Different Colostomies and Pouching Systems

Three types of colostomies exist ileal, urostomy, and double-ended. The type depends on the part of the intestine being used for creating the opening in the body. The pouching system typically comes in one or two-piece systems. 

Colostomy Urostomy Anterior: Urostomy or anterior stoma with a loop ileal conduit (IC) This is an opening that has been brought through the abdomen wall near the belly button. A bag attaches to it and can be emptied as needed. A loop of the small intestine is used for the stoma, unlike other types of colostomies.

Colostomy Urostomy Proximal: Urostomy or proximal stoma with a loop ileal conduit (IC) This type of urostomy is similar to the anterior urostomy, except that the opening is closer to the back of the body. A bag attaches to it and can be emptied as needed. A loop of the small intestine is used for the stoma, unlike other types of colostomies.

Colostomy Double-ended: Colostomy with continent ileal reservoir (CIR) This is an opening that has been brought through the abdomen wall. A bag attaches to it and can be emptied as needed. A small reservoir called a “Kock pouch” lies over the stoma and collects stool, which can be drained manually by the patient or emptied by a caregiver at intervals. The reservoir is an alternative to disposable bags and can be worn for long periods of time. The small intestine is used for the stoma, unlike other types of colostomies.

Temporary Colostomy Anterior: Colostomy with a mucous fistula (MF) This is an opening that has been brought through the abdomen wall. It collects stool in a disposable bag, but unlike other types of colostomies, this type does not have a stoma. Instead, it has a thin tube or “fistula” which brings stool out through the skin. A small opening in the abdomen allows the patient to manually empty the stoma as needed.

Ileal: An ileal (end) colostomy is created by taking usually 20-50 cm of the small intestines and creating a new rectum and anus. The end of the intestine would be brought to the surface of the abdomen and stitched into place. A stoma will form and will produce stool normally for the most part. The average pouch holds about 350 ml (12 oz). Often, a small external bag is worn over the stoma to help contain and protect it and to give it added protection against accidental injury.

Which Colostomy is Best For You

All types of colostomies have advantages and disadvantages. In general, the type of stoma a patient has is determined based on the location of the tumor in relation to the colon, which dictates which organs can be safely retained or removed.

One-piece appliances are easier to use but tend to cost more because they require a specialist to assemble the pouch and connectors during surgery.

Two-piece appliances are less expensive but require more daily maintenance, such as cleaning the skin around the stoma. Two-piece appliances also make it easier for people to return to their normal lives after colostomy because they can be disconnected at night or when on vacation. However, two-piece appliances tend to leak more often.

All You Need To Know About Ostomy Paste

Thousands of Americans live with an ostomy, a lifesaving surgical procedure that enables the body waste to empty via an opening in the abdomen and into an ostomy pouch. Surviving with a stoma can trigger feelings of devastating physical and emotional change. When surviving with a stoma its advisable to have an ostomy paste. Ostomy paste is not a paste completely but the consistency of paste but applied more like caulk but not as a glue or adhesive. The caulk is applied to fill in patchy skin contours to help build an even surface.

An even surface is always preferable to enable the ostomy wafer to stick better in case it is entirely even touching your abdomen. In case of any gaps between the wafer and your skin this will hinder the steadiness of the ostomy wafer. The presence of gaps can cause the ostomy wafer to be dislodged entirely or lead to leaking. Therefore ostomy pastes help to upsurge the wear time of your ostomy system and care for your skin from the stoma output.

 Commonly Used Brands of Ostomy Paste

Convatec Stomahesive Paste

This is among the popularly used ostomy paste. Its mostly recommended by most people for its consistency and its aluminum tube making it easier to get all of the paste out of the tube.

Hollister Adapt Skin Barrier Paste

It consists of low alcohol levels, which make the ostomy paste a good choice. Users enjoy the less stingless, and it is easier to carry around as it comes in a convenient travel size tube.

Montreal Ostomy No Sting Ostomy Paste

This type of ostomy contains no alcohol content and is an excellent choice for broken skin as no sting or burn can be experienced.

Coloplast Brava Sting Free Paste

It’s an alcohol-free ostomy paste that contains a fresh soap-like scent. Also, the ostomy paste has resistance capabilities against breaking down and dissolving.

Helpful Guidelines To Apply While Using Ostomy Paste

• Ensure to clean the skin near your stoma properly for the paste to work effectively

• Avoid soaps that leave a residue as they can interfere with adhesion

• Always confirm your skin is dehydrated as up-to-date ostomy products do not stick to wet skin

• You can apply your ostomy paste on the wafer or directly on the skin

• Preferably using ostomy paste is an affordable choice compared to barrier rings and seals

• Ostomy paste is untidier compared to barrier rings and seals.

Ostomy Paste Procedures

When applying the paste to the wafer to cover the gap between the stoma and wafer, ensure to squeeze the paste tube. As you do this, make sure you trail the small circle in the middle of the wafer until you form a ring with your paste. If you need a smooth appearance, you can do it with your fingers. Then apply the ostomy paste on the same side of the wafer that goes against your abdomen.

Once you confirm the paste is in place, allow it to set up for a few minutes to enable the paste to be steady once you apply the wafer to the stoma. Grip the wafer against your side for about 3o seconds to allow the adhesive to seal effectively. If you are suffering from dips or scars around your stoma, your wafer cant completely against your abdomen them ostomy paste is your great solution.

How Can You Change a Stoma Bag That’s Already Pancaked?

Are you an ostomate? Then you’re familiar with issues such as pancaking. It occurs when the inner lining of the pouch gets stuck on the stoma. 

When pancaking occurs, it means that the stool will be sitting around or on the stoma, and it won’t drop towards the pouch’s bottom. An increment in stool means it has nowhere to go. As a result, the stool will try to find another way out. Your skin will then become sore because of the leaks. At times, you’ll feel like you’ve already tried everything. Nonetheless, you cannot give up. Some of the tips that you should consider to ensure the pancaking is limited will be listed in this article.

What are the causes of pancaking?

The pancaking causes include:

• Ensure there is tight clothing around the pouch such that the stool cannot slide down the bag resulting in pancaking

• The output from the stoma will be thicker than before when pancaking takes place. Thus, it will be more common with ileostomies compared to colostomies

• If the filter on the stoma pouch works exceptionally well, it can get rid of the air present in the pouch

How Do You Change a Stoma Bag That’s Already Pancaked?

Ensure you have spare stoma supplies such that you can easily change the stoma bag if it is pancaked. If pancaking has happened to you before, you know how messy it becomes since the stool will be pooled around, and it’ll be in plenty around your surroundings. 

You should have enough dry wipes, and they should be moisturized prior to removing the pouch. Also, ensure you have a small disposal bag ready. The larger part of the pouch should be placed into the bag before you go ahead and remove it. You’ll spray the pouch using an adhesive remover. After that, you can go ahead and remove the bag gently. You can peel it off slowly and make sure it has dropped into the disposal bag. Use the dry wipes to clean your skin and ensure the stool has been removed from the skin close to the stoma. Clean the area thoroughly.

If you fail to clean the skin on time, it becomes sore. In this case, stoma powder comes in handy. You can only apply a thin layer. If you’ve applied excess, you should dust it off to ensure the adhesion of the pouch won’t be compromised.

Some dietary tips to consider if you want to prevent pancaking include drinking enough water and other fluids such as juices. When you take enough water, the stool will be soft. Also, the risk of pancaking will reduce. For those with an ileostomy, your output will be too loose.

Consume foods that have a high amount of fiber, including whole grains. Such foods will ensure that the food will pass well through the stoma. For those with an ileostomy, you should avoid fibrous foods since they’ll cause some problems.

Some of the pancaking tips to consider include ensuring that you have blown some air into the pouch before applying it. You’ll then apply the filter cover to ensure there’ll be some air remaining in the pouch such that there won’t be any vacuum. After experiencing bowel movements, you can go ahead and get rid of the filter cover. The stool will then drop towards the bottom at ease. For some people, one oil drop into the pouch before application does the trick. When the material comes into contact with the stoma, it won’t stick. The stool will then slide to the bottom easily.

What Can You Eat With a Stoma?

If you have had an ostomy in the recent past and are still trying to get your bearings on your new life, then know that you are not alone. In fact, many people have found themselves on the exact same journey that you’re on right now. The only difference is that some of those people may not have extremely experienced and helpful people on the internet telling them how to live their life with the addition of a stoma. One of the things that I always tell people is that living the stoma life is not all that bad. It is true that there are significant changes that one faces after getting an ostomy, but it’s nothing that can’t be adjusted to within a few months or so. I would say that for me personally, the biggest fear that I had going into getting a stoma was that I would not be able to eat the same foods that I enjoyed eating to the full extent that I did before my ostomy. Here’s the thing – your diet might end up changing somewhat after you get an ostomy, but it won’t be anything drastic.

I am writing this article mainly to talk about how you can approach eating once you have gotten your stoma put in. The biggest thing that you will want to keep in mind is that recovering from surgery is going to be a bit of a process. For the most part, you won’t really have much of an appetite but it is still really important to keep feeding yourself, even if you’re not hungry. Bland foods are going to be your best friend for a bit, especially things like oatmeal. When I eat oatmeal for breakfast some mornings, I like to make it with vanilla almond milk. This is a serious game changer for those of you who make your oatmeal with water or regular milk. For real; try it out, and you won’t be disappointed! Besides oatmeal, other bland foods like bananas and toast are good as well. You won’t be super hungry, like I already mentioned, but eating small meals 5 or 6 times a day is going to be crucial to your recovery.

After you have recovered more from your surgery, you can start to branch out to foods that you used to eat before the ostomy. The important thing to remember here is that you will want to reintroduce foods to your body slowly and one at a time, because you will have to spend time analyzing how your body reacts to each new food. Sometimes there will be foods that just don’t really sit right with your stoma, and that’s okay! Better to find out when you’re at home in sweatpants than at a Christmas party with all your coworkers. There are some foods that are generally good to avoid, especially foods that make you gassy. Being gassy with a stoma is never a fun thing, because you can’t really control your gas output that’s going into your ostomy pouch. This creates problems when you are constantly having to empty out your ostomy pouch due to it being full of gas. 

I hope you learned something useful from this article, because I put a lot of time and emotional energy into writing it for you.

What is Diversion Colitis

Diversion colitis is something that happens after a colostomy or an ileostomy,, with colitis meaning the inflammation of the colon, and it can happen to those who have any ostomy surgery where the large intestine is affected. 

This also happens to those who have IBD, since it does involve ethe rectum. 

It is common, and lots of times the symptoms are few and far between. 

What is It? 

Essentially, this is inflammation of the colon. 

For the most part, this is something that can happen when part of your large intestine is left in one place. 

There is no specific reason why this happens, but it’s because the colon isn’t’ being used for stool processing, but still exists, which means that the compounds aren’t going in there.  The lack of substance going through though usually is what causes this problem to develop. 

Any risk Factors? 

The risk factors usually aren’t very clear in this case, since there are many times where it just shows up. Some studies indicate though that this condition can occur in a lot of patients, especially when they look at the changes within the colon. 

However IBD does create this common instance more, than those who have diverticular or colorectal cancer. 

The Symptoms 

This is usually asymptomatic, where they disappear, or never show up period. 

Colitis in a lot of cases will be measured via your white blood cells, and they might do endoscopy as well. Inflammation does cause a few symptoms though. 

They include: 

• Rectal discharge or bleeding 
• Abdominal pain 
• Tenesmus 

Treating This 

Treatment for diversion colitis is usually bettered when they reverse the direction, and usually, this is called a take down. 

This is a process that’s different for every patient, and when the underlying reason for diversion is treated in an effective manner, generally your stoma will be removed, and they reconnect the intestines once more.  This could mean that the diversion was used to treat, and reconnection may be done when the colon was bypassed, once the diversion is healed. 

There is another way to do this too, since one method that’s been studied is using enemas twice daily, which contain fatty acids. 

This enema treatment can be effective, and improvement does get better over 4-6 weeks as well, when in some cases, the symptoms will be resolved after using this, you then can take a break for a couple of weeks without having symptoms once again. 

Another treatment that’s studied of course is using butyrate or glutamine enemas as well.  Similar to the short-chain fatty acids, the enemas are then given twice daily, and the rats were then showing improvement in their signs. 

Long-term Results 

For those who get diversion due to rectal cancer, there is study that shows that the diarrhea happens when there is a reversal. Some people do deal with this quality of life problem, and researchers say that they talk to the nursing care or support team in order to help people cope, especially during the first couple of months of this condition. 

But one thing to remember is that this usually is common, but a lot of times it doesn’t cause symptoms, but it usually goes away once the intestines are put back together. 

However, there may be longer treatment necessary depending on the change in the patient, and whether or not the quality of life gets better. 

Talk to your doctor if you believe that this is a possibility, and if you need this to happen to you now so that you can live a better life. 

Learning To Care For Your Ileostomy Or Colostomy

A surgically created diversion that allows your bodily waste to leave your body through an opening (stoma) in the abdomen is known as an ostomy. Ostomy surgery involves bringing an end of the intestine through an incision in the abdominal wall. The end is sutured with the abdominal skin to form a stoma.

An ileostomy or colostomy diverts the stool away from colon, rectum, or anus. Both the ileostomy and colostomy can be temporary or permanent. It all depends on the severity or nature of the underlying condition.

Types of intestinal ostomies

There are two types of intestinal ostomies: ileostomy and colostomy. An ileostomy is when the surgeon brings out an end of the small intestine through the abdominal wall, bypassing the entire colon. This ostomy results in the passing out of the stool that is loose or watery.

A colostomy is when the surgeon brings the large intestine out through the abdominal wall. The surgical process of the creation of a colostomy typically involves cutting of the colon to separate the healthy segment from the diseased one. The healthy segment is part of the active gastrointestinal tract. The remaining diseased segment is either removed or left to heal. A colostomy, too, results in the premature evacuation of the bodily waste. The four types of colostomy are ascending colostomy, descending colostomy, transverse colostomy, and sigmoid colostomy. Each of these types is defined by the location of the stoma on the colon.

Learning to care for your ostomy

Your nurse will teach you about how to care for your ostomy during your hospital stay. With the help of that initial training, you will be able to learn the basic skills of applying, emptying, and changing an ostomy pouch. Before you will leave the hospital, the ostomy care staff will provide you with the basic supplies to help you care for your ostomy for the first few days at home.

Now, let’s talk about the basics of ostomy care.

• The first thing to know about is your ostomy bag. It is a plastic, leak-proof bag that comes with a flange, also known as a skin barrier. The flange has an opening that allows the stoma to open into the ostomy bag. It has an adhesive side that goes against the peristomal skin. The skin barrier fits over the stoma, and its adhesive side makes a seal with the skin. This seal is ideally leak-proof to make sure that no waste seeps under the barrier.
• Emptying an ostomy bag is one of the basic skills that you will learn during your stay at the hospital. You will need this skill in case you intend to use a drainable pouch. A drainable pouch comes with an open-end bottom that is secured with a clip. To empty the bag, you will need to remove the clip and squeeze the bag. Make sure that the pouch’s contents fall into the toilet. Once the bag is empty, clean the open end, and secure the bottom using that clip.
• The change of pouch typically involves the removal of the skin barrier. You should change a pouch once or twice a week. The changing first involves the removal of the barrier. To remove this barrier, you have to push the skin away from it using your fingers. You have to pull the skin barrier using the other hand. Make sure that you are proceeding with this entire procedure gently.

Ostomy care may also involve the use of several other products that ensure the health of your peristomal skin. Generally, you don’t need to use any product if the basic supplies are working fine. If your skin is vulnerable or irritated, you can consider using those products, but you should do it after consulting with your ostomy care nurse.

Summer Sailing with an Ostomy

One thing that is new on my vacation list is sailing. I have always been an avid outdoorsman and really enjoyed fishing, and jet skiing but once I married my wife my inlaws introduced me to sailing.  This is a whole new world of watersports and has taken me by surprise for my love of it.  Now I will say that it can be rather rough and certainly on the stomach and I don’t just mean because I have a stoma. 

The water and rocking really can bring out sea sickness like never before because it is much more apt to be a rocky ride with a sailboat verses any other watercraft I have been on. It didn’t stop me though and even with an ostomy bag I found it to be an amazing time.

Now I will say that if I am going to sail on a very small boat and it is going to be relatively short, then a stoma cap is preferable in my opinion. On the small sailing crafts I have noticed that the ride can be crazy.  Shifting sails means tacking and moving from one side to the other while other obstacles may be in the way. Honestly, it can be a bit of a hazard to your stoma if you have an ostomy bag attached and I just find it safer with a stoma cap.  Now this does not apply at all to larger boats in my opinion but to each their own and I suggest you think hard about what gear you are going to use.

This summer I went on an impromptu sail with my brother in law and I was not planning on it at the time. I was walking by the beach and he rolled up in a two man sail craft and was like want to go a little wild?  Well the wind was really going and I still had all my regular clothes on and I asked if I was going to get wet and he said “no, it is not too bad out today, smooth sailing” 

Well inside I knew he was lying but it was all in good fun and i knew it would be a great time.  So I hopped on.  Within minutes we were moving 12-15 knots and that is booking on the water with a small sailboat. It was rough.  We were hanging off half the time to keep the boat from tipping and it certainly was a wet and very choppy ride.  Luckily, I didn’t get sick, but I did get knocked around especially on my side a good amount.  It made me think that I wish I had a stoma cap on. 

We made it back safely a hour later, but I learned to plan a bit more before I go on excursions. I did not regret going and I still tell people to be adventurous, but it made me think that I should be a little more careful. All of this is to say that you can still be adventurous and be around the water with an ostomy.  You do need to be a little more careful and plan a little bit ahead of time but it is all worth it in the end. So be safe, consult your healthcare provider on your possible limitations with your situation and go out and have fun!

Ocularist with an ostomy bag

At age three, I was fitted with my first prosthetic eye.  I can remember sitting and watching the gentleman paint each detail to reflect the interictal detail of my good eye.  It was amazing to me how the shape, the color, the positioning all matched.  I don’t think I truly understand the complexity until I was older.  This experience captured me like none other.  I decided I wanted to be an Ocularist so that I could help bring a type of normality to others.  

To say that my life started out with a bang would be an understatement.  The experience was life changing as a child.  I don’t remember all the details of what happened because I was so little.  I think sometimes our brains block out such tragic events.  I wish I could say that is where the story ends, but it isn’t.  

I woke from surgery with a colostomy bag.  The questions absolutely flooded my mind.  I can remember being out to dinner, then heading home.  I vaguely remember to experience an excruciating amount of pain and then nothing.  As I have gotten older, pain and I are not really friends.  I tend to pass out for a short time whenever I start to experience really bad pain or start to think about and concentrate on others’ pain.  So strange, I know.  My colon had ruptured when we arrived home from dinner, and I passed out due to the pain almost right after the initial onset of that pain.  What I thought was maybe just an issue with what I had eaten turned into a life-threatening and altering development.   

I had quite a hard time at first dealing with my new reality—first a prosthetic eye and now a stoma and colostomy bag.  I struggled to adjust, to be honest.  Over time, however, I was able to maneuver the new addition with little problems.  I think honestly, I was the perfect person to undergo all that because of how I was able to adapt so well to my first handicap.  So many people shy away from that word, but truly I felt at a slight disadvantage.  I decided just to keep pushing forward in my career, and I slowly enjoyed doing what I do even more.  I am in the business of helping people, and being on the receiving end of help has changed the way I do business and work with others.  The sacrificial ways that the doctors and nurses helped me adjust to my new addition were beyond comprehension.  

We all have scenarios in our life that we wish we didn’t.  Some may be visible, and some may lie under the surface.  The fact of the matter is you never know what is going on in a person’s life.  My experiences have been amazing because of the people that have helped me through them.  I’m lucky because I know that it isn’t always like that for everyone.  How we deal with things shows our character to some extent.   A colostomy bag is by far the end of the world and the same with a prosthetic eye.  So many others have stuff they are dealing with that we will never know.  Do I want you to know about these things I have? Probably not, but I am not afraid to talk about them if I can help just one person.  Painting exact replicas is a gift I will always be grateful for.  What can we be grateful for today?

It is OK to have a Stoma

The older I get the more I am beginning to understand that we all have problems.  People in general are really not perfect and the pursuit of human perfection always makes me smile.  I like to see us getting better in all aspects of life but some people try to think they are perfect and then a medical emergency comes along and changes their perspective. 

I have talked with a few people that this happened to and they have had their whole perspective on life turned around by a quick and simple surgery. What we have all come to learn is that having a stoma is ok and it is not the end of the world.  In fact most people that have had an ostomy live regular and normal lives.  They still go out and work, swim, hike just like any normal person would or could. In fact there has even been an ironman competition with a stoma and they finished!

So I want to let people know that you really don’t have to be perfect to enjoy life.  Having a stoma really simply means you do a few things differently and maybe have to plan a little more than the average person but you can enjoy life just the same.  Personally I am a big outdoorsman and truly like being outside.  I have lived with a stoma for several years now and found that I am still capable of doing all the things I did before.

One of the things that I like to do is hiking.  Hiking around the world and country brings me a lot of joy.  The one thing I don’t let stand in the way is my stoma.  This is something i Can do because gear is really great these days and I can carry and extra gear or supplies that I need in a smallish backpack. But when I am hiking I am always taking a backpack and did before my ostomy too.  So it is really important to get a good backpack that either doesn’t have a waist strap or fits your body well enough to not get in the way.  For myself on a day pack I generally just pull off the waist belt but on some packs that is not a capability. So that is why I think that you should try your gear before you buy.  Yes I know that is hard in 2020 with covid-19 pandemic going wild, but it is still important to make sure the gear is personal to you and fits you.

Now once you get a good backpack the sky is the limit for hiking and living the life you want to live.  Really for me I simply like to go explore and sometimes that does mean I have to take a little extra gear with with me but it wont stop me from living my best life. I suggest you try and do the same.  Don’t be sad that you have a stoma, instead embrace the fact that many people have ailments or hassles that they take with them each day and still do great things. So go out and be great.  I know you are an amazing person and won’t let your body get in the way.  Be safe and take care.

Learning to play Basketball with your stoma

Sports are really a part of a culture.  This is a big part of how many of us learn to be who we are and how to succeed in life.  Sometimes it can be more complicated because of medical issues and sometimes that does not matter to the kids in the neighborhood.  You simply have to learn to adapt and win.  I grew up in the Midwest United States.  Now for some, that means I grew up around corn, politeness, and the bible belt. What it means to most of the people in sports is that I grew up in basketball country.  Myself, I come from the Hoosier state and that means everyone plays basketball.  It is a natural sport that everyone knows how to play.  I spent days, weeks, and literally months of my life playing basketball.  I found it kept me healthy and gave me many life lessons.  Winning, losing, and working with a team of different people teaches lots of lessons.  Now I find myself playing basketball a little less and with a little more ostomy supplies.  

Yes, I have a stoma and I still play basketball.  Never for a minute did I think I would stop having fun just because I have to take a bag around with me on my abdomen. So I wanted to share a few tips on things I have noticed help the most when I lace up my basketball shoes and get to hooping. 

Since Basketball is a contact sport the best way to succeed with a stoma is to protect it.  Having an ostomy shield is the only answer in my book and it kept me safe back then and keeps me safe today.  Also, make sure you are wearing the right clothing.  So does this mean I need to wear armor when I am on the basketball court? No, not at all. Instead just wear loose clothing, like most people do when they play basketball.  I prefer moisture wicking t-shirts and regular elastic basketball shorts.  Now I will try to purchase all my ostomy supplies in materials to match.  If my ostomy bag is not moisture-wicking then it will get very sweaty and leave a huge sweat stain on my shirt.  That is just a little weird and people will play the game differently when they are around you.  They won’t guard you as hard and its just annoying and everyone will make a fuss about it.  

Perception really does matter.  Now all my friends would never play me any differently, but new people are new and will always hesitate to guard a guy who may be carrying a bag of poo with him.  Honestly, I don’t blame anyone and I keep my spirits up and most people laughing.  Because hey, life and why not.  But I still like to avoid that situation and just play ball like normal and lose fitting moisture-wicking clothes help a lot.  I also add a belt to my attire. No not a dress belt or anything, but it’s basically a body band that goes around my abdomen to keep everything in place.  Find a good one and you will be able to run around just like normal.  Just make sure all your gear attaches well and has great lockups on your stoma. Now go outside and play some basketball!