Bowel Disease: Caring for Your Ostomy
What is an Actionset?
Caring for your ostomy is an important part of maintaining your quality of life. You will need to:
You may also irrigate a colostomy, which helps you control when you eliminate waste. Irrigation requires your doctor's approval and guidance.
Wound, ostomy, and continence nurses (WOCNs) are available in some medical centers to help you learn how to care for your ostomy.
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An ostomy is a surgical procedure. When a part of the digestive system is diseased or damaged and not able to work normally, a hole is made in the abdomen and a portion of the small or large intestine is brought to the surface of the skin. This opening is known as the ostomy, and the end of the exposed intestine is known as the stoma. A colostomy and ileostomy are cared for in a similar manner with similar products.
When you have a colostomy or ileostomy, waste leaves the body through the stoma, the end of the intestine that is attached to the abdominal wall, instead of the anus. Since there is no muscle around the stoma, you are not able to control when waste or gas passes out of the body. An odor-proof plastic pouch (an ostomy pouch) surrounds the stoma to collect the waste. It is held to your skin with an adhesive. Pouching systems may be one-piece or two-piece.
Other accessories may include:
Test Your Knowledge
Test your knowledge about what an ostomy is.
When you have had an ostomy, you are not able to control waste leaving your body.
You need to care for your ostomy because:
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Test your knowledge about why you need to care for an ostomy.
One reason you need to care for an ostomy is to prevent skin irritation.
Proper care for your ostomy includes learning how to empty and replace the pouch and knowing what to watch for.
Some people choose to irrigate a colostomy. Irrigation is a procedure in which you stimulate and flush the intestines at a regular time to control when you eliminate solid wastes.
Note: If caring for an infant or child with an ostomy, the same information and procedures generally apply. But the ostomy pouch will be smaller and will most likely need to be replaced more often. Different adhesives may be used to attach the pouch because a child's skin is more sensitive than an adult's skin. Your wound, ostomy, and continence nurse (WOCN) will help you learn how to care for your child with an ostomy. Irrigation is not appropriate for children.
Emptying your ostomy pouch
Ostomy pouches can be drainable or closed. A drainable pouch opens at one end to allow you to empty it. A closed pouch is disposed of and replaced with a new one as needed.
The pouch fills with waste and gas. It is best to empty the pouch when it is one-third to one-half full. This prevents the pouch from getting too full and heavy and pulling off. Many people routinely empty the pouch each time they urinate.
Replacing your ostomy pouch
How often you change your ostomy pouch depends on many things, including the type of stoma you have and what you prefer. Some pouching systems are changed daily. Others are changed every 3 to 7 days. You may need to change your pouching system more often if there is a leak in the pouch or itching or burning under the barrier. The pouch itself is usually emptied or replaced after each bowel movement.
Treating skin irritation
If the skin under your pouch is red, irritated, or itchy, you need to treat your skin. Follow these steps:
If you continue to have skin irritation, consult your wound, ostomy, and continence nurse (WOCN) or another nurse or a doctor.
Irrigating a colostomy
Irrigating a colostomy allows more control over the elimination of waste, because it stimulates the intestine to function at a regular time. It is typically done at the same time every day or every other day. If you irrigate, you may need only a cover or pad over your stoma and may not need an ostomy pouch.
Children do not use irrigation.
Only a colostomy can be irrigated. You cannot irrigate an ileostomy.
To irrigate a colostomy, you need to have all of the following equipment and supplies ready, including:
See a picture of colostomy irrigation.
A two-piece pouch system is usually used for irrigation. A nurse or doctor will show you how to irrigate your colostomy. The basic procedure is as follows.
Preparing the equipment
What to watch for
Here are some things to watch for. Call your doctor if:
Test Your Knowledge
Test your knowledge about how to care for your ostomy.
An adult should change the pouching system:
Every 3 to 7 days.
If there is a leak in the system, itching under the barrier, or burning under the barrier.
You should empty or dispose of your pouch when:
It is one-third to one-half full.
It is full.
Now that you have read this information, you are ready to care for your ostomy. If you have any questions about caring for your ostomy, contact your doctor or a wound, ostomy, and continence nurse (WOCN).
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