WHAT IS AN OSTOMY? Ostomy; created through a surgical procedure that creates an opening from the bowel to the abdomen resulting in a stoma for the purpose of eliminating waste in the form of stool. Ostomies may be temporary or permanent depending on the reason they were created and the extent of injury or the disease process. Stoma; a segment of bowel formed from mucosal tissue and brought to the surface of the abdomen. It should be red and moist in appearance and will ideally protrude about 1.5-2.5 cm out of the abdomen. Unlike the anus, the stoma has no sphincters or valves meaning the individual will have no control over the passage of stool from the stoma. However, there are no nerve endings in the stoma meaning it should not cause any pain or discomfort for the individual. (UOA, n.d & American Cancer Society, 2011) (Normal Colon, 2000) Reasons people have ostomies; - Inflammatory bowel disease (ulcerative colitis or crohn’s - Cancer - Intestinal blockage - Intestinal tear (often caused by diverticulitis) - Trauma or bowel injury - Non-healing wound - Infection or abscess in intestines - Congenital anomalies or birth defects (Walker& Lachman, 2013 & RelayHealth, 2012) Types of Ostomies; Colostomy; a surgical opening from the colon (large intestines) to the surface of the abdomen to form a stoma for the purpose of discharging stool. It is usually created when a portion of the colon or the rectum is removed and the remaining colon is brought to the abdominal wall. Colosomies require an external appliance and are further defined by the portion of the colon involved. (Colostomy, 2010) - Sigmoid colostomy; the most common type of ostomy where the descending (sigmoid) colon is brought to the surface of the abdomen to create a stoma. They are usually located on the lower left quadrant of the abdomen. - Transveres colostomy; created with the transverse colon and results in one or two stomas, that are generally located in the right upper or middle side of the abdomen. - Loop colostomy; created with the transverse colon and results in the construction of two stomas, one to discharge stool and one to secrete mucus. - Ascending colostomy; not commonly seen but created with the ascending colon and is located on the right side of the abdomen. (Ileolostomy, 2010) Ileostomy; a surgical opening from the ileum (small bowel) to the surface of the abdomen to form a stoma for the purpose of discharging stool. They are generally located on the lower right side of the abdomen. - Continent ileostomy; the construction of an intra-abdominal pouch from part of the ileum. It may be referred to as an abdominal pouch. External appliances are not required, instead a few times a day a catheter must be inserted into the site to drain the waste. - Ileo-anal reservoir; the construction of a pouch made from the ileum and rectum, it is then placed inside the body in the pelvis and connected to the anus. It may be reffered to as a J-pouch or pelvic pouch and actually allows the individual to pass stool through the anus. (UOA, n.d & American Cancer Society, 2011) Ostomy Appliances Ostomy appliances come in endless shapes, sizes and brands and depend on the location and size of the stoma as well as individual preference. The main appliances used are one or two-piece systems and flat or convex systems. Furthermore, the actual appliance ring that surrounds the ostomy can be ordered to fit the size of the stoma or can be cut to size accordingly. Ensure you are using the right size pouching system because if the opening is too small it will cause the stoma to swell and cause obstruction and if the opening is too big then it may cause leakage or the skin around the stoma to become irritated. Ostomy bags should be emptied as per individual preference and when about 1/3 full, the entire appliance should be changed every 3-7 days. (American Cancer Society, 2011 & personal communication, March 6, 2013) A good pouching system should be: - Secure, with a good leak-proof seal that lasts for 3 to 7 days - Odor resistant - Protect the skin surrounding the stoma - Nearly invisible when covered with clothing - Easy to put on and take off - Easy to empty (American Cancer Society, 2011) Skin barriers are used to protect the skin surrounding the stoma and most common ones used are barrier wipes, ostomy rings and stomahesive paste. However, please note that barrier wipes are NOT covered by insurance and will have to be paid out of pocket, make sure you patients are aware of all options before pursuing the wipes. (Potter, Perry, Ross-Kerr and Woods, 2009 & personal communication, March 6, 2013) Emptying an Ostomy Emptying an ostomy is very easy but often done wrong by nurses in the hospital due to a lack of understanding and education when it comes to ostomies. The bag should be emptied when it reaches about 1/3 full, as needed or when there is significant gas build up. Emptying the ostomy bag frequently ensures there is a smaller chance of the ostomy leaking, bursting or bulging underneath clothes. When emptying an ostomy ensure to turn the end of the bag inside out and empty as much stool as possible. After the bag is empty, clean the end of the bag with toilet paper or a throw away cloth. By having the end of the bag turned inside out it helps to keep the tail of the ostomy bag clean and stool free. If the patient is emptying the ostomy independently, have them do it in the washroom over the toilet with the above steps. Lastly, ensure to wash your hands and have the patient do the same after emptying their ostomy. (personal communication, March 6, 2013) Changing an Ostomy Appliance The ostomy should be changed approximately every five days or as needed. 1. gather all your supplies including garbage bag and new ostomy appliance 2. carefully take off the old appliance (be prepared to move quickly if the stoma is very active) 3. cleanse the stoma and skin surrounding the stoma with warm soapy water (use a mild soap) 4. dry the skin around the stoma thoroughly 5. prepare the skin with a barrier OR apply the barrier paste/ring to the new appliance 6. if needed, cut the flange to the proper size of the stoma (not too big or small) 7. take the tape off the back of the ostomy appliance and secure it to the skin 8. if using a two- piece system, secure the bag to the appliance 9. ensure there is a good seal of the ostomy appliance to the skin and the bag to the appliance 10. wash your hands (personal communication, March 6, 2013) (Ostomy Supplies, 2013) It is important for HCP to note; - what the stoma looks like (ie. red, moist and active) - what the appearance of the stool looks like (ie. liquid, pasty or formed) - what type of appliance and skin barrier the patient uses - what size the stoma is - any issues with the stoma or surrounding skin (ie. skin rash or swollen stoma) - how did the patient respond/ are they independent in stoma and ostomy care/ do they need further teaching (personal communication, March 6, 2013) Lifestyle / Ostomy & Stoma Care - Nutrition; well balanced diet and adequate fluid intake are very important with the management of an ostomy. While there are foods difficult to digest with an ostomy, there are actually no “off limit” foods. It is recommended that and individual doesn’t eat these difficult to digest or stringy foods all in the same sitting (ie. celery, lettuce and other raw vegetables). It is also very important that people with an ostomy chew their food very well, this will help prevent blockage by food at the stoma site. - Bathing; a normal bathing routine is encouraged for individuals who have an ostomy. It is personal preference whether the individual likes to shower or bathe with their appliance on but it is important to ensure the stoma is cleansed on a regular basis with mild soapy water and that the ostomy appliance is changed if it becomes very wet or the seal is broken. It is recommended that patients use waterproof tape around the outsides of the appliance in order to protect the barrier and appliance. Lastly, it is always important for the individual and HCP to perform hand hygiene after changing or emptying an ostomy. - Exercise; it is recommended that people with ostomies still get the regular recommended daily exercise and activity. However, keep in mind that heavy/weight lifting and contact sports risk the chance that there could be damage to the stoma or a chance of herniation. - Sexual activity; sexual relationships and intimacy are encouraged to continue with individuals who have a stoma and ostomy. While sexual function in women generally doesn’t change, men can occasionally be affected by changes and have difficulty getting or keeping an erection, however this should not last for long. The most important part of resuming sexual activity after surgery to create an ostomy is communication between partners and making sure that any concerns are discussed openly. (American Cancer Society, 2011 & personal communication, March 6, 2013) (Colostomy Stoma, 2013) Complications and Concerns -- It is normal for your ostomy to have short periods of time where there is little to no output. However, if the stoma is not active for over 4-5 hours or there is a new onset of cramps or nausea then there may be a block or obstruction to the ostomy. Obstruction can be caused by a food blockage or internal changes such as adhesions. If this happens; drink ginger-ale or warm liquids, take a warm bath to relax the abdominal muscles, try changing positions, do NOT take laxatives and if none of these tips are working, contact the doctor or ET nurse or go to the emergency department. -- A rash or denuded skin can occur due to an improper appliance fit or seal. Itching and burning are signs that the skin needs to be cleaned and the pouching system should be changed. Denuded skin or “burnt” skin generally means that stomach acid and stool is leaking onto the surrounding skin and this means the appliance should be changed and a better seal around the stoma needs to be created. -- Bleeding can occur because blood vessels in the tissue of the stoma are very sensitive and can bleed easily. Small amounts of blood after cleaning the stoma is not concerning however it becomes a concern if the bleeding continues or worsens, if this occurs contact the doctor, ET nurse or go to emergency department. -- Odor is inevitable with ostomies just as it is with a normal bowel movement. Certain foods may cause an individual more gas or odor but it is very personal so the individual must learn from experience. In order to limit odor; empty the ouch often, use an odor resistant pouch, ensure the pouch is sealed properly to the skin and odor resolving tablets or spray can be added to the pouch if necessary. -- Hernia’s occur commonly after the creation of an ostomy or during heavy lifting and is the bulging of an area or loop of the organ or tissue surrounding the stoma. Hernia’s generally occur over a longer period of time so alert your doctor or ET nurse if you are noticing any changes or new bulges in the skin post-op. -- Diarrhea is frequent, loose or water bowel movements and usually signifies that something is not quite right. It can be caused by certain food or beverages but becomes dangerous when it continues for greater than 5-6 hours as it can lead to severe electrolyte imbalance. It is recommended that you contact a health professional if diarrhea or a significant change in stool occurs. Note: depending on the placement of your colostomy (ie. transverse and ascending) and ileostomy the ‘normal’ bowel movement might be very liquidy, this is normal and not considered a concern or emergency. (American Cancer Society, 2011 & personal communication, March 6, 2013) Ostomies and Nursing Ostomies are becoming more common on hospital units due to cancer, surgery and trauma it is important that floor nurses and health care professionals know how to care for patients with ostomies. It is very important that nurses have the tools and resources in order to help patients to learn ostomy self care as well as to help them through any emotional, physiological or physical issues or challenges they may come across with having an ostomy. When in doubt, consult an ET nurse who specializes in ostomy and wound care. Enterostomal Therapy nurses (ET nurse) are trained in ostomies and do stoma and ostomy education with patients preoperatively and postoperatively. ET nurses help the patients adjust to their new stomas and work with the patient to find a good fit for an ostomy appliance. These nurses are an excellent resource for floor nursing staff when they have questions or concerns regarding a patient with an ostomy (ie. rash around stoma develops, stoma changes colour or continuously leaking appliance) and their knowledge and skills should be utilized as they are ‘experts’ in the field of ostomies. (personal communication, March 6, 2013) References American Cancer Society. (2011). Colostomy: a guide. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/ostomies/colostomyguide/colostomy-guide-toc American Cancer Society. (2011). Iliostomy a guide. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/ostomies/ileostomyguide/ileostomy-living-with-ileostomy Colostomy. (2010). Relay health [online image]. Retrieved March 10, 2013 from http://www.summitmedicalgroup.com/library/adult_health/aha_colostomy Colostomy Stoma. (2010). Healthwise incorporated [online image]. Retrieved March 14, 2013 from http://www.webmd.com/digestive-disorders/colostomy-stoma Ileostomy. (2010). Relay health [online image]. Retrieved March 10, 2013 from http://www.summitmedicalgroup.com/library/adult_health/aha_colostomy Normal Colon. (2000). Radiographics [online image]. Retrieved March 12, 2013 from http://radiographics.rsna.org/content/20/2/399/F1.expansion.html Ostomy Information. (n.d). United Ostomy association of Canada (UOA). Retrieved from http://www.ostomycanada.ca/ostomy_information Ostomy Supplies. (2013). Steveneddy [online image]. Retrieved March 14, 1013 from http://steveneddy.wordpress.com/pics/ Potter, P. A, Perry, A. G., Ross-Kerr, J. C., & Wood, M. J. (Eds.). (2009). Canadian fundamentals of nursing (4th ed.). Toronto, ON: Elsevier Mosby. Relay Health. (2012). Colostomy and ileostomy. Retrieved from http://www.summitmedicalgroup.com/library/adult_health/aha_colostomy Walker, C. A., & Lachman, V. D. (2013). Gaps in the Discharge Process For Patients with an Ostomy: An Ethical Perspective. MEDSURG Nursing, 22(1), 61-64.

When you first get an ostomy, the world of products available can be a very disorientating and intimidating place. Do I need a ring? What is a flange? I decided to put together a glossary type guid…

There is no specific “ostomy diet” but there are important considerations as you discover the foods that work best for you. For guidance on ostomy diet and nutrition, follow a nurse or doctor’s orders at each stage of your post-op adjustment.

WHAT IS AN OSTOMY? Ostomy; created through a surgical procedure that creates an opening from the bowel to the abdomen resulting in a stoma for the purpose of eliminating waste in the form of stool. Ostomies may be temporary or permanent depending on the reason they were created and the extent of injury or the disease process. Stoma; a segment of bowel formed from mucosal tissue and brought to the surface of the abdomen. It should be red and moist in appearance and will ideally protrude about 1.5-2.5 cm out of the abdomen. Unlike the anus, the stoma has no sphincters or valves meaning the individual will have no control over the passage of stool from the stoma. However, there are no nerve endings in the stoma meaning it should not cause any pain or discomfort for the individual. (UOA, n.d & American Cancer Society, 2011) (Normal Colon, 2000) Reasons people have ostomies; - Inflammatory bowel disease (ulcerative colitis or crohn’s - Cancer - Intestinal blockage - Intestinal tear (often caused by diverticulitis) - Trauma or bowel injury - Non-healing wound - Infection or abscess in intestines - Congenital anomalies or birth defects (Walker& Lachman, 2013 & RelayHealth, 2012) Types of Ostomies; Colostomy; a surgical opening from the colon (large intestines) to the surface of the abdomen to form a stoma for the purpose of discharging stool. It is usually created when a portion of the colon or the rectum is removed and the remaining colon is brought to the abdominal wall. Colosomies require an external appliance and are further defined by the portion of the colon involved. (Colostomy, 2010) - Sigmoid colostomy; the most common type of ostomy where the descending (sigmoid) colon is brought to the surface of the abdomen to create a stoma. They are usually located on the lower left quadrant of the abdomen. - Transveres colostomy; created with the transverse colon and results in one or two stomas, that are generally located in the right upper or middle side of the abdomen. - Loop colostomy; created with the transverse colon and results in the construction of two stomas, one to discharge stool and one to secrete mucus. - Ascending colostomy; not commonly seen but created with the ascending colon and is located on the right side of the abdomen. (Ileolostomy, 2010) Ileostomy; a surgical opening from the ileum (small bowel) to the surface of the abdomen to form a stoma for the purpose of discharging stool. They are generally located on the lower right side of the abdomen. - Continent ileostomy; the construction of an intra-abdominal pouch from part of the ileum. It may be referred to as an abdominal pouch. External appliances are not required, instead a few times a day a catheter must be inserted into the site to drain the waste. - Ileo-anal reservoir; the construction of a pouch made from the ileum and rectum, it is then placed inside the body in the pelvis and connected to the anus. It may be reffered to as a J-pouch or pelvic pouch and actually allows the individual to pass stool through the anus. (UOA, n.d & American Cancer Society, 2011) Ostomy Appliances Ostomy appliances come in endless shapes, sizes and brands and depend on the location and size of the stoma as well as individual preference. The main appliances used are one or two-piece systems and flat or convex systems. Furthermore, the actual appliance ring that surrounds the ostomy can be ordered to fit the size of the stoma or can be cut to size accordingly. Ensure you are using the right size pouching system because if the opening is too small it will cause the stoma to swell and cause obstruction and if the opening is too big then it may cause leakage or the skin around the stoma to become irritated. Ostomy bags should be emptied as per individual preference and when about 1/3 full, the entire appliance should be changed every 3-7 days. (American Cancer Society, 2011 & personal communication, March 6, 2013) A good pouching system should be: - Secure, with a good leak-proof seal that lasts for 3 to 7 days - Odor resistant - Protect the skin surrounding the stoma - Nearly invisible when covered with clothing - Easy to put on and take off - Easy to empty (American Cancer Society, 2011) Skin barriers are used to protect the skin surrounding the stoma and most common ones used are barrier wipes, ostomy rings and stomahesive paste. However, please note that barrier wipes are NOT covered by insurance and will have to be paid out of pocket, make sure you patients are aware of all options before pursuing the wipes. (Potter, Perry, Ross-Kerr