WHAT YOU NEED TO KNOW:

What is colostomy care? You or a family member will need to learn to care for your colostomy. It may require changes in your lifestyle. You may work with an ostomy specialist to find the best ways to care for yourself.

How do I change my pouch? How you change your pouch depends on the type you have. Your healthcare provider will give you specific instructions on how to change your colostomy pouch. The following is general information about how to change your pouch:

• Ask how often to change your colostomy pouch: The type of pouch you wear affects the amount of time it can be worn. The kind and amount of bowel movement you have also affects how long the pouch stays on.
  
  
• Remove the pouch: Gently remove the pouch by pushing the skin down and away from the adhesive skin barrier with one hand. With the other hand, pull the pouch up and away from the stoma.
  
  
• Gently clean the skin around your stoma: Use mild soap and water. Do not use soaps that have oil or perfumes. Pat your skin dry.
  
  
• Use a pouch with the right size opening: Use a pouch that has an opening that is ⅛ of an inch larger than your stoma.
  
  
• Use skin products to help reduce irritation: These products can help protect your skin and keep it dry.
  
  
• Use slight pressure to place your pouch: Center the pouch over the stoma and press it firmly into place on clean, dry skin. It may be helpful to hold your hand over the new pouch for 30 seconds. The warmth of your hand can help stick the adhesive skin barrier into place.
  
  
• Dispose of the used pouch correctly: If the pouch is disposable, place the old pouch in another plastic bag and throw it in the trash. If you use a reusable pouch, talk to your healthcare provider about how to clean it.

How do I empty my pouch?

• Empty the pouch when it is ⅓ to ½ full: Do not wait until the pouch is completely full. This could put pressure on the seal and cause it to leak or spill.
  
  
• Hold the pouch up by the bottom end: If the pouch has a clamp system, remove the clamp. You may need to roll the end back to keep it from getting soiled.
  
  
• Drain the pouch: Place toilet paper into the toilet before you empty the pouch to reduce splash back. Drain the pouch by squeezing the contents into the toilet.
  
  
• Clean the end of the pouch: Use toilet paper or a moist paper towel. You may also rinse the pouch but it is not necessary. Keep the end of the pouch clean.
  
  
• Close the end of the pouch: Unroll the end of the pouch. Replace the clamp or close the end of the pouch according to your healthcare provider's instructions.

How do I care for my skin? Look at the skin around your stoma each time you change your pouch. Your stoma should be pink or red and moist. You may have a small amount of bleeding when you clean your stoma. This is normal. Your stoma will get smaller and become its normal size in about 8 weeks.

• Make sure the skin barrier opening fits well: The skin barrier is the part of the pouch that sticks to the skin of your abdomen. It should be no more than ⅛ of an inch larger than your stoma. If the opening is too large, bowel movement can leak onto your skin and cause irritation. Measure the size of your stoma with the guide that comes with your colostomy supplies. Make sure you cut the skin barrier smaller as your stoma gets smaller.
  
  
• Soothe irritated skin: If your skin is red, it may mean that the skin barrier was on too long. It is important to find the cause of your skin irritation. Ask your healthcare provider if you need help finding the cause of your skin irritation.

What types of foods can I eat after a colostomy?

• Eat a variety of healthy foods: Healthy foods include fruits, vegetables, whole-grain breads, low-fat dairy products, and lean meats. Do not eat foods that give you cramps or diarrhea.
  
  
• Limit foods that may cause gas and odor: These include vegetables such as broccoli, cabbage, and cauliflower. Beans, eggs, and fish may also cause gas and odor. Eat slowly and do not use a straw to drink liquids. Yogurt, buttermilk, and fresh parsley may help control odor and gas.
  
  
• Drink liquids as directed: Ask your healthcare provider how much liquid to drink each day and which liquids are best for you. This may help reduce constipation.

What are some problems that can happen with a stoma? Most stoma problems happen during the first year after your surgery.

• Stoma retraction: This is when the height of the stoma goes down to or below the skin level. Retraction may happen soon after surgery if the colon does not become active soon enough. Retraction may also happen if you gain weight. The type of pouch you use may need to be changed to fit the stoma shape.
  
  
• Peristomal hernia: This is when a part of your large intestine bulges into the area around the stoma. A hernia may be more obvious when you sit, cough, or strain. Hernias may make it difficult to create a proper pouch seal or irrigate. You may need to change the type of pouch you use or wear a hernia belt. You may need surgery to repair the hernia.
  
  
• Prolapse: This is when a part of your bowel pushes out of your stoma. The stomal prolapse may be caused by increased abdominal pressure. Surgery may be done to fix the prolapse.
  
  
• Stenosis: Your stoma may become more narrow. Your healthcare provider may be able to stretch your stoma if it has mild stenosis. Severe stenosis can cause blockage and surgery is usually needed.

Where can I find support and more information?

• United Ostomy Associations of America, Inc.
  P.O. Box 512
  Northfield , MN55057-0512
  Phone: 1- 800 - 826-0826
  Web Address: http://www.ostomy.org
  

• Wound Ostomy and Continence Nurses Society
  15000 Commerce Parkway
  Mount Laurel , NJ08054
  Web Address: www.wocn.org
  

When should I contact my healthcare provider?

• You have a fever.
  
  
• You have a foul odor coming from your colostomy bag or stoma that lasts longer than a week.
  
  
• Your skin around the stoma becomes red and irritated.
  
  
• You have nausea, vomiting, pain, cramping, or bloating.
  
  
• You do not have regular bowel movements through your stoma.
  
  
• The size of your stoma changes.
  
  
• You have questions or concerns about your condition or care.

When should I seek immediate care or call 911?

• Your bowel movements are black or bloody.
  
  
• Your stoma is bleeding and you cannot stop the bleeding.
  
  
• You are too weak to stand up.
  
  
• You have severe abdominal pain.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.