Your state of health necessitated the making of a temporary or permanent digestive stoma "colostomy". This advice sheet has been developed to help you in its management. Practical Advice for Ostomates After A Colostomy Surgery

The stoma is not a sore

The stoma is not sore, it is the intestinal lining that touches the skin. It is not sterile and requires only simple and routine hygiene care.

When to perform the treatment?

To carry out the care, it is necessary to choose a "calm" moment to change the apparatus, if possible after having had a bowel movement.

How to clean the stoma?

First of all, you have to gather all the necessary equipment: pocket, tissues or non-sterile compresses, gloves, plastic bag or trash ... The use of a neutral soap such as Marseille soap. Is only possible if the rinsing is adequate. .

• Beforehand: wash your hands.
• Peel off the pouch gently, holding the skin with your finger
• Throw the pocket in a garbage bag
• Do not rub it, dab it carefully
• Wash the stoma and the peristomal skin with tap water and possibly with Marseille soap
• Rinse
• Thoroughly dry the peristomal skin by dabbing with: compresses, paper handkerchiefs or glove reserved for this use.
• Never use products that are aggressive to the skin (antiseptics, ether, alcohol, perfume, etc.) which dry out the skin and which risk causing irritation or an allergy.
• Cut or trim the hair around the stoma if necessary, but do not shave it.
• Apply the new pocket (Cf. chapter below)
• After treatment, wash your hands.

Can you take a shower?

You can take a bath or a shower with (the equipment is waterproof) or without a collection bag. The ostomy may be working then, but once you find your rhythm you will know what time of day you can shower safely without your pocket. Avoid using bath salts or creams that could prevent the pouch from adhering to the skin.

How do you pair up?

The bags have a skin protector which, to be effective, must be in direct contact with the skin. The fitting is an essential element of your comfort and well-being. So be sure to choose a pocket suitable for the type of ostomy.

Left colostomy  → molded stool →  closed bag with a filter with or without base 

Ileostomy →  liquid stools (irritating) →  drainable bag with a filter with  or without base   

• During the first fittings, mark the diameter of the stoma on the support or keep the cutting "template" which will facilitate the following fittings because in the first weeks following the operation, the size of your stoma changes and it is necessary to readjust the cutout of the protective support.
• Use a pocket with a cutout that is well suited to the size and shape of the stoma (the diameter of the cutout should be greater than 3 and 5 mm than the diameter of the stoma).
• If you use a drainable bag, check that the field is properly closed (in case of diarrhea)
• During your treatment, before or after eliminating the effluents, you can strike a match: it is a very effective deodorant.
• Once fitted, do not forget to check that the bag is securely in place by pulling it slightly downwards.

When and how to use the protective paste?

The paste protects the skin around the stoma. It acts as a tight seal between the appliance and the stoma. It is to be used in case of diarrhea or skin irritation.

•   Wet your finger and take a dab of paste on your fingertip.
•   Spread it out by drawing a comma just at the edge of the stoma
•   Rewet your finger and repeat until you have gone around the stoma.
•   Carefully recap the tube after use
•   Do not be surprised by the tingling sensation when applying the paste (for 30 seconds), linked to the alcoholic excipient it contains
•   Use the alcohol-free paste if skin irritations.

What is colonic irrigation (only indicated for a left colostomy)

Those with a left colostomy have the option of performing colonic irrigation if their surgeon agrees. The principle is based on the regular administration of an enema of lukewarm tap water through the stoma. This enema (“irrigation”) allows all of the colonic contents to be evacuated. The stoma thus has no flow between two irrigations.

Irrigation is carried out every 2 to 3 days. This check therefore makes it possible not to wear a collection pocket. Only a small protective dressing is applied to the stoma between 2 irrigations.

The education will be done at a distance from the operation, in an ostomy consultation.

Some dietary advice

On discharge from the hospital, a normal diet should be continued.

Follow a few simple hygiene rules:

• Eat slowly and calmly
• Chew food well
• Drink regularly throughout the day
• Do not take drugs affecting intestinal transit (laxatives, constipants) without a medical prescription.

Consume in moderation:

• Pulses (lentils, split peas, flageolet beans), cabbages, turnips, artichokes, salsify, and mushrooms which tend to give off-gas.
• Fermented cheeses, pheasant meats, and cold meats are foods that make stool smelly. Finally, be aware that black pudding, spinach, iron-based drugs color the stools black (which is of no consequence).

In case of constipation, increase the ration of green vegetables and fruits, drink a lot (water, herbal teas, broths) to hydrate the stool.

In case of diarrhea, increase the drinks to compensate for the fluid losses. Eliminate dairy products and vegetables (except carrots) for 48 hours. Eat rice, pasta or semolina.

Some clothing advice

Modern equipment is discreet. You should be able to continue dressing with the greatest freedom as long as the garment or belt does not compress the stoma or pocket.

You should not hesitate to go to the beach or to the swimming pool. The devices are easy to conceal in a bathing suit and they can withstand salt or chlorinated water. At these times, you can carry a smaller pocket.

Activities and social life

The length of your convalescence depends on various factors: the type of surgery, additional treatments, etc. The existence of your stoma does not contraindicate the resumption of your professional activity. Only hard labor can be a problem. It is rarely necessary to consider retraining or adapting to a job.

Usual travel, whether by car or not, does not pose any particular problem. As motorists, be sure to put on your seat belt without compressing the stoma.

Whether individual or collective, you can practice all sports except those involving brutal physical contact (boxing, karate, wrestling, aerobatics, etc.). In case of prolonged efforts, take drinks and salt (Vichy water).

Generally speaking, if the bag is likely to move, hold it with a microporous adhesive.

Of course, you can travel by simply taking a few precautions with regard to the eating habits of the countries visited and by providing yourself with all the necessary equipment. Store the bags in a dry place, away from heat. It is preferable to take your equipment in hand luggage rather than a suitcase which risks being lost and to keep a copy of your prescription as well as the precise references of your equipment that you can present to a doctor during the renewal. of your prescription.

You can therefore change your appliance according to your activities, the evolution of your ostomy, or the innovations of the manufacturers. Many associations of ostomates and stoma nurses can answer your questions.