stoma is wrinkle-free. Center the opening on the stoma, then press firmly to your abdomen (Fig. 4). Look in the mirror to check if you are placing the pouch, or wafer, in the right position. For a 2-piece system, snap the pouch onto the wafer. Make sure it snaps into place securely.
UPMC Information for Patients
(Fig. 2)
(Fig. 4) 12. Place your hand over the stoma and the pouch or wafer for about 30 seconds. The heat from your hand can help the pouch or wafer stick to your skin.
(Fig. 3) 8. Optional: Apply a skin barrier powder to surrounding skin if it is irritated (bare or weeping), and dust off the excess.
13. Add deodorant (such as Super Banish or Nullo) to your pouch. Other options include food extracts such as vanilla oil and peppermint extract. Add about 10 drops of the deodorant to the pouch. Then apply the closure clamp. Note: Do not use toxic chemicals or commercial cleaning agents in your pouch. These substances may harm the stoma.
9. Optional: Apply a skin-prep wipe (such as Skin Prep or All-Kare) to the skin around the stoma, and let it dry. Do not apply this solution if the skin is irritated (red, tender, or broken) or if you have shaved around the stoma. 10. Optional: Apply a skin barrier paste (such as Stomahesive, Coloplast, or Premium) around the opening cut in the back of the pouch or wafer. Allow it to dry for 30 to 60 seconds.
14. Optional: For extra seal, apply tape to all 4 sides around the pouch or wafer, as if you were framing a picture. You may use any brand of medical adhesive tape. 15. Change your pouch every 5 to 7 days. Change it immediately if a leak occurs.
2
continued
COLOSTOMY CARE
UPMC Information for Patients
16. Wash your hands.
Emptying Your Pouch
If you are wearing a 2-piece system, you may use 2 new pouches per week and alternate them. Rinse the pouch with mild soap and warm water and hang it to dry for the next day. Apply the fresh pouch. Alternate the 2 pouches like this for a week. After a week, change the wafer and begin with 2 new pouches. Place the old pouches in a plastic bag, and put them in the trash.
• Empty your pouch when it is one-third full (of urine, stool, and/or gas). If you wait until your pouch is fuller than this, it will be more difficult to empty and more noticeable. • When you empty your pouch, either put toilet paper in the toilet bowl first, or flush the toilet while you empty the pouch. This will reduce splashing. You can empty the pouch between your legs or to one side while sitting, or while standing or stooping. If you have a 2-piece system, you can snap off the pouch to empty it. Remember that your stoma may function during this time.
Tips for colostomy care Applying Your Pouch • You may stand or sit to apply your pouch.
• If you wish to rinse your pouch after you empty it, a turkey baster can be helpful. When using a baster, squirt water up into the pouch through the opening at the bottom. With a 2-piece system, you can snap off the pouch to rinse it. After rinsing your pouch, empty it into the toilet.
• Keep the skin where you apply the pouch wrinkle-free. If the skin around the pouch is wrinkled, the seal may break when your skin stretches. • If hair grows close to your stoma, you may trim off the hair with scissors, an electric razor, or a safety razor.
• When rinsing your pouch at home, put a few granules of Dreft soap in the rinse water. This helps lubricate and freshen your pouch.
• Always have a mirror nearby so you can get a better view of your stoma. • When you apply a new pouch, write the date on the adhesive tape. This will remind you of when you last changed your pouch.
• The inside of your pouch can be sprayed with non-stick cooking oil (Pam spray). This may help reduce stool sticking to the inside of the pouch.
Changing Your Pouch Bathing
• The best time to change your pouch is in the morning, before eating or drinking anything. Your stoma can function at any time, but it will function more after eating or drinking.
• You may shower or bathe with your pouch on or off. Remember that your stoma may function during this time. • The materials you use to wash your stoma and the skin around it should be clean, but they do not need to be sterile.
3
continued
COLOSTOMY CARE
Wearing Your Pouch
UPMC Information for Patients
• When you travel, carry your ostomy supplies with you at all times. Keep them within easy reach. Do not pack ostomy supplies in baggage that will be checked or otherwise separated from you, because your baggage might be lost. If you’re traveling out of the country, it is helpful to have a letter stating that you are carrying ostomy supplies as a medical necessity.