and Woods, 2009 & personal communication, March 6, 2013) Emptying an Ostomy Emptying an ostomy is very easy but often done wrong by nurses in the hospital due to a lack of understanding and education when it comes to ostomies. The bag should be emptied when it reaches about 1/3 full, as needed or when there is significant gas build up. Emptying the ostomy bag frequently ensures there is a smaller chance of the ostomy leaking, bursting or bulging underneath clothes. When emptying an ostomy ensure to turn the end of the bag inside out and empty as much stool as possible. After the bag is empty, clean the end of the bag with toilet paper or a throw away cloth. By having the end of the bag turned inside out it helps to keep the tail of the ostomy bag clean and stool free. If the patient is emptying the ostomy independently, have them do it in the washroom over the toilet with the above steps. Lastly, ensure to wash your hands and have the patient do the same after emptying their ostomy. (personal communication, March 6, 2013) Changing an Ostomy Appliance The ostomy should be changed approximately every five days or as needed. 1. gather all your supplies including garbage bag and new ostomy appliance 2. carefully take off the old appliance (be prepared to move quickly if the stoma is very active) 3. cleanse the stoma and skin surrounding the stoma with warm soapy water (use a mild soap) 4. dry the skin around the stoma thoroughly 5. prepare the skin with a barrier OR apply the barrier paste/ring to the new appliance 6. if needed, cut the flange to the proper size of the stoma (not too big or small) 7. take the tape off the back of the ostomy appliance and secure it to the skin 8. if using a two- piece system, secure the bag to the appliance 9. ensure there is a good seal of the ostomy appliance to the skin and the bag to the appliance 10. wash your hands (personal communication, March 6, 2013) (Ostomy Supplies, 2013) It is important for HCP to note; - what the stoma looks like (ie. red, moist and active) - what the appearance of the stool looks like (ie. liquid, pasty or formed) - what type of appliance and skin barrier the patient uses - what size the stoma is - any issues with the stoma or surrounding skin (ie. skin rash or swollen stoma) - how did the patient respond/ are they independent in stoma and ostomy care/ do they need further teaching (personal communication, March 6, 2013) Lifestyle / Ostomy & Stoma Care - Nutrition; well balanced diet and adequate fluid intake are very important with the management of an ostomy. While there are foods difficult to digest with an ostomy, there are actually no “off limit” foods. It is recommended that and individual doesn’t eat these difficult to digest or stringy foods all in the same sitting (ie. celery, lettuce and other raw vegetables). It is also very important that people with an ostomy chew their food very well, this will help prevent blockage by food at the stoma site. - Bathing; a normal bathing routine is encouraged for individuals who have an ostomy. It is personal preference whether the individual likes to shower or bathe with their appliance on but it is important to ensure the stoma is cleansed on a regular basis with mild soapy water and that the ostomy appliance is changed if it becomes very wet or the seal is broken. It is recommended that patients use waterproof tape around the outsides of the appliance in order to protect the barrier and appliance. Lastly, it is always important for the individual and HCP to perform hand hygiene after changing or emptying an ostomy. - Exercise; it is recommended that people with ostomies still get the regular recommended daily exercise and activity. However, keep in mind that heavy/weight lifting and contact sports risk the chance that there could be damage to the stoma or a chance of herniation. - Sexual activity; sexual relationships and intimacy are encouraged to continue with individuals who have a stoma and ostomy. While sexual function in women generally doesn’t change, men can occasionally be affected by changes and have difficulty getting or keeping an erection, however this should not last for long. The most important part of resuming sexual activity after surgery to create an ostomy is communication between partners and making sure that any concerns are discussed openly. (American Cancer Society, 2011 & personal communication, March 6, 2013) (Colostomy Stoma, 2013) Complications and Concerns -- It is normal for your ostomy to have short periods of time where there is little to no output. However, if the stoma is not active for over 4-5 hours or there is a new onset of cramps or nausea then there may be a block or obstruction to the ostomy. Obstruction can be caused by a food blockage or internal changes such as adhesions. If this happens; drink ginger-ale or warm liquids, take a warm bath to relax the abdominal muscles, try changing positions, do NOT take laxatives and if none of these tips are working, contact the doctor or ET nurse or go to the emergency department. -- A rash or denuded skin can occur due to an improper appliance fit or seal. Itching and burning are signs that the skin needs to be cleaned and the pouching system should be changed. Denuded skin or “burnt” skin generally means that stomach acid and stool is leaking onto the surrounding skin and this means the appliance should be changed and a better seal around the stoma needs to be created. -- Bleeding can occur because blood vessels in the tissue of the stoma are very sensitive and can bleed easily. Small amounts of blood after cleaning the stoma is not concerning however it becomes a concern if the bleeding continues or worsens, if this occurs contact the doctor, ET nurse or go to emergency department. -- Odor is inevitable with ostomies just as it is with a normal bowel movement. Certain foods may cause an individual more gas or odor but it is very personal so the individual must learn from experience. In order to limit odor; empty the ouch often, use an odor resistant pouch, ensure the pouch is sealed properly to the skin and odor resolving tablets or spray can be added to the pouch if necessary. -- Hernia’s occur commonly after the creation of an ostomy or during heavy lifting and is the bulging of an area or loop of the organ or tissue surrounding the stoma. Hernia’s generally occur over a longer period of time so alert your doctor or ET nurse if you are noticing any changes or new bulges in the skin post-op. -- Diarrhea is frequent, loose or water bowel movements and usually signifies that something is not quite right. It can be caused by certain food or beverages but becomes dangerous when it continues for greater than 5-6 hours as it can lead to severe electrolyte imbalance. It is recommended that you contact a health professional if diarrhea or a significant change in stool occurs. Note: depending on the placement of your colostomy (ie. transverse and ascending) and ileostomy the ‘normal’ bowel movement might be very liquidy, this is normal and not considered a concern or emergency. (American Cancer Society, 2011 & personal communication, March 6, 2013) Ostomies and Nursing Ostomies are becoming more common on hospital units due to cancer, surgery and trauma it is important that floor nurses and health care professionals know how to care for patients with ostomies. It is very important that nurses have the tools and resources in order to help patients to learn ostomy self care as well as to help them through any emotional, physiological or physical issues or challenges they may come across with having an ostomy. When in doubt, consult an ET nurse who specializes in ostomy and wound care. Enterostomal Therapy nurses (ET nurse) are trained in ostomies and do stoma and ostomy education with patients preoperatively and postoperatively. ET nurses help the patients adjust to their new stomas and work with the patient to find a good fit for an ostomy appliance. These nurses are an excellent resource for floor nursing staff when they have questions or concerns regarding a patient with an ostomy (ie. rash around stoma develops, stoma changes colour or continuously leaking appliance) and their knowledge and skills should be utilized as they are ‘experts’ in the field of ostomies. (personal communication, March 6, 2013) References American Cancer Society. (2011). Colostomy: a guide. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/ostomies/colostomyguide/colostomy-guide-toc American Cancer Society. (2011). Iliostomy a guide. Retrieved from http://www.cancer.org/treatment/treatmentsandsideeffects/physicalsideeffects/ostomies/ileostomyguide/ileostomy-living-with-ileostomy Colostomy. (2010). Relay health [online image]. Retrieved March 10, 2013 from http://www.summitmedicalgroup.com/library/adult_health/aha_colostomy Colostomy Stoma. (2010). Healthwise incorporated [online image]. Retrieved March 14, 2013 from http://www.webmd.com/digestive-disorders/colostomy-stoma Ileostomy. (2010). Relay health [online image]. Retrieved March 10, 2013 from http://www.summitmedicalgroup.com/library/adult_health/aha_colostomy Normal Colon. (2000). Radiographics [online image]. Retrieved March 12, 2013 from http://radiographics.rsna.org/content/20/2/399/F1.expansion.html Ostomy Information. (n.d). United Ostomy association of Canada (UOA). Retrieved from http://www.ostomycanada.ca/ostomy_information Ostomy Supplies. (2013). Steveneddy [online image]. Retrieved March 14, 1013 from http://steveneddy.wordpress.com/pics/ Potter, P. A, Perry, A. G., Ross-Kerr, J. C., & Wood, M. J. (Eds.). (2009). Canadian fundamentals of nursing (4th ed.). Toronto, ON: Elsevier Mosby. Relay Health. (2012). Colostomy and ileostomy. Retrieved from http://www.summitmedicalgroup.com/library/adult_health/aha_colostomy Walker, C. A., & Lachman, V. D. (2013). Gaps in the Discharge Process For Patients with an Ostomy: An Ethical Perspective. MEDSURG Nursing, 22(1), 61-64.

Shield HealthCare provides a list of links to ostomy resources that are relevant, reliable and positive. Follow the links to learn more about ostomies.

My diet as a colostomy patient wasn’t much different from my pre-ostomy days, and If you’ve just had an ostomy, you'll want to know what you can and can't eat & drink. Here you’ll find tips on my experience, the nutritional pattern I followed, my diet, and my general eating habits.

There are many misconceptions about what life is like after you have ostomy surgery. Get answers to the myths of living with a stoma.

Have questions about a urostomy? Worried that getting one will change your life dramatically? Terrified of the idea of one and wondering what people will think? By Robin Glover Don’t […]

As the name might imply, a stealbelt protector (also called a seatbelt cover) is an accessory that’s used to protect your stoma from impacts caused by a seatbelt.

Please note – I am not a medical professional and this is written based on my experiences, information I have been told and things I have researched. If you are having issues with stayi…

Explore the various surgical interventions available for Crohn's disease, their benefits, risks, and post-operative care. Stay informed with our expert insights on Crohn's disease surgery.

How has my ostomy impacted my plant-based diet? The answer may surprise you.

I personally have an ileostomy, so this will be mostly talking about stoma facts based on my experiences and those of and those of people I...

This Ostomy Medical Planner is an easy and effective tool for keep track of your ostomy supplies in one place. The PDF pages are perfect for colostomy & ileostomy patients as well as care givers or nurses of ostomy patients & provides an easy way to keep track of order dates and product styles that work best for your needs. The pages can be printed as many times as you'd like! ♥ This is a digital download and no physical product will be shipped to you. ♥ Once your purchase has been verified by Etsy, your purchase will be available for download under your Etsy profile - under Purchases & Reviews (on a desktop computer only). Pages include: 1 Supply Tracker 1 Refill Tracker 1 Contact Information Page 1 Website Information Page ♥ BY PURCHASING YOU ARE AGREEING TO THE FOLLOWING: ♥ 1. You do not have the rights to resell this template as separate items nor as a full set. 2. This is a digital download and no physical product will be shipped to you. 3. You acknowledge that there are no refunds or exchanges offered ♥ Prime Perfection Digital Boutique ♥

Have questions about a urostomy? Worried that getting one will change your life dramatically? Terrified of the idea of one and wondering what people will think? By Robin Glover Don’t […]

The term “burping” isn’t something you’d expect to go hand in hand with ostomy care, but it is something that ileostomates and colostomates should familiarize…

Choosing the right ostomy supplies can make life much easier and more comfortable after surgery. Make sure to buy from only trusted medical supplies providers.

I got a whole day to get my head around the idea of having an ileostomy, many people don’t get even get that long, as it is often performed during emergency surgery. For some however, t…

Finding the right type of ostomy supplies is an essential element for living well with an ostomy. For more information, read our list of manufacturers and product suppliers.

Reference guide perfect for nursing students/new grads! Reference sheet comes double sided with your choice of laminated- or not. "Ostomy Care" includes supplies you will need to prepare, assessing the stoma, and an in depth walkthrough of pouching the ostomy! "Tracheostomy Care" includes information about preparing for tracheostomy care, performing suctioning, caring for disposable/non-disposable inner cannulas, cleaning and securing the tracheostomy site. For more reference sheets & bundle options head over to my page for more! :)

There is no specific “ostomy diet” but there are important considerations as you discover the foods that work best for you. For guidance on ostomy diet and nutrition, follow a nurse or doctor’s orders at each stage of your post-op adjustment.

There are several ways to empty an ostomy bag, and each one is suited to different people and situations. Find out more in this article.

I got a whole day to get my head around the idea of having an ileostomy, many people don’t get even get that long, as it is often performed during emergency surgery. For some however, t…

Having an ostomy EDC bag is a wise choice, and could be the difference between an inconvenience and a catastrophic leak while in public. Video incl.

Maintaining good hydration with an ostomy is crucial, but it can be challenging too. Learn ways to avoid dehydration in this article and video.

This week, we share some words of wisdom from Carol Marshall-Hanson, RN who is a Certified Wound Ostomy Nurse (CWON) at Seton Healthcare Family in Austin, TX. She gives her tips and best practices for patients with ileostomies. “Ileostomy” by BruceBlaus is licensed under CC BY-SA 4.0. Ileostomy is a surgery in which a small opening, called a stoma, is made in the abdomen. The surgeon brings a piece of the lowest part of the small intestine, called the ileum, through the opening where digested food passes into a pouch attached to the stoma. A temporary stoma is one that is usually taken down within 6-8 weeks. It can be a loop or end stoma. A permanent ileostomy is one that will stay with the patient for life. These are usually due to cancer. Causes for ileostomies include Crohn’s disease, colonic dysmotility, ulcerative colitis, familial polyposis, diverticulitis, and some cancers. FOOD DO’S and DON’TS Don't: Foods high in non-soluble fiber Foods that do not breakdown during digestions Example: nuts, whole corn, popcorn, and shellfish Do: Eat a B-R-A-T diet to thicken stool Examples: bananas, white rice, peeled apples (avoid the skin), and toast It is OK to use Lomotil or other anti-diarrheal meds to thicken stool It is OK to use Beano, Gas-X, etc, to decrease gas production HYDRATION AND ELECTROLYTES Drink plenty of water, Gatorade, and similar fluids! A person with an ileostomy loses a great deal of fluid as it does not stay inside the body long enough for liquids to be absorbed. Probably the most common cause for readmission to the hospital within a week of going home is dehydration accompanied by electrolyte imbalance Loss of Sodium can cause confusion, seizures Loss of Potassium and Magnesium can cause muscle cramps, irregular heartbeat, and even heart attacks Dehydration can also lead to kidney injury If dehydration and electrolyte imbalance is suspected, attempt oral intake of food and water or electrolyte-based fluids to replenish. If unable to tolerate food/water or too confused, have family/friend transport or call EMS to transport them to the ER immediately MEDICATION PRECAUTIONS Bowel transit time is at best around 3-hours with an ileostomy, so large hard pills or those with coatings intended to dissolve over several hours will be excreted before they dissolve. AVOID: Long-acting, enteric-coated, sustained-release medications. Large pills (Potassium, Vitamins). Try Gummy Vitamins instead! PERISTOMAL SKINCARE Ileostomy stool contains digestive enzymes (bile and pancreatic fluids) that digest food. If they leak onto the skin, they will “digest” the skin causing severe irritation and pain. (See instructions on using Antifungal Powder and No-Sting wipes for skin irritation around the stoma or ask your ostomy nurse for help if irritation develops on the skin around the stoma). Do not, under any circumstances, let your doctor prescribe ointments or creams to go on the peristomal skin. No pouch will adhere on top of ointments and creams. To avoid skin problems from enzymatic erosion: Change the pouch generally about every 3-4 days. Cut or obtain a pre-sized wafer 1/8-1/4” larger than the stoma. If the stoma is oval, you MUST custom-cut the wafer opening to protect the skin. Consider using a barrier ring. These rings look like a gasket and can be stretched or formed to any size/shape needed. They absorb and expand when in contact with liquid stool; compared to stoma paste that is eaten away from liquid stool and can cause leaks. Stoma paste also leaves a very sticky residue that is hard to get off, compared to barrier rings that leave very little residue on the skin. Call your ostomy nurse if you have frequent pouch leakage and start to develop skin irritation. The worse the skin gets, the harder it is to get ANYTHING else to adhere around the stoma. MARSHMALLOWS Eating marshmallows can slow down output within 5-10 minutes. Eating a few before bedtime can reduce the risk of leakage at night. Marshmallows are also great to carry in an emergency kit for changing appliances and traveling. The best part? It’s okay to make smores! Remember to check with your doctor before making any dietary wound care changes. Resources Organizations United Ostomy Associations of America CrohnsandColitis.org Crohns & Colitis Foundation Crohns and Me Blogs & Community Stolen Colon Uncover Ostomy Crohnsdisease.com Gutless and Glamorous The Vegan Ostomy 10 Spoonie Self-Care Tips

WARNING – This post will contain photos of stoma output for reference “No Natalie, you are not haemorrhaging internally, dying or suffering from some sort of tropical disease – yo…

Do you know the difference between a stoma and an ostomy? Learn this and other important facts and tips about stomas, including whether or not they’re reversible.

