Getting a Stoma: Addressing Complications

When preparing for a surgical stoma, there are undoubtedly some concerns about potential complications. Like with any surgery, a surgical procedure creating a stoma comes with some risks. Doctors recommend surgical stomas because they believe that they will improve the outcomes of your condition. They will likely review the benefits and risks of the surgery and describe potential complications and their chances. Issues can arise with the stoma opening itself, as well as the area around the stoma, known as the peristomal skin. However, many of these complications can be managed with awareness, proper care, and communication with your medical team. 

Stoma Complications

Studies in Denmark and Canada have found that a major contributing factor to problems with peristomal skin disorders is that. While a significant portion of people who had a stoma had a complication with the peristomal skin, only a minority of people were concerned about it. Most of the people with the complication also did not seek medical help. Although the peristomal skin can have significant rates of complications, especially between six months and two years after stoma surgery, most people do not recognize the risk or know how to address it. There are often no formal procedures in place to follow up after the stoma surgery. However, risk factors for peristomal complications can often be predicted before the surgery takes place.

A good way to prepare for stoma surgery is to discuss certain information with your medical team. First, to determine whether you have any risk factors for complications after surgery. Second, to establish a postoperative follow-up schedule with your surgeon or Enterostomal Therapy Nurse. This way, you will have a system in place to contact in case of any questions or concerns, and also identify and address any potential complications after surgery. 

Addressing Risk Factors

There are some factors to look out for after getting stoma surgery. These can be addressed relatively easily as long as they are addressed early. Consult with your surgeon for information about what a stoma and the surrounding skin contours should look like. Then, you can keep an eye on the area as you recover and address any concerns with your doctor. If your stoma is not in an ideal configuration, it can be corrected with methods such as appropriate pouching. 

For example, excessive weight fluctuation can cause complications to the skin surrounding the stoma. The stoma may also shrink a few weeks after surgery. These two factors may cause the flange around the edge of the stoma to need adjustment. These concerns can be addressed to your medical team and see if flange resizing is needed during your next flange change. 

While the thought of surgery can be worrying, the main thing is to have a clearly laid out plan with the medical professionals involved in your surgery. By checking in and being aware of your body after surgery, you should be able to head off major complications. Be aware and proactive when caring for your stoma after surgery. Your surgeon likely recommended a stoma because they believe it can improve your life, and with proper awareness and follow-up, you can have a smoother recovery. 

 

Different Types of Ostomy Barriers

There are many types of ostomy barriers. Ostomy barriers can be made from a variety of materials, and they serve different purposes. The most common type is the adhesive barrier used to cover the stoma (opening) when you go swimming or participate in other water-related activities that might cause leakage. This adhesive barrier is a typically waterproof material that sticks to the skin and provides an airtight seal. Some ostomy barriers can be worn during light activity, such as those who lead active lifestyles or participate in sports like golfing. An adhesive barrier is also used after bowel movements when you need extra protection from leakage. It's essential to know how to use ostomy barriers properly.

Another type is an external pouch that holds your pouching system outside your clothing and covers it with pants or skirts. This style of ostomy barrier makes it easier for you to wear clothes without worrying about leaks getting on them. The external pouch is worn over the pouching system and clothing but is removed when changing your ostomy appliance. It is possible to buy pre-made clothing that will work with your ostomy system, but you can also make some clothes yourself.

Common external pouches are the belt or suspender type, where a strap goes around your waist, and another strap goes over each shoulder, attaches in the back, so they help hold up the pouch. One type is a belt that connects to your waist and then loops through the back of your pants or skirt-like suspenders. This style can be more convenient for those who work in healthcare because scrubs are already part of the typical uniform.

Ostomy belts are another type of external pouching system that goes around your waist. There are also elastic or fabric pouches that you can attach to your belt or clothing items with velcro straps cheaper than buying pre-made vests like those for ostomates who work in healthcare.

There are also adhesive belts for wearing an ostomy pouch; they tend to be more expensive than other external pockets. This style is similar to the disposable adhesives that doctors use during surgery or when you get a tattoo because it's made with medical-grade materials instead of typical fabric. An advantage is that you won't have to worry about adjusting the pouch or having it slip down your body. They're made of high-quality materials and will last for years; these typically come in different sizes, so you can get one that fits well and provides a comfortable feel.