• During hot weather, or if you perspire a lot in general, wear a cover over your pouch. This may prevent a rash on your skin under the pouch. Pouch covers are sold at ostomy supply stores. • Wear the pouch inside your underwear for better support. • Watch your weight. Any gain or loss of 10 to 15 pounds or more can change the way your pouch fits.
• If you need ostomy supplies while traveling, look in the yellow pages of the telephone book under “Surgical Supplies.” Or call the local ostomy organization to find out where supplies are available.
Going Away From Home • A collapsible cup (like those that come in travel kits) or a soft plastic squirt bottle with a pull-up top (like a travel bottle for shampoo) can be used for rinsing your pouch when you are away from home. Tilt the opening of the pouch at an upward angle when using a cup to rinse.
• Do not let your ostomy supplies get low. Always order new pouches before you use the last one.
Reducing Odor • Limit foods such as broccoli, cabbage, onions, fish, and garlic in your diet to help reduce odor.
• Carry wet wipes or extra tissues to use in public bathrooms. • Carry an extra pouching system with you at all times.
• Each time you empty your pouch, carefully clean the opening of the pouch, both inside and outside, with toilet paper.
• Never keep ostomy supplies in the glove compartment of your car. Extreme heat or cold can damage the skin barriers and adhesive wafers on the pouch.
• Rinse your pouch 1 or 2 times daily after you empty it (see directions for emptying your pouch and going away from home). • Add deodorant (such as Super Banish or Nullo) to your pouch. • Use air deodorizers in your bathroom. • Do not add aspirin to your pouch. Even though aspirin can help prevent odor, it could cause ulcers on your stoma.
4
continued
COLOSTOMY CARE
UPMC Information for Patients
When to call the doctor
When to call your ostomy nurse
Call the doctor if you have any of the following symptoms:
Call your ostomy/enterostomal therapy (ET) nurse if any of the following occurs:
• purple, black, or white stoma
• frequent leaking of your pouching system
• severe cramps lasting more than 6 hours
• change in size or appearance of your stoma, causing discomfort or problems with your pouch
• severe watery discharge from the stoma lasting more than 6 hours • no output from the colostomy for 3 days
• skin rash or rawness
• excessive bleeding from your stoma
• weight gain or loss that causes problems with your pouch
• swelling of your stoma to more than 1/2-inch larger than usual
My ET/ostomy nurse’s name:
• pulling inward of your stoma below skin level • severe skin irritation or deep ulcers
_____________________________________ My ET/ostomy nurse’s telephone number: _____________________________________
• bulging or other changes in your abdomen
Pittsburgh, Pa., USA www.upmc.com
© UPMC 2008 SYS350780 AEL/JDS ORIG 03/00 FORM 4804-82178-1008
For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1. UPMC is an equal opportunity employer. Policy prohibits discrimination or harassment on the basis of race, color, religion, national origin, ancestry, sex, age, marital status, familial status, sexual orientation, disability, or veteran status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.
The following guidelines will make care of your colostomy easier. Keep this information close by for quick reference.
Helpful hints • Eat a well-balanced diet including vegetables and fresh fruits. Eat on a regular schedule. Drink at least 6 to 8 glasses of fluids daily. • Eat slowly in a relaxed atmosphere. Chew your food thoroughly. Avoid chewing gum, smoking, and drinking from a straw. This will help decrease the amount of air you swallow, which may help reduce gas. • Eating yogurt or drinking buttermilk may help reduce gas. • To control gas at night, do not eat after 8 p.m. This will give your bowel time to quiet down before you go to bed. • If gas is a problem, you can purchase Beano. Sprinkle Beano on the first bite of food before eating to reduce gas. It has no flavor and should not change the taste of your food. You can buy Beano over the counter at your local drugstore. • Foods like fish, onions, garlic, broccoli, asparagus, and cabbage produce odor. Although your pouch is odor-proof, if you eat these foods you may notice a stronger odor when emptying your pouch. If this is a concern, you may want to limit these foods in your diet.
