6 Problems to Expect If You Have a Colostomy
With a stoma, there are a number of mishaps and situations, some of them kind of embarrassing, that you'll most likely encounter. Even though some may appear worrisome, and others a bit funny (yes, hilarious), most are not really serious and not worth worrying about either.
Once you know what to expect, you will know how to manage, and even overcome them.
Bothersome Mishaps to Lookout For
As an ex-ostomate who has been there, I'll tell you of the ones that gave me a bit of a bother and let you know how I managed such occurrences and eventually overcame them.
Personally, I find passing gas as an ostomate a kind of a comic relief.
Why do I say this? Because gas passing out through the stoma is hardly ever silent.
For some strange reason, it always reminds me of a baby gurgling or the act of blowing bubbles. I find the sounds quite cute actually.
Before gas is expelled, you'll start to get a funny feeling in your tummy, letting you know it’s on its way. You get about 10 to 15 seconds notice before it finally erupts, so learn to recognize it.
AND the sound IS loud enough to attract those sitting close to you.
To handle this situation, I approached it with some sense of humor.
If it was within earshot (which is usual), I simply chuckle while the sound is on, and just say "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 was ever offended, and IF they were, they never showed it. Good enough for me!
2. Loose Stool
You will soon discover that foods with high levels of roughage - some fruits, cereals, and salads, for instance, are "among the most efficient foods and produce the least amount of stool". These are good to eat before going out for a function.
Your colostomy bag won't fill up unexpectedly and you won't need to go back and forth for a change or drain.
On the there hand, junk foods - 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.
Also, try to study which foods take long to process in your digestive system, and which ones don't.
What I do is to keep a mental note of my observations, and adhere strictly to it.
For instance, as one patient said, "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 a long road trip".
Very loose stool fills your bag up in no time so plan your meals according to your daily lined up activities especially if you are always on-the-move. This way, you can avoid embarrassing situations and will be able to keep colostomy bag inconveniences to the barest minimum.
3. Bag Leaks
This is one situation you don't want to encounter, especially when you are outdoors. When leaks happen, feces seeps out through an open bubble in the colostomy bag's faceplate and the first thing you'll notice is that whiff of smell; that telltale odor. You can't miss it!
As soon as you detect this odour, go and change your bag, and replace the waxy faceplate if need be. Never dismiss it because it will just get worse and the odour will spread before you know it.
A great must-have are seal rings. With a seal ring fitted, you can be doubly sure there'll be no leakages and thus no seeping odour. You can even take a bath and not worry about leaking or the bag peeling off.
I never had much problem with this (I can detect smell faster than a bloodhound) and I'm up and off to the loo before anyone notices. If I'm far away from a public or private toilet, I'm in deep you-know-what, and so will you! Lucky enough, I was fortunate not to be in that situation.
I can't emphasise this enough - you must carry at least two spare colostomy bags and one faceplate (if you use the two-piece appliance) AT ALL TIMES. If a leak or blowout occurs they will be a real lifesaver.
4. Discomfort in the Rectum
I vividly remember the first time I had some discomfort in my rectum. I kept getting this weird feeling of wanting to go to the loo to defaecate. It was so alarming, I called my doctor.
He then calmed my nerves and informed me that once in a while, I will eliminate rectally. He told me to use a very mild suppository and I did.
This is when I learned that the rectum still produces mucus that needs to be eliminated when it has accumulated. Good thing? It only happens once in a while for most ostomates and it’s hardly larger than a red grape, but this is normal so don't get alarmed if/when it happens.
5. Face Plate Water Absorption
The wax-like faceplate of a colostomy bag is fine if you shower. Because you only spend a short time showering, there's hardly enough time for it to absorb water. Of course, the bag itself is waterproof.
An ostomate can also swim comfortably with a bag on as long as he or she doesn't stay in the water for more than a quarter of an hour, tops.
You'll find that if you stay longer in the water, the waxy plate absorbs the water from the edges slowly and if it is exposed to water for longer than is necessary, the wax starts to soften, becoming almost like putty, and lift from its position.
At this stage, the appliance will lose its sticky quality and begin to come off. Disaster!
How to avoid this? Swim for no longer than 45 minutes and ensure you change the whole bag (if disposable) or the faceplate (if a 2piece system) once you are done with swimming.
One more thing, don't sunbathe for longer than is necessary. Your stoma is insensitive to pain or stimulus, so don't expose the area to direct sunlight any more than is necessary. You don't want to 'fry' the poor little button with sunburn.
6. Pancaking (or Patty-caking)
An occurrence that many colostomates don't really see as a problem, but is an annoying one nonetheless, pancaking (or patty caking) occurs when stool collects around the stoma instead of going right into the colostomy bag. Stool forms a 'cake', the shape of a pancake and thickens around the stoma, pushing its way underneath the flange or faceplate as it piles up.
This can cause problems if you are sore around the stoma and will make it open to infection. Pancaking also causes unpleasant odour or leaks as it pushes and lifts part of the flange of the abdomen.
But what causes pancaking?
It is caused by one of two things. Either the stool passed out 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 very flat against the abdomen.
This problem can be tricky to resolve, but here are the ways I was able to resolve it whenever it occurs.
- Increase fluid intake - This is the #1 remedy and it is absolutely important because if enough fluid, preferably water is not taken, stool will become hard or sticky.
- Alter diet slightly - Do this by increasing your fibre intake which helps alter the consistency of faeces.
- Blow a bit of air into the colostomy bag - Before fitting on your appliance, blow in a bit of air to help avoid it being perfectly flat against your tummy.
- Use filter stickers - Because the filter can be over-effective at times, place a sticker (those little white stickers that come with your supplies) over the filter hole. This way, the bag doesn't look 'sucked-up' and it allows the gas that precedes stooling create more space for the stool to move freely down the bag.
On a final note, it’s good to remember that your stoma is sort of alien to your abdomen and needs some extra attention if you wish to avoid or keep to the barest minimum unforeseen situations or colostomy bag/stoma mishaps.
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. What I loved most about this book was the incredible spirit and sarcastic humour weaved 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 an ostomy.
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