The following guidelines will make care of your colostomy easier. Keep this information close by for quick reference.
- 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:
- Place all your equipment close at hand before removing your pouch.
- Wash your hands.
- 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.
- 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.
- 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.
- 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.
- 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.
- Optional: Apply a skin barrier powder to surrounding skin if it is irritated (bare or weeping), and dust off the excess.
- 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.
- 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.
- 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.
- 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.
- 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.
- 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.
- Change your pouch every 5 to 7 days. Change it immediately if a leak occurs.
- Wash your hands.
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.
Tips for colostomy care
Applying Your Pouch
- You may stand or sit to apply your pouch.
- 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.
- 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.
Changing Your Pouch
- 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.
Emptying Your Pouch
- 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.
- 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.
- When rinsing your pouch at home, put a few granules of Dreft soap in the rinse water. This helps lubricate and freshen 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.
- 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.
Wearing Your Pouch
- 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.
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.
- Carry wet wipes or extra tissues to use in public bathrooms.
- Carry an extra pouching system with you at all times.
- 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.
- 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.
- 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.
- Do not let your ostomy supplies get low. Always order new pouches before you use the last one.
- Limit foods such as broccoli, cabbage, onions, fish, and garlic in your diet to help reduce odor.
- Each time you empty your pouch, carefully clean the opening of the pouch, both inside and outside, with toilet paper.
- 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.
When to call the doctor
Call the doctor if you have any of the following symptoms:
- Purple, black, or white stoma
- Severe cramps lasting more than 6 hours
- Severe watery discharge from the stoma lasting more than 6 hours
- No output from the colostomy for 3 days
- Excessive bleeding from your stoma
- Swelling of your stoma to more than 1/2-inch larger than usual
- Pulling inward of your stoma below skin level
- Severe skin irritation or deep ulcers
- Bulging or other changes in your abdomen
When to call your ostomy nurse
Call your ostomy/enterostomal therapy (ET) nurse if any of the following occurs:
- Frequent leaking of your pouching system
- Change in size or appearance of your stoma, causing discomfort or problems with your pouch
- Skin rash or rawness
- Weight gain or loss that causes problems with your pouch
My ET/ostomy nurse’s name:
My ET/ostomy nurse’s telephone number: