During the operation part of the large bowel is brought to the surface of the abdomen to form the stoma, usually on the left hand side of the body. This is where the faeces will now pass from the body.
You can have either an end or a loop colostomy but both function and are looked after the same way. A colostomy can be permanent or temporary.
Even though the rectum has been bypassed it is not uncommon for people to experience the need to go to the toilet via the back passage. This may be caused by a mucous discharge, which is normal. Just sit on the toilet and clean yourself in the usual way.
If the rectum has been removed, people may still experience this urge and, again, this is normal and should ease with time.
After the operation you may see the stitches that have been used to hold the stoma in place. These will eventaully dissolve away as the stoma shrinks, or can be removed by your stoma care nurse.
Looking After Your Stoma
One of the most important things to remember is to take good care of the skin around the stoma. If the pouch does not fit snugly around the stoma the skin can become exposed to the harmful effects of the faeces. Leakage, as well as the too frequent removal of the pouch and the use of harsh skin cleansers can also cause some irritation of the skin. Look at the skin around the stoma when changing the pouch, if you notice any swelling, rash or redness which does not go away after a couple of changes, please get in touch with your stoma care nurse.
Changing The Pouch
It is a good idea to try to establish a routine for changing the pouch. As you get used to your stoma you may find that at certain times of the day it is more active than at others, for example shortly after a meal. Try to choose a time when it is relatively inactive, perhaps first thing in the morning.
Before starting to change the pouch make sure you have everything to hand that you will need to complete the process.
- Check you have everything you need: wipes, warm water, a new pouch, any accessories and a disposable bag.
- If you are using a drainable pouch remember to empty it before removing it.
- Remove the old pouch, working slowly and gently from the top to the bottom.
- Wash the stoma and the surrounding skin with warm water and wipes.
- Dry the area well with the wipes.
- Fit the new pouch making sure it is secure all the way around.
- Place the old pouch into the disposable bag, seal it and put in the dustbin. Do not try to flush it down the toilet as this will cause a blockage.
- Remember to wash your hands after changing or emptying the pouch.
Types of Pouch
Most people with a colostomy use a closed pouch, however if the output is particularly liquid a drainable pouch may be more appropriate. There are many different sorts of pouches available and your stoma care nurse will be able to help you choose the most suitable type for you.
It is a good idea to change the pouch when it is about one third full.
There are two main types of pouches available. These are known as the a one-piece and the two piece systems. A one piece comprises of a single unit which is made up of the collection bag and the adhesive area which firmly attaches the pouch around the stoma.
The two-piece system has the collection bag separate from the adhesive area and the two halves are then connected together. This means that you do not have to remove the adhesive part from around the stoma every time you change the bag.
Some people with colostomies choose to irrigate (or wash out) their stoma to give them more control over the output. Your stoma care nurse will be able to advise you about this.
On leaving hospital your stoma care nurse will provide you with enough pouches and other necessary supplies to keep you going until your own supply is organised. The nurse will give you the necessary codes for your specific requirements and these should be given to your GP who can issue you with a prescription. This prescription can be taken to your local pharmacy who will then obtain the items for you. Stoma care supplies are covered by the Medical Card and by the Drug Payment Scheme.
Be careful not to store your equipment in direct sunlight or near heat as this may make them deteriorate.
Just like everyone else you should eat a well balanced diet, which can include all your favourite foods. However, for the first month you should avoid
- Green vegetables.
- Breakfast cereal containing bran.
- High fibre bran or wholegrain brown bread.
- Nuts, pips, seed, skins and kernels of fruit.
- Curries or highly spiced dishes.
You may find that certain foods produce more wind than others, for example cabbage and broccoli, and if this becomes a problem, simply cut down on these foods. Alcohol is fine in moderation but remember that beer and lager can also produce wind and may cause the output to become more liquid. With a little experimentation you will soon find a balanced diet that is right for you.
It is still possible to get diarrhoea or constipation with a colostomy.
There is no reason why a colostomy should restrict your ability to travel in any significant way. Just remember to pack all the things you need for the journey and to make sure that you have enough supplies for the duration of your time away. It is advisable to take all stoma supplies in you hand luggage. Your stoma care nurse will be happy to answer any particular questions you may have with regard to travel.
Exercise is good for everyone and just because you have a colostomy you are no exception. It is very likely that the exercise you enjoyed before the operation will be suitable afterwards. Obviously you will need to start with gentle exercise at first but soon you should find that you are able to do as much, if not more, than before.
Sex and Relationships
In most cases a normal loving relationship can be resumed, however there is a stronger risk of impotence when the rectum has been removed. It is very important to talk to your partner and to not feel self-conscious because of the operation. Your stoma care nurse will discuss any questions you may have with this delicate issue. Remember, for women, is is still possible to have children after having a stoma and for some men to father children.