Crohn’s Disease, Ostomy, And Ostomy Care

A majority of individuals with Crohn’s disease find permanent relief through ostomy surgery. The total number of people with stomas in the US is 450,000, and 120,000 new ostomy cases are registered every year. These states suggest that patients must find ways to overcome difficulties of stoma management. Fortunately, healthcare professionals and stoma care nurses are available across the country to provide stoma care guidance.

Ostomy care challenges and Crohn’s disease

It can be pretty difficult for many patients to live with a stoma, particularly when they are first learning to manage it. The critical elements of stoma care are leak prevention, ostomy bag emptying, and taking care of the skin around the stoma. Many patients find it hard to manage their stomas. Many patients hesitate to commit to a physically active lifestyle because they fear their ostomy pouches dislodging during their workout. That is why every patient must get adequate knowledge of how to manage their stomas. That’s where the role of healthcare professionals and ostomy care nurses becomes important.

Useful teaching points

  • The first question most ostomy patients will ask is how often to empty an ostomy pouch. Although it is one of the most uncomfortable subjects for such patients, they must learn how to empty their pouches to prevent leakage and other complications. It is the job of doctors and stoma care nurses to assure their patients about the simplicity of the procedure. They should insist their patients empty their ostomy pouches when they are one-third to half full. They should also help their patients understand the procedure that seems simplest and most effective.
  • The skin around the stoma is particularly vulnerable to irritation and infections due to the high risk of contact with the stomal output. Skin complications that may occur are contact dermatitis, skin infection, and papular over-granulation. Cleaning the area around the stoma using a pH-balanced cleansing product can help prevent infections. Using barrier products around the stoma helps reduce the risk of moisture accumulation, which is usually the main reason for peristomal skin infections.
  • A stoma can function properly without causing any leaks with the help of a stoma pouch that uses strong but medically-safe adhesives. A long-lasting medical adhesive will not only prevent leakages but also help patients lead a fuller and more active life. It is also crucial to avoid any mechanical traumas and irritation from the adhesive. Certain medical adhesives make allergic contact with the peristomal skin, causing pain, itching, and erythema. Skin damage can occur as a result of the frequent removal of adhesives. So, it is crucial to choose a medical adhesive that is gentle on the skin.
  • The teaching will not be helpful if the patient is unwilling to comply. Healthcare professionals should help their patients understand that all stoma care guidelines are for their benefit. Skipping on any stoma care elements will result in an affected quality of life. They must help their patients understand that a stoma doesn’t mean a disability. All it takes is proper compliance from the patient.

Reversing A Colostomy Or Ileostomy

For some people, having an ileostomy or colostomy may mean a lifetime commitment to an odd toilet routine. Others will have it temporarily, meaning that they will get it to allow the diseased part of their bowel to recover from the impact of disease and subsequent surgery.

In some cases, people just want to seal up their ostomies and get back to a natural way of emptying their bowels.

Is reversal an option?

First and foremost, you have to be in good health to undergo ostomy reversal surgery. Even if a part of your bowel has been removed from your abdomen, you can qualify for reversal surgery if you have enough of your rectum left. Furthermore, your bowel and abdominal muscles must be strong enough to pass out waste materials. Your doctor will decide to refer you to a surgeon for the reversal procedure after speaking to you, examining your anal canal, and testing the strength of your muscles in the rectum and anus.

You will get a surgical appointment for the reversal procedure about 3-12 months after ostomy surgery. By that time, you will be finished with chemotherapy or any other treatment for your bowel condition. Sometimes, it may take years for you to become fit enough to undergo a reversal procedure.

You will have to ask your surgeon if you need to perform any exercises or physical therapy to work the muscles in your rectum before surgery. Such exercises will give your bowel enough strength to become function soon after surgery.

Possible complications

Most reversal procedures for ileostomies or colostomies are generally quite simple. However, a reversal can be quite a difficult process and may take a longer time if all or much of your colon had been removed during ostomy surgery. That said, some complications related to a reversal procedure may include the following.

  • You may suffer temporary bowel paralysis. You can get rid of this complication by taking complete rest or getting other help.
  • This procedure may lead to the leakage of stools inside your belly.
  • Scar tissues can develop, making it hard or impossible to pass out stools.
  • Sometimes, your bowels may poke through the cut made for your stoma, forming a hernia.
  • Some people may suffer bladder infections.

Recovery

After surgery, you may have to stay in the hospital for 3-10 days, depending on the recovery speed. You can go home when your bowels start moving without showing any signs of complications.

It will take some time before you start to move your bowels normally again. During the first few days,

  • You may have loose or watery stools
  • You may need to go to the restroom several times a day
  • You may feel like your bowels are not completely empty after going to the toilet
  • There might be the leakage of stools

Here are some tips to help you recover more quickly after reversal surgery.

