Living With A Colostomy Bag: What You Need To Know

People suffering from colorectal cancer or other illnesses of the lower digestive tract often require a colostomy, a type of surgery that creates an alternative pathway for feces and urine to leave the body. Having a colostomy is a major physiological change, and knowing what you are in on can help you cope with the changes effectively.

What Is A Colostomy?

The colon consists of the first five to six feet of the large intestine. It consists of three portions; the ascending colon (goes to the right side of the abdomen), the transverse colon (runs across the abdomen) and the descending colon (runs down the left side of the abdomen). It absorbs nutrients and water from the feces and returns them to the body.

The surgery requires general anesthesia. Depending on the abnormality, the procedure can be an open surgery or a laparoscopy. An open surgery is a highly invasive method that involves making a large incision in the abdominal cavity. The alternative is to make use of a laparoscope, which involves inserting a thin flexible tube with a camera at one end via small incisions into the abdomen. Both approaches have the same basic procedure, in which an opening (stoma) is made in the abdominal cavity. A healthy part of the colon, brought out through the stoma, is stitched to the skin around the opening. Placed around the stoma is a bag or pouch into which the feces and urine drain. 

What To Expect After A Colostomy

The outcomes of the procedure vary from person to person. After a colostomy, certain differences occur in the consistency of the stool produced:

• If the stoma exists at the lower end of the colon, the consistency of the stools is more solid due to increased water absorption.
• If the colostomy is near the rectum (along the descending colon), stools have a well-formed consistency very similar to that of normal feces. 
• If the colostomy is along the transverse or ascending colon, there is decreased water absorption from the feces and they have a loose consistency. They pass through the stoma quickly and the patient may require a thicker stoma to accommodate them.

Besides the changes in the consistency of the stool, patients may also experience difficulty in digestion, changes in the appetite, dull abdominal pain, and other symptoms.

Colostomy Equipment

Colostomy bags are manufactured using non-allergic materials with special filters for odor reduction. A variety of colostomy appliances are available, which include:

• One-piece pouches – the flange (part that adheres to the skin) and pouch are attached together. The bag is disposed when it is full.
• Two-piece pouches – the flange and pouch are separate, but attachment is an option. The bag can be emptied several times before disposing.

Additional products to facilitate patients and limit complications include:

• protective skin wipes.
• support girdles and belts.
• products inserted into the colostomy bag to minimize odors.
• protective stoma rings and caps to prevent leakages.
• adhesive-removing sprays.
• specially-designed undergarments.

Life After A Colostomy: Practical Considerations For Those With A Colostomy Appliance

Living with a colostomy bag requires certain crucial lifestyle modifications. However, with proper guidance and support, it is quite possible to lead a fully functioning life.

Maintaining Hygiene

Your doctor and heath-care nurse will provide instructions to aid the healing of the stoma and maintain the appliance. These usually involve cleaning the wound and changing the appliance regularly. Focusing on issues such as showering, preventing infections, and thoroughly rinsing the skin is important.

Good Adherence

Making sure the flange can adhere to the skin effectively is very important. Changes in humidity and temperature significantly affect wear-time. Increased physical activity and perspiration can decrease wear-time. Thus, the skin must be clean and dry before attaching the flange.

Dietary Precautions

Foods affect the digestive system of each individual differently. There are no specific dietary regulations. However, try to avoid foods that cause flatulence or diarrhea, since this could lead to problems of leakage and odor.

Managing Stool Production

The frequency and consistency of stools depends on the type of colostomy you have. Keeping track of bowel movements is vital. A major concern is constipation. Drink plenty of fluids and consume an adequate amount of fiber and juices to keep the stools from becoming too hard or too soft. If the constipation becomes persistent, the doctor may prescribe a timely dose of mild laxatives. 

Precautions at Work

People who have a physically demanding job that involves activities such as lifting and walking can wear a support belt or girdle.

Controlling Odor

Products to control odor are available as liquids and solids. Some are taken internally, and others are placed within the pouch. Emptying the bag periodically will limit the production of off smells as well.

Precautions during Sexual Intercourse

A colostomy can create various practical issues during sexual intercourse. Women, after removal of their rectum, may find sex in the traditional position extremely distressful, since there is no vaginal support. Vaginal dryness is another common issue. For men, surgery might damage the blood vessels and nerve endings innervating the penis, causing temporary erectile dysfunction and premature ejaculation. 

Nevertheless, there are many tips for managing these problems, a few of which include:

• using a lubricant for managing vaginal dryness.
• protecting and supporting the stoma with a soft pillow or cushion.
• trying to have sex in a more comfortable position.
• not putting any weight or pressure on the stoma while having intercourse.
• avoiding anal sex – can lead to extreme pain and rupturing of the stoma.
• changing the colostomy appliance before having sex.

Some General Precautions

When traveling, always carry an emergency kit with back-up supplies. This should include things such as an extra bag, a precut flange, tape, mirror, Q-tips and protective skin wipes. Try to wear loose clothing to facilitate your skin to breathe. Loose fitting clothes also help conceal the colostomy bag and make you feel more self-assured and comfortable in public. Avoid any strenuous physical activities, and caution your children about taking care when they play with you or sit in your lap. While driving, make sure that the seatbelt does not press the stoma or exert pressure on the flange. In case of any psychological issues, talk to your loved ones and confide in your doctor for assistance.