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    Caring for Your Ostomy Following Bowel Surgery

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    What is an Ostomy?

    An ostomy, usually either a colostomy or ileostomy, is a surgical procedure where the intestine is surgically brought through the abdominal wall to the skin. The ileostomy or colostomy opening on the skin is called a stoma. It is red, usually round, and often raised above the surrounding skin. This is the opening through which stool will now exit your body. The stoma does not have any sensation. Therefore, stool can pass through the stoma without your awareness. An ostomy pouch will be placed over the stoma after surgery to collect the gas and stool. After surgery, your nurse will provide the following instructions on caring for your ostomy.

    You Will Learn:

    • How to empty your ostomy pouch.

    • How to change your ostomy pouch.

    • When you will need to call your doctor or Ostomy Nurse Specialist.

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    How Do I Empty the Ostomy Pouch?

    Your ostomy pouch will fill with stool during the day and night. Empty your pouch when it is 1/3 full of stool or gas. Note: If the pouch overfills, the pouch seal may leak causing stool and gas to seep from the edge of the pouch.

    Pouch Emptying Procedure

    1. Float tissue on the toilet water to prevent splashing.

    2. Sit on the toilet in the usual way for having a bowel movement.

    3. Hold the bottom of the ostomy pouch upward. Release the clamp and then turn the tail of the pouch inside out making a cuff.

    4. Pinch the cuff and aim the open end of the pouch into the toilet bowl.

    5. Wrap paper around the pouch and push the stool from the pouch into the toilet.

    6. Wrap toilet paper around your finger and wipe the stool from the inside and outside of the pouch tail until it is clean.

    7. Turn the cuff back and reapply the pouch clamp.

    8. When emptying gas from the pouch: If your pouch fills with gas, remove the clamp, and release the gas from the bottom of the pouch. Do not put a pin hole in the pouch to relieve the gas. Any puncture to the pouch will destroy the odor-proof qualities of the pouch.

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    How Often Do I Change the Pouch?

    Change your ostomy pouch twice a week. Changing the pouch on a regular basis will prevent leakage problems. Do not patch a leaky pouch. If your pouch is leaking, change it promptly. This will prevent skin irritation and itching around your stoma.

    Changing a One-Piece Pouch

    1. Remove the paper covering from the skin barrier.

    2. Apply a small amount of ostomy paste around the stoma opening of the pouch.

    3. Remove the paper covering from the pouch tape. Set prepared pouch aside.

    4. Gently remove the old pouch by lifting the tape with one hand, and pushing your skin away from it with the other hand.

    5. Wash the skin around your stoma with water, or while showering.

    6. Dry your skin well.

    7. Pull your abdominal skin upward, and center the opening of the pouch over the stoma. Starting below the stoma, press firmly around the stoma and then smooth out the tape.

    8. Apply the clamp to the bottom of the pouch.

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    Do I Need to Follow a Special Diet?

    • Most people can resume their regular diet. However, eating soft, easy-to-digest foods after surgery is encouraged. If you have specific questions about your diet after surgery, talk with your surgeon or Ostomy Nurse Specialist.

    • Some people are bothered by excess gas in the pouch. The following vegetables may cause gas: cauliflower, broccoli, cabbage, dried beans, cucumbers and onions. Limiting your intake of these vegetables may reduce gas in the pouch.

    Frequently Asked Questions
    Question: Can I take a shower with my ostomy pouch?
    Answer: You may shower with or without the pouch. If you shower with the pouch, do not take any special precautions to keep it dry. Simply dry the outside of the pouch after your shower.

    Question: What should I do if my stoma is bleeding?
    Answer: A small amount of bleeding from the stoma during routine cleaning is normal. Stoma tissue is fragile and does bleed occasionally. A large amount of bloody stool in the pouch is not normal. If the pouch fills with blood report this to your doctor immediately.

    Question: What should I do if the skin around my stoma is irritated?
    Answer: Sometimes the skin around the stoma can become irritated. This may be caused by several factors. If the skin around the stoma is painful, red, raw, or weeping for longer than one week, call your health care provider.

    Question: What can I do about odor?
    Answer: You can buy special preparations to place in your pouch to control stool odor. Do not put an aspirin in the pouch. Aspirin may cause bleeding from the stoma.

    Question: Can I travel after ostomy surgery?
    Answer: You may travel after ostomy surgery once you have recovered. Usually, your doctor will recommend it is safe to travel after you have been home for a few weeks. When you travel, always carry extra ostomy supplies. If you travel by plane, make sure to place your ostomy equipment in your carry-on luggage rather than your suitcase.

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    When to Call the Doctor

    Call the Doctor if You Have:

    • A temperature of 101°F / 38.3°C or above.

    • Persistent abdominal pain, nausea and vomiting, or severe constipation or diarrhea.

    • The ostomy pouch fills with blood. A large amount of bloody stool in the pouch is not normal.

    • The skin around the stoma is painful, red, raw or weeping for longer than one week.
    Call the Ostomy Nurse Specialist if you experience any of the following difficulties in caring for your ostomy:
    • You may call the Ostomy Nurse Specialist if you are having difficulty getting a secure pouch seal, for skin problems around your stoma, or any questions related to your general ostomy care at home.

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    How Can I Get my Ostomy Supplies after Surgery?

    • Ostomy supplies are provided for you in the hospital.

    • After you leave the hospital, you can obtain ostomy supplies from a local specialty supplier or through a mail-order company. The Ostomy Nurse Specialist and the home health care team will instruct you in how to order your ostomy supplies.

    • Your insurance company may cover the cost of part or all of your ostomy equipment.

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    Will I Have Help at Home?

    • If your doctor has ordered home health care services, the hospital case manager will arrange these services before you leave the hospital. The home health agency will call you at home to set up a time for the first home visit.

    • Insurance usually covers medically necessary home health care. You will be notified if you are responsible for a portion of the visit cost.

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    More Ways to Learn

    Visit the United Ostomy AssociationOpens new window Web site for ostomy information or call (800) 826-0826.

    Produced by the Center for Patient and Community Education in association with the staff and physicians at California Pacific Medical Center. Date: 1/03

    Funded by: A generous donation from the Mr. and Mrs. Arthur A. Ciocca Foundation.

    Note: This information is not meant to replace any information or personal medical advice which you get directly from your doctor(s). If you have any questions about this information, such as the risks or benefits of the treatment listed, please ask your doctor(s).

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