The third type of ostomy barrier is the internal pouch which slips into your underwear and holds your colostomy bag inside. This type of ostomy barrier is not expected, but some people prefer it because it prevents the colostomy bag from touching their skin. An internal pouch also provides more protection against leaks than an external pouch or belt type of ostomy barrier. However, you can buy pre-made underwear with a pocket for holding your colostomy bag, and you can also make your own.

 The last type is the ostomy wrap which goes around your waist or hips instead of a belt. It's designed to hold your pouch in place without being visible under clothing; an advantage over other styles is that they're less likely to slip down or cause pain when worn for long periods. Ostomy wraps are typically made of soft, elastic materials instead of the stiffer fabrics used in belts or pouches, which can be uncomfortable for some people.

 

How Ulcerative Coilitis Is Treated

Treating ulcerative colitis involves more than one would expect. You have to consider your symptoms and the time of the disease's occurrence. Luckily, there are various constructive medication and treatment solutions you can use. 

While the treatment of ulcerative colitis involves numerous techniques, this guide looks at the major highlights:

Prescriptions

There are many categories of medications that you can use to address ulcerative colitis, including:

Anti Inflammatories 

These are drugs that are helpful as the first line of treatment against the disease and can include:

• 5-aminosalicylates, which you can consume in various ways, including orally or as a suppository. The common types include Delzicol and Dipentum.

• Corticosteroids such as Hydrocortisone and Prednisone. These are suitable for moderate to severe cases of the disease because of these drugs' potency. Some side effects of excessive usage including increased blood pressure, emotional disability, and various others. 

  
  

Immune System Suppressors 

These medications help regulate the inflammation that occurs due to the immune system's response mechanism. The drugs in this category include:

• Asian and Imuran fall in the category of immunosuppressant's, and they work by adjusting the production of the body's DNA molecules. 

• You can use Gengraf and Sandimmune, which medical health experts prescribe to people who have struggled with other medications. A good example would be Cyclosporine. 

Antibiotics 

These refer to medication that health experts prescribe for any health issues that might have occurred to the colon. However, people with Ulcerative Colitis sometimes have to avoid using the drug as it can lead to diarrhea.

Some researchers have also shown the strong relationship between patients who use antibiotics and the occurrence of Inflammatory Bowel Disease.

 Over the Counter Therapies 

These refer to medications that help control the symptoms that can occur due to ulcerative colitis. However, they work well alongside prescription drugs, as they only suppress some of the diseases' symptoms. The common OTC medications can include:

• Antidiarrheal medications help regulate unusual bowel movements. A good example would be loperamide, but you have to use it with caution. 

• Pain relievers work well for addressing issues such as mild pain, with a good example being Tylenol. 

 Complementary Medicine (CAM) 

While some medications are highly effective for controlling the symptoms of Ulcerative Colitis, many experts believe more research should occur in this field. Here are the common drugs that fall in this category:

• Probiotics or "stomach-friendly bacteria" help suppress the effects of the disease and compromised bower functions. 

• You can use Aloe Vera gel, which one can extract from the inside of the plan using DIY techniques. 

Lifestyle Changes 

Similar to all other health issues, making lifestyle changes can considerably impact the management of ulcerative colitis. The common suggestions include:

•  You have to avoid spicy foods because they can irritate the bowel and lead to various issues like diarrhea. 

•  You also have to Limit fat and fiber consumption because these can worsen your symptoms. 

•  You also have to Avoid alcohol consumption as it's highly acidic and can also irritate your bowel. 

•  Avoid certain medications such as nonsteroidal anti-inflammatory drugs or NSAIDs such as aspirin. 

  
  
  

Frequently Asked Questions 

Does Ulcerative Colitis Have a Cure?

No, ulcerative colitis has no well-known cure. However, going for treatments such as surgery and using the proper medications can have many benefits.

How Long Will it Take to Treat Ulcerative Colitis?

It takes a few days or weeks for ulcerative colitis to be healthy effectively. In some cases, remission can occur for months, depending on the treatment approach you choose.