Applying the pouching system To apply your pouch, follow these steps: 1. Place all your equipment close at hand before removing your pouch. 2. Wash your hands. 3. Stand or sit in front of a mirror. Use the position that works best for you. Remember that you must keep the skin around the stoma wrinkle-free for a good seal. 4. Gently remove the used pouch (1-piece system) or the pouch and old wafer (2-piece system). Empty the pouch into the toilet. Save the closure clip to use again. 5. Wash the stoma itself and the skin around the stoma. Your stoma may bleed a little when being washed. This is normal. Rinse and pat dry. You may use a wash cloth or soft paper towels (like Bounty), mild soap (like Dial, Safeguard, or Ivory), and water. Avoid soaps that contain perfumes or lotions. 6. For a new pouch (1-piece system) or a new wafer (2-piece system), measure your stoma using the stoma guide (Fig. 1) in each box of supplies.
(Fig. 1) continued
COLOSTOMY CARE
7. Trace the shape of your stoma onto the back of the new pouch or the back of the new wafer (Fig. 2). Cut out the opening (Fig. 3). Remove the paper backing and set it aside.
11. Hold the pouch (1-piece system) or wafer (2-piece system) with the sticky side toward your body. Make sure the skin around the stoma is wrinkle-free. Center the opening on the stoma, then press firmly to your abdomen (Fig. 4). Look in the mirror to check if you are placing the pouch, or wafer, in the right position. For a 2-piece system, snap the pouch onto the wafer. Make sure it snaps into place securely.
UPMC Information for Patients
(Fig. 2)
(Fig. 4) 12. Place your hand over the stoma and the pouch or wafer for about 30 seconds. The heat from your hand can help the pouch or wafer stick to your skin.
(Fig. 3) 8. Optional: Apply a skin barrier powder to surrounding skin if it is irritated (bare or weeping), and dust off the excess.
13. Add deodorant (such as Super Banish or Nullo) to your pouch. Other options include food extracts such as vanilla oil and peppermint extract. Add about 10 drops of the deodorant to the pouch. Then apply the closure clamp. Note: Do not use toxic chemicals or commercial cleaning agents in your pouch. These substances may harm the stoma.
9. Optional: Apply a skin-prep wipe (such as Skin Prep or All-Kare) to the skin around the stoma, and let it dry. Do not apply this solution if the skin is irritated (red, tender, or broken) or if you have shaved around the stoma. 10. Optional: Apply a skin barrier paste (such as Stomahesive, Coloplast, or Premium) around the opening cut in the back of the pouch or wafer. Allow it to dry for 30 to 60 seconds.
14. Optional: For extra seal, apply tape to all 4 sides around the pouch or wafer, as if you were framing a picture. You may use any brand of medical adhesive tape. 15. Change your pouch every 5 to 7 days. Change it immediately if a leak occurs.
2
continued
COLOSTOMY CARE
UPMC Information for Patients
16. Wash your hands.
Emptying Your Pouch
If you are wearing a 2-piece system, you may use 2 new pouches per week and alternate them. Rinse the pouch with mild soap and warm water and hang it to dry for the next day. Apply the fresh pouch. Alternate the 2 pouches like this for a week. After a week, change the wafer and begin with 2 new pouches. Place the old pouches in a plastic bag, and put them in the trash.
• Empty your pouch when it is one-third full (of urine, stool, and/or gas). If you wait until your pouch is fuller than this, it will be more difficult to empty and more noticeable. • When you empty your pouch, either put toilet paper in the toilet bowl first, or flush the toilet while you empty the pouch. This will reduce splashing. You can empty the pouch between your legs or to one side while sitting, or while standing or stooping. If you have a 2-piece system, you can snap off the pouch to empty it. Remember that your stoma may function during this time.
Tips for colostomy care Applying Your Pouch • You may stand or sit to apply your pouch.
• If you wish to rinse your pouch after you empty it, a turkey baster can be helpful. When using a baster, squirt water up into the pouch through the opening at the bottom. With a 2-piece system, you can snap off the pouch to rinse it. After rinsing your pouch, empty it into the toilet.
• Keep the skin where you apply the pouch wrinkle-free. If the skin around the pouch is wrinkled, the seal may break when your skin stretches. • If hair grows close to your stoma, you may trim off the hair with scissors, an electric razor, or a safety razor.
• When rinsing your pouch at home, put a few granules of Dreft soap in the rinse water. This helps lubricate and freshen your pouch.
• Always have a mirror nearby so you can get a better view of your stoma. • When you apply a new pouch, write the date on the adhesive tape. This will remind you of when you last changed your pouch.