  • Do not eat spicy or fatty foods during the first few months.
  • Instead of having fewer large meals a day, consider having several small meals.
  • Drink plenty of water.
  • Avoid any foods that cause gas.

The Negative Impact Of Skin Complications

The negative impact of even a minor peristomal skin complication might seem significant. In this article, we are going to talk about a few complications related to the skin around the stoma.

The peristomal skin starts healthy when you start using the ostomy pouch. Unfortunately, it doesn’t remain the same in most cases due to several reasons. Any issue with the peristomal skin is not just an issue related to the skin. This area of the skin has to provide support to the ostomy pouch. So any complication there tends to affect the quality of life.

That said, it would be worth talking about a few peristomal skin complications.

Soreness and pain

Connecting an ostomy pouch to irritated peristomal skin can add significantly to the pain. That makes it extremely difficult for a patient to divert his attention from the peristomal skin due to the consistent discomfort in the area. This issue is more common in the people with an ileostomy as this type of ostomy results in the excretion of stool in liquid form. The presence of digestive enzymes makes the stomal output more corrosive. The best way to prevent this condition from happening is to use the ostomy pouch that fits well around the stoma.

The cycle of leakage

The stomal output is corrosive. The risk of irritation or infection becomes high when the skin is frequently exposed to the stomal output. It can cause the ill-fitting of the skin barrier. As a result, the skin is more exposed to the stomal output, which makes the condition of the peristomal skin even worse. This cycle can result in the issue becoming very difficult to handle.

The impact on your social life

How good you are in your social life depends heavily on your wellbeing. Even a minor issue with the peristomal skin can result in a negative impact on your sense of wellbeing, which might lead you to a psychological condition that makes it difficult for you to go out and meet the people in your social circle. This condition only gets worse if you do not do anything about it.

How can you prevent skin complications?

The good news is that you can prevent peristomal skin complications by using the right products. Changing the ostomy pouch regularly to make sure that the stomal output doesn’t come in contact with your peristomal skin is the least you can do. But that doesn’t mean that you should become paranoid when it comes to ensuring skin hygiene. You have to use the products that suit you well. For this purpose, you can get help from your ostomy care nurse.

Tips For Ostomy Skincare

The most crucial part of an ostomy care routine is skincare. The skin around your stoma is just like the skin anywhere in your body, but it remains more susceptible to irritation and infection due to a heightened risk of getting in contact with the stomal output. Skin irritation is not the only reason for you to take care of your peristomal skin. This area of skin has to provide all the support an ostomy bag needs to stay connected with the stoma. Any irritation or infection in this area can lead to poor attachment of the skin barrier, resulting in poor ostomy management.

That said, it would be worth mentioning how to take care of your peristomal skin.

Visually check your ostomy system

A stoma doesn’t have a nerve ending, meaning that it is not possible for you to feel any pain if something undesirable happens to your stoma. Similarly, any infection in the stoma can affect the skin around it. The best way to avoid these situations is to check your ostomy system daily. See if the barrier is connected to the peristomal skin the way it should. Look for the leaks under the wafer. Remember, even small leaks can cause significant problems with the peristomal skin. You need to take care of these issues even before their occurrence.

Making the most out of ostomy bag changes

When you have a stoma, you have to wear an ostomy bag. It is not something optional. You are going to have to wear your ostomy appliance the entire time, day and night. The only time you can take care of your skin is when you change the ostomy pouch. That’s when you remove the skin barrier. The peristomal skin becomes fully visible, allowing you to check if there are any issues. Once you make sure that there is no issue with the skin around the stoma, be sure to remove the residue from the peristomal skin. This leftover adhesive might be stubborn enough to cause rashes on the skin when you try to remove it. You can use an adhesive remover to get rid of that residue without causing any injury to the peristomal skin. After removing the leftover adhesive, wash the stoma and the skin around it, dry the entire area, and continue with the procedure of connecting the new ostomy pouch.

Using stoma powder

You will have to attach the ostomy bag, even if the peristomal skin becomes red, irritated, or weepy. The best way you can avoid further irritation or infection in the area is to use peristomal skincare products. One of the most effective products is the stoma powder, which creates an additional protective layer over the peristomal skin. The newly created surface is smooth enough to offer a proper seal with the skin barrier.

There are several other types of skincare products also available. You can ask your doctor for a piece of advice regarding which product will fit your needs.

Diet With An Ileostomy Or Colostomy

An ileostomy consists of a small opening in the abdomen to let the ileum (the lower part of the small intestine) to evacuate bodily waste, bypassing the removed or compromised lower part of the intestinal tract. This type of ostomy is created by pulling the end of the ileum through the abdominal wall, creating a stoma, which is the opening that allows the waste to leave the body.

Depending on the circumstances, an ileostomy can be permanent or temporary. With a temporary ileostomy, you will have to make sure that you are taking good care of your stoma throughout your ostomy. And if you have a permanent ileostomy, you will need to ask your doctor about the changes that you need to bring in your life.

There is not much difference between an ileostomy and a colostomy. Colostomy surgery involves pulling out of an end of the colon out of the abdominal wall. The location of the stoma may vary depending on where the colon is disconnected from its remaining part. From the perspective of daily care and overall management, a colostomy is almost entirely similar to an ileostomy.

In this article, we are going to discuss a few diet tips to manage an ileostomy or colostomy.

Is the change in diet necessary?

Many people assume that a drastic change in the diet becomes inevitable after an ileostomy or colostomy surgery. It is not true, except for a few cases in which the patient has to deal with other problems in the GI tract along with an ostomy.

Your intestines will indeed need some time to adapt to a new intestinal length after you get an ileostomy or colostomy, and you may have to stick with a different diet plan in that duration. But as soon as your GI tract gets used to the change, there will be a limited restriction on what you should eat and what you shouldn’t.

That said, it is necessary to have a balanced diet whether or not you have an ostomy to manage. With an ostomy, your GI tract will not be as powerful as a fully functioning one. Although your doctor will not instruct you to avoid a particular just because you have an ostomy, you are going to have to be careful about the meal size, the number of meals a day, and several other factors related to how you eat.

Diet tips

To ensure proper healing of your GI tract after surgery, you are going to have to pay attention to your nutrition. Here are a few tips that you may find helpful.

  • Instead of having a couple of big meals a day, you can consider having several small meals. That will help your body to digest foods properly without overloading your digestive tract.
  • When you eat, make sure that you chew each of your bites well. That will help you to digest properly and absorb all of the nutrients.
  • With all of, or a part of, your colon removed or bypassed, you might run the risk of dehydration. You are going to avoid that by upping your fluid intake.

It is worth mentioning here that avoiding blockage should be your top priority. If the intake of excessively fibrous foods causes blockage in your GI tract, you are going to have to avoid such foods. Similarly, it is necessary to avoid foods that cause gas. You can talk about your diet plan with your doctor.

Is fashion a thing with a stoma?

In no way am I the hottest person out there.  But to me, I think looking good is still important and maybe even more so now that I have a stoma.  I am more self-conscious and I simply want to look good.  But there really are times that I am a big fan of showing off a little and trying to be fashionable.  It is a bit hard sometimes and can be really complicated.  I am by no means considered fashionable, but even after getting a ostomy, I have been able to keep up with the fashion trends and fit in.  It can be really hard to do this with a stoma because you are always carrying around an ostomy bag or sometimes a stoma cap depending on the quick moment. Feeling good in your own body is key to living a healthy life.  No matter what you look like you need to feel good about it. 

Now I have an ostomy bag to deal with and I have never been that great at fashion in the first place.  So what do I do?  In fact, I am the complete opposite and rely on others to help me with looking good during a whole lot of different areas.  Don’t feel down when you find out a stoma is going to be your companion for life.  The idea of looking good can be a huge hit for most people and we all struggle with the thoughts of feeling and looking beautiful again.  But there really is hope and you are beautiful.  Beautify is on the inside and trust me you can still look fine as wine with a stoma.  I have been pretty surprised by the number of people who are living with an ostomy bag and still rocking a social media lifestyle as well.  If it was not for social media I would be totally in trouble. But I have been lucky to find some key things. 

Just do it.  Jump in and find what is really important out there.   It is a huge deal to look and feel good.  Make sure to broaden your searches to all different platforms to find people who you like and whose look you would like as well.  But remember that not all body types are the same and know that what may work well for one person totally doesn’t work for another.  We have stoma’s in different locations and we are all ourselves in different shapes and sizes.  That means that even some of my favorite social media models who have stoma are not good fits for me.  A lot of what they do simply does not work for my body or lifestyle.  That is totally fine!  I just know some people don’t know that yet and won’t understand and you can overcome that.

Now I am able to simply say, ok this is real life.  But there is still an amazing amount of information on fashion on Youtube, Instagram, and Facebook.  That is where I follow lots of different people and love to see and read the comments on the posts as well.   I have found lots of information from the followers and gotten some great and also some not-so-great advice! But don’t give up hope, just keep looking and you will find what you are looking for. Find your own style and don’t be afraid is something that works for someone else doesn’t work for you. No two of us are the same.