An Overview Of Ostomy

Your intestine could have a disease or injury, which may result in it requiring resting and healing or removal. In either of these cases, you may need an ostomy. An ostomy is an intestinal diversion that allows bodily wastes to leave the body without proceeding to the diseased section of the bowel. Wastes will leave the body through an opening (stoma) in the belly.

The surgeon will remove or disconnect the part of your colon to create an ostomy. After disconnecting the healthy part of the GI tract from the diseased part of the colon, the surgeon will bring the end of the healthy part of the tract to the abdomen and pull it out through a small incision. The end sticking on the belly will form an opening to allow waste materials to leave the body. This bud-like end of the intestinal tract is known as the stoma.

There are two types of intestinal ostomies: colostomy and ileostomy.

If you have a colostomy, you will retain a part of the colon, which means that a majority of nutrients will absorb in your body. The stool passing out of a colostomy is thick.

If you have an ileostomy, you will no longer have a colon. The small intestine will still absorb nutrients, but the absence of the colon will cause a significant amount of water with electrolytes to leave the body. If you do not compensate for this loss of fluids and nutrients, you may run the risk of having dehydration and other issues.

Understanding your stoma

The stoma is the end of the intestine, sticking out on the abdominal skin. After pulling it out of the cut in the belly, the surgeon will turn the edges of the end of the intestine onto itself and suture them to skin of the belly. It forms a bud-like opening that allows bodily wastes to pass out of the body.

You may want to know a few characteristics of the stoma in this regard.

• It is red
• It may bleed easily when you rub it
• It remains moist
• It can move with bowel movements
• It has no nerve ending, meaning that you won’t feel anything on it
• With no sphincter muscles in the stoma, you will not be able to control when to move your bowels

Caring for an ostomy

At first, caring for an ostomy may seem like a daunting task, but it gets easier with time.

First of all, you will need to learn to manage your ostomy supplies, and also how to care for your ostomy. It will take some time, but you will have to figure out what products work best for you. You may also want to know where to buy your ostomy supplies.

Your ostomy care nurse should be the first point of contact in case you face any problem or you want to know something about caring for the stoma. Your nurse will also run you through the process of ostomy pouch management, which includes emptying and changing pouch. If the skin around your stoma is susceptible to infections, your nurse will suggest you the products that will help you prevent skin infections.

You might want to join an ostomy support group to prevent psychological impact of surgery from causing anxiety.

Vacationing in Hawaii with your Ostomy

This year is going to be amazing. I am so excited for how the year has panned out. Yes we did have a pandemic and pandemic did have me a bit scared.  I may even be a little more at risk for catching it due to my ostomy, but I am still excited for what is to come.  I have never been one to let a fun opportunity get me down no matter what was going on.  

This year we got stimulus checks in the mail and decided to take that money and put it right back into our economy.  This year I am taking my family to Hawaii. So traveling with a stoma can sometimes be a little more work than I would like but I plan on taking my ostomy care seriously and making sure all is going to be well.

The first thing that I am working on is having enough supplies to get me through my trip without having to go around and shop in a new state.  The last thing I want is to try a new product or go shopping for an ostomy bag on vacation.  That is why it is important to plan for the worst in order to avoid this type of situation. 

  First thing to do is to pack double what you need.  WHAT? That may sound like a bit too much, but what happens if your luggage does not arrive with your or arrive at all.  I like to make sure my carry on has enough ostomy care gear to get me through the week of vacation if I need it.  It is really better to be safe than sorry. So planning ahead can really save you and I suggest separating out your gear in two parts and packing it in your carry on and luggage.  That is my goal and it will likely keep me from having to shop in Hawaii if something gets lost.  I mean would you rather be on a beach or at a pharmacy in paradise? 

The next thing is to make sure you have the right and comfortable gear for the water.  I like to bring stoma caps for the water because I have been working on my body and I want people to focus on me and not my stoma.  It is an easy way to protect my stoma and enjoy the water. But that is a personal choice.

New Ostomates And The Depression Problem

Depression can have an impact on thinking and overall perception of life. A surgery that tends to bring a permanent change in life, such as an ostomy, is one of the most common reasons for depression. According to a study, there are over one million people in the USA with ostomies. This number increases at a rate of 100,000 per annum.