I personally have an ileostomy, so this will be mostly talking about stoma facts based on my experiences and those of and those of people I...

UOAA Presents Ostomy Academy! A quarterly online educational seminar to bring trusted and comprehensive ostomy information to all members of the ostomy community. Top experts, medical professionals, and experienced ostomates will focus on a new series of quality of life topics in each presentation.

This week, we share some words of wisdom from Carol Marshall-Hanson, RN who is a Certified Wound Ostomy Nurse (CWON) at Seton Healthcare Family in Austin, TX. She gives her tips and best practices for patients with ileostomies. “Ileostomy” by BruceBlaus is licensed under CC BY-SA 4.0. Ileostomy is a surgery in which a small opening, called a stoma, is made in the abdomen. The surgeon brings a piece of the lowest part of the small intestine, called the ileum, through the opening where digested food passes into a pouch attached to the stoma. A temporary stoma is one that is usually taken down within 6-8 weeks. It can be a loop or end stoma. A permanent ileostomy is one that will stay with the patient for life. These are usually due to cancer. Causes for ileostomies include Crohn’s disease, colonic dysmotility, ulcerative colitis, familial polyposis, diverticulitis, and some cancers. FOOD DO’S and DON’TS Don't: Foods high in non-soluble fiber Foods that do not breakdown during digestions Example: nuts, whole corn, popcorn, and shellfish Do: Eat a B-R-A-T diet to thicken stool Examples: bananas, white rice, peeled apples (avoid the skin), and toast It is OK to use Lomotil or other anti-diarrheal meds to thicken stool It is OK to use Beano, Gas-X, etc, to decrease gas production HYDRATION AND ELECTROLYTES Drink plenty of water, Gatorade, and similar fluids! A person with an ileostomy loses a great deal of fluid as it does not stay inside the body long enough for liquids to be absorbed. Probably the most common cause for readmission to the hospital within a week of going home is dehydration accompanied by electrolyte imbalance Loss of Sodium can cause confusion, seizures Loss of Potassium and Magnesium can cause muscle cramps, irregular heartbeat, and even heart attacks Dehydration can also lead to kidney injury If dehydration and electrolyte imbalance is suspected, attempt oral intake of food and water or electrolyte-based fluids to replenish. If unable to tolerate food/water or too confused, have family/friend transport or call EMS to transport them to the ER immediately MEDICATION PRECAUTIONS Bowel transit time is at best around 3-hours with an ileostomy, so large hard pills or those with coatings intended to dissolve over several hours will be excreted before they dissolve. AVOID: Long-acting, enteric-coated, sustained-release medications. Large pills (Potassium, Vitamins). Try Gummy Vitamins instead! PERISTOMAL SKINCARE Ileostomy stool contains digestive enzymes (bile and pancreatic fluids) that digest food. If they leak onto the skin, they will “digest” the skin causing severe irritation and pain. (See instructions on using Antifungal Powder and No-Sting wipes for skin irritation around the stoma or ask your ostomy nurse for help if irritation develops on the skin around the stoma). Do not, under any circumstances, let your doctor prescribe ointments or creams to go on the peristomal skin. No pouch will adhere on top of ointments and creams. To avoid skin problems from enzymatic erosion: Change the pouch generally about every 3-4 days. Cut or obtain a pre-sized wafer 1/8-1/4” larger than the stoma. If the stoma is oval, you MUST custom-cut the wafer opening to protect the skin. Consider using a barrier ring. These rings look like a gasket and can be stretched or formed to any size/shape needed. They absorb and expand when in contact with liquid stool; compared to stoma paste that is eaten away from liquid stool and can cause leaks. Stoma paste also leaves a very sticky residue that is hard to get off, compared to barrier rings that leave very little residue on the skin. Call your ostomy nurse if you have frequent pouch leakage and start to develop skin irritation. The worse the skin gets, the harder it is to get ANYTHING else to adhere around the stoma. MARSHMALLOWS Eating marshmallows can slow down output within 5-10 minutes. Eating a few before bedtime can reduce the risk of leakage at night. Marshmallows are also great to carry in an emergency kit for changing appliances and traveling. The best part? It’s okay to make smores! Remember to check with your doctor before making any dietary wound care changes. Resources Organizations United Ostomy Associations of America CrohnsandColitis.org Crohns & Colitis Foundation Crohns and Me Blogs & Community Stolen Colon Uncover Ostomy Crohnsdisease.com Gutless and Glamorous The Vegan Ostomy 10 Spoonie Self-Care Tips

Ostomy output can vary in consistency. In general an ileostomy output will be more watery than that from a colostomy. The problem with a watery output is that it can easily lead to dehy…