Medical Edge Newspaper Column

Ostomy Does Not Have to Limit Lifestyle

April 10, 2009
Dear Mayo Clinic:
I am a 73-year-old retired nurse who has a urostomy. As a member of a local ostomy association, I often meet new people who have just had a urostomy or colostomy, and we all agree that it is difficult to find new information. Please share what is important to know about ostomies, especially if there is anything new on the horizon.

Answer:
People often have misconceptions about ostomies and how they affect daily life. Getting reliable information can go a long way toward successfully adjusting to an ostomy. Despite what you may have heard, an ostomy doesn't have to limit your lifestyle.

Basically, an ostomy is a surgical procedure in which a portion of your gastrointestinal or urinary tract is brought to the surface of your abdomen. Depending on the type of ostomy, stool or urine pass through the ostomy opening (stoma) and into an external collecting device (a pouch) that is adhered to the skin around the stoma and changed one to two times a week.

One of the best sources for information about ostomies is a wound/ostomy/continence (WOC) nurse. These health care professionals are registered nurses who have completed additional training regarding ostomies. They can explain the essentials, what to expect, and how to best manage an ostomy. Most major medical centers and some home health agencies have WOC nurses. Mayo Clinic recommends that its patients who are having ostomy surgery meet with a WOC nurse prior to the procedure, if possible, to discuss questions and concerns.

One common concern people have about ostomies is odor. Fortunately, the pouch systems used now are odor-proof. Also, most pouches have a Velcro or clamp closure at the bottom and are emptied whenever they are one-third to one-half full. In some cases, an option is a disposable pouch that doesn't have to be emptied; instead, it's just thrown away and replaced.

Companies that make ostomy products often introduce new, enhanced items to the market. So, if you are having problems with a product, it is important to contact a WOC nurse to find out about other products that may work better for you. For example, a variety of skin-friendly adhesives are now available that keep the pouch attached securely to the abdomen. Over time, some people may develop a reaction to a particular type of adhesive. Switching to a different type of adhesive or a different brand may help. If an ostomy product isn't meeting your needs, