Understanding and Managing Your Stoma at Home

What is a Stoma?

A stoma is a surgically created opening on the abdomen that allows waste (urine or stool) to exit the body when the normal route is no longer possible. The word “stoma” comes from the Greek word for “mouth” or “opening.”

There are several types of stomas:

• Colostomy: Connected to the colon (large intestine), allowing stool to exit
• Ileostomy: Connected to the ileum (small intestine), producing a more liquid stool
• Urostomy: Connected to the urinary system, allowing urine to exit

A healthy stoma appears moist and red or pink in color, similar to the inside of your mouth. The stoma itself has no nerve endings, so it should not cause pain when touched, though the skin around it may be sensitive.

Daily Stoma Care Essentials

Supplies You’ll Need

• Stoma pouching system (bag and adhesive wafer)
• Measuring guide
• Scissors (if cutting to fit)
• Skin barrier wipes or paste
• Clean water and mild soap (fragrance-free)
• Soft, lint-free washcloths or paper towels
• Disposal bag
• Hand mirror (helpful for viewing)

Changing Your Pouching System

1. Prepare all supplies before starting the change.
2. Remove the old pouch gently by pushing the skin away from the adhesive rather than pulling the adhesive from the skin.
3. Clean the stoma and surrounding skin with warm water and mild soap. Avoid using soaps with oils, lotions, or deodorants.
4. Pat the area dry thoroughly with a soft towel.
5. Examine your stoma and skin for any changes in color, shape, or size. The skin should be intact without redness, rash, or irritation.
6. Measure your stoma using the measuring guide to ensure proper fit.
7. Prepare the new wafer by cutting it to fit your stoma if needed (leaving 1/8 inch clearance around the stoma).
8. Apply skin barrier products if recommended.
9. Apply the new pouching system, ensuring good adhesion to the skin.
10. Secure the pouch and make sure the bottom is properly closed.

Managing Common Stoma Issues

Skin Irritation

• Causes: Leakage, improper fit, allergic reaction, frequent pouch changes
• Prevention/Treatment:
  • Ensure proper pouch fit
  • Use skin barrier products
  • Change the pouching system at the first sign of leakage
  • Consult healthcare provider for persistent irritation

Odor Management

• Use odor-proof pouches
• Empty pouch regularly when 1/3 to 1/2 full
• Consider stoma deodorant drops (placed inside the pouch)
• Maintain good hygiene
• Be aware that certain foods may increase odor

Pouch Leakage

• Check for proper fit regularly
• Change the pouching system every 3-7 days or as recommended
• Empty the pouch when it’s 1/3 to 1/2 full
• Ensure the skin is completely dry before applying a new pouch
• Use additional adhesives or barrier rings for challenging areas

Diet and Lifestyle Considerations

Food Guidelines

• Introduce new foods slowly one at a time to identify those that cause issues
• Stay hydrated, especially with an ileostomy
• Chew food thoroughly to prevent blockages
• Foods that may cause gas: carbonated beverages, beans, onions, cabbage, broccoli
• Foods that may cause odor: eggs, fish, some spices, asparagus
• Foods that may help control odor: yogurt, buttermilk, cranberry juice

Activity and Exercise

• Most activities can be resumed after recovery
• Consider smaller pouches or supportive accessories for active pursuits
• Empty pouch before physical activities
• Avoid heavy lifting (more than 10 lbs) for 6-8 weeks after surgery

When to Seek Medical Help

Contact your healthcare provider if you experience:

• Change in stoma color (pale, dark purple, or black)
• Significant change in stoma size
• Persistent bleeding from the stoma (beyond minor spotting during cleaning)
• Persistent skin problems around the stoma
• Watery diarrhea lasting more than 24 hours
• No output from the stoma for 4-6 hours (for ileostomy) or as directed
• Severe abdominal pain, cramping, or bloating
• Unusual swelling around the stoma

Emotional Well-being

Adjusting to life with a stoma can be challenging emotionally. Remember:

• Give yourself time to adjust
• Connect with support groups or others with stomas
• Speak with your healthcare provider about concerns
• Consider consulting with a mental health professional

Additional Resources

• United Ostomy Associations of America (UOAA): www.ostomy.org
• Your local hospital’s wound care or ostomy nurse
• Manufacturer websites for your specific ostomy products

This information is for educational purposes only and should not replace personalized medical advice. Always consult with your healthcare provider regarding your specific situation.