• The inside of your pouch can be sprayed with non-stick cooking oil (Pam spray). This may help reduce stool sticking to the inside of the pouch.
Changing Your Pouch Bathing
• The best time to change your pouch is in the morning, before eating or drinking anything. Your stoma can function at any time, but it will function more after eating or drinking.
• You may shower or bathe with your pouch on or off. Remember that your stoma may function during this time. • The materials you use to wash your stoma and the skin around it should be clean, but they do not need to be sterile.
3
continued
COLOSTOMY CARE
Wearing Your Pouch
UPMC Information for Patients
• When you travel, carry your ostomy supplies with you at all times. Keep them within easy reach. Do not pack ostomy supplies in baggage that will be checked or otherwise separated from you, because your baggage might be lost. If you’re traveling out of the country, it is helpful to have a letter stating that you are carrying ostomy supplies as a medical necessity.
• During hot weather, or if you perspire a lot in general, wear a cover over your pouch. This may prevent a rash on your skin under the pouch. Pouch covers are sold at ostomy supply stores. • Wear the pouch inside your underwear for better support. • Watch your weight. Any gain or loss of 10 to 15 pounds or more can change the way your pouch fits.
• If you need ostomy supplies while traveling, look in the yellow pages of the telephone book under “Surgical Supplies.” Or call the local ostomy organization to find out where supplies are available.
Going Away From Home • A collapsible cup (like those that come in travel kits) or a soft plastic squirt bottle with a pull-up top (like a travel bottle for shampoo) can be used for rinsing your pouch when you are away from home. Tilt the opening of the pouch at an upward angle when using a cup to rinse.
• Do not let your ostomy supplies get low. Always order new pouches before you use the last one.
Reducing Odor • Limit foods such as broccoli, cabbage, onions, fish, and garlic in your diet to help reduce odor.
• Carry wet wipes or extra tissues to use in public bathrooms. • Carry an extra pouching system with you at all times.
• Each time you empty your pouch, carefully clean the opening of the pouch, both inside and outside, with toilet paper.
• Never keep ostomy supplies in the glove compartment of your car. Extreme heat or cold can damage the skin barriers and adhesive wafers on the pouch.
• Rinse your pouch 1 or 2 times daily after you empty it (see directions for emptying your pouch and going away from home). • Add deodorant (such as Super Banish or Nullo) to your pouch. • Use air deodorizers in your bathroom. • Do not add aspirin to your pouch. Even though aspirin can help prevent odor, it could cause ulcers on your stoma.
4
continued
COLOSTOMY CARE
UPMC Information for Patients
When to call the doctor
When to call your ostomy nurse
Call the doctor if you have any of the following symptoms:
Call your ostomy/enterostomal therapy (ET) nurse if any of the following occurs:
• purple, black, or white stoma
• frequent leaking of your pouching system
• severe cramps lasting more than 6 hours
• change in size or appearance of your stoma, causing discomfort or problems with your pouch
• severe watery discharge from the stoma lasting more than 6 hours • no output from the colostomy for 3 days
• skin rash or rawness
• excessive bleeding from your stoma
• weight gain or loss that causes problems with your pouch
• swelling of your stoma to more than 1/2-inch larger than usual
My ET/ostomy nurse’s name:
• pulling inward of your stoma below skin level • severe skin irritation or deep ulcers
_____________________________________ My ET/ostomy nurse’s telephone number: _____________________________________
• bulging or other changes in your abdomen
Pittsburgh, Pa., USA www.upmc.com
© UPMC 2008 SYS350780 AEL/JDS ORIG 03/00 FORM 4804-82178-1008
For help in finding a doctor or health service that suits your needs, call the UPMC Referral Service at 412-647-UPMC (8762) or 1-800-533-UPMC (8762). Select option 1. UPMC is an equal opportunity employer. Policy prohibits discrimination or harassment on the basis of race, color, religion, national origin, ancestry, sex, age, marital status, familial status, sexual orientation, disability, or veteran status. Further, UPMC will continue to support and promote equal employment opportunity, human dignity, and racial, ethnic, and cultural diversity. This policy applies to admissions, employment, and access to and treatment in UPMC programs and activities. This commitment is made by UPMC in accordance with federal, state, and/or local laws and regulations. This information is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. You should not rely entirely on this information for your health care needs. Ask your own doctor or health care provider any specific medical questions that you have.
