When asked what an ostomy or stoma is — most times, people do not know how to care for it until it affects them or unless they know someone in the family who has it. The terms stoma and ostomy are used interchangeably even though they have different meanings.
An ostomy refers to the surgically created opening in the body for the discharge of body wastes. The word stoma is a Greek word that means mouth, and in anatomy, stoma is known as any openings in the human body. Examples of natural stomatas are our mouths, noses, ears and anuses.
What about artificial stomas? An artificial stoma can be created onto any hollow organ such as the esophagus, stomach, ileum, colon, urinary bladder and ureters, and renal pelvis. A stoma is the actual end of the organ that is red in colour and can be seen protruding through the abdominal wall.
Ostomies may be permanent or temporary and about 1.9 million individuals in the world have a stoma. Here is a complete guide on ostomy and stoma care.
Who gets an ostomy?
A person goes through an ostomy surgery and a stoma is created because of these reasons:
- When one is born without an anus (imperforate anus)
- If one is incapable of bowel movement in the rectum
- Cancer such as bowel cancer or bladder cancer
- Inflammatory bowel diseases such as Crohn’s disease or ulcerative colitis
- A tear or injury to the colon
What are the different types of stoma?
There are three types of ostomies, or stomas that are the most common in individuals which are colostomy, ileostomy and urostomy. Although they are cared for similarly, they are all located at different parts of the body.
A colostomy is when the surgeon removes the damaged part of your colon. Your body waste goes out through a stoma on the abdominal wall in the large intestine. Colostomy is divided into two types: loop colostomy and end colostomy. It can either be temporary or permanent.
- Loop colostomy: A reversible colostomy that is usually performed as a temporary measure for emergency operations. This is when the looped part of the colon is pulled through to the abdomen and is above surface level.
- End colostomy: One end of the colon is pulled through and sewn to the abdomen and the diseased bowel is removed or allowed to heal before the colon is joined back together.
Colostomy discharge varies in terms of consistency depending on where the stoma is created on the colon. There are no dietary restrictions for those with colostomy, however some foods may induce odour from food such as broccoli, eggs, and fish.
This opening is surgically created in the abdomen in which a piece of the ileum (lowest part of the small intestine) is brought outside the abdominal wall to create a stoma. Ileostomy is also categorised in two parts; loop ileostomy and end ileostomy.
A urostomy is done when there are complications that may lead to incontinence or disease such as bladder cancer. It redirects urine away from the bladder, and it changes the way urine is normally dispelled from the body.
Myths and misconceptions about stoma care
It may be your first time with a stoma or your family member is getting a stoma and you need some guidance with proper stoma care. There is a misconception that individuals with stoma will need to give up their quality of life or day-to-day such as swimming, food and even exercise. In fact, that is not the case at all as people with stomas are more than adept at doing all of the above and more, with very minor intrusions by having some adaptations along the way.
There is no need to worry as stoma pouches are water resistant and are leak-proof as they come with proper seal. A good tip: women can opt for patterned swimsuits and men can try to find for shorts with a higher waistband. Another tip is to fully empty the bag before entering the water.
The thought of travelling with a stoma bag can seem daunting at first but individuals will soon realise that stoma bags do not inflate due to external pressures! A good way to prepare is to have at least two new stoma bags and dry wipes at hand at any given time. If an individual is caught in a traffic jam, one can discreetly empty their stoma bag into a nappy bag.
In the first few days after surgery, a low residue diet can help quicken the healing process. One does not have to restrict their food options, but a good measure would be to try out different types of food in smaller portions. There is a misconception that consuming high-fibre foods can cause blockages but that will only happen when it is eaten with little or no fluids.
Another misconception is that dairy can cause indigestion, but in most cases individuals who find that dairy has caused digestive problems have disruptions in their bowel such as an infection of inflammatory bowel disease.
It is important for individuals to consume enough amounts of liquids to keep dehydration at bay. The keyword here is moderation.
Yes, you can still exercise even with a stoma. To start off, a good 30 minutes of walking a day will help keep the blood flowing. Pilates and yoga are also good forms of exercise that can help build strong core strength by helping to power the abdominal muscles, without straining it.
Having an ostomy can lead to a quicker dehydration, so having a bottled water at hand would help. If something hurts, stop! The journey to recovery is one that takes patience.
When should you call a doctor?
Notice something amiss and think you should call a health professional? Here are some pointers as to when to call your doctor when these things take place:
- Fever of 38.3 degrees Celsius or higher.
- The skin around the stoma looks red, raw or leaks fluid.
- When you go through muscle cramps, urinate less than usual, or feel weak.
- Nausea, vomiting, pain in your gut, severe constipation or diarrhoea.
Caring for seniors with stoma
With advanced age and medical conditions such as dementia and Parkinson’s, taking care of individuals with a stoma can be a challenging experience. In reality, caregivers face basic care challenges such as seniors not knowing when to empty the pouch, appliances being ripped off or the challenge of simply changing stoma bags from time to time due to frailty or tremors.
A distraction can help especially with seniors who might resist a bag change. By getting seniors to focus on other tasks such as brushing their teeth or combing their hair, caregivers can use that window to change one’s stoma bag.
Hiring care services from a home care service provider can help primary caregivers get hassle-free care in the comforts of their own home without the need to travel for hospital appointments or clinic visits.