The loss of control over stool and gas is an understandable consequence of ostomy surgery. In most of the cases, this consequence tends to be permanent. According to a study, people who have ostomies usually have decreased health-related quality of life. The study further elaborates on the level of difficulty those people face while dealing with their life and relationships.

The lifestyle changes occurring as a result of ostomy surgery are usually quite complicated to adapt. More specifically, the first few weeks after the surgery bring a lot of insecurities and fear to the minds of ostomates.

The negative psychological impact

An ostomy is much like a learning curve for the new ostomates. If they do not have proper guidance about it, they can end up frustrated and depressed. The newly developed body change brings with it the feeling of helplessness, anguish, fear, and sadness. These feelings further result in the loss of self-esteem and health, coupled with other negative emotions such as a sense of uselessness. Many of the ostomates also get caught by insecurity and fear of rejection in society.

Further down the road, ostomates also develop a fear of isolation due to the negative experiences in managing ostomy appliances. The leakage of gas or stomal output in public causes real embarrassment for the ostomates.

All these issues can result in a much negative psychological impact on an ostomate's life.

Overcoming depression

It is understandable for new ostomates to develop difficulty coping with a new phase of life after ostomy surgery. But it doesn't mean they cannot live normally. All it takes is the right guidance and a will to cope with the new change. The selection of the right ostomy supplies has a huge role to play in this regard. The use of the right ostomy supplies in the right way results in much-needed satisfaction, which is necessary to gain a psychological advantage.

Posoperative education

Most of the new ostomates are not familiar with the experience of dealing with an ostomy. In that case, it becomes necessary to pay attention to the instructions by ostomy care nurses and medical staff. These detailed instructions tend to educate the new ostomates about how to get their lives back on track.

The Right Time To Use Stoma Paste

The stoma paste is a type of skin barrier that comes in a tube. The primary purposes of this paste are to fill the skin indentations and prevent the skin from coming in contact with the cut opening of the pouch skin barrier. Note that this paste is not the glue that can hold a pouch.

The primary purpose of the stoma paste is to fill in rough skin surface around the stoma. The skin smoothness, which develops after the paste application, allows the skin barrier to sit well over the peristomal skin, forming a leakproof seal. This seal prevents the stomal output from leaking out of the pouching system. Stomal leak can result in social, psychological, and physical discomfort for ostomy patients. And these leaks can occur as a result of the poor fitting of the ostomy pouching systems, mainly due to irregularities of skin outlines. Stoma paste is the best means to counter such skin irregularities.

Benefits of using stoma paste

Prevention of stoma drainage and resultant discomfort in the peristomal skin is the primary benefit of stoma paste. Patients need to apply this paste while changing the pouching system. To avoid evacuation from the stoma during the pouching system change, doing it before mealtime is a good idea.

Instructions to avoid adverse effects

Applying stoma paste in excess can do more harm than good. Many of the cylinder pastes available in the market contain alcohol. Sensitive patients might start getting a burning sensation after the application of such paste. Strips stoma pastes do not usually contain alcohol. Patients who are sensitive to alcohol-based cylinder pastes can consider using the strips pastes to avoid any skin discomfort.

Also, the stoma paste can leave an adverse effect on the ideal wear time of the wafer. So, before using the stoma paste, patients need to be sure that they need to apply it.

Adverse effects of adhesive agents

Some adhesive agents in the stoma paste can cause damage to the skin, especially at the time of pouch change. While stoma paste is not primarily an adhesive agent, it fortifies adhesion to a certain degree. Individuals whose skin is fragile or the ones who have to change pouches frequently should not use this paste without the nurse's advice. Individuals who are benefitted more from this paste are the ones who fail to prevent leakage with the pouching system's normal adhesion.

How to apply the stoma paste

There are a few steps that you need to follow while applying the stoma paste.

• Wash the peristomal skin thoroughly to remove any residue. Then, dry it until there is no moisture left.
• You can apply stoma paste directly on the peristomal skin or the inner side of the wafer. Allow it to sit for two minutes after applying it to the peristomal skin.
• If you are applying the paste on the wafer, place it on the skin as usual. There you need to hold the wafer against the abdomen for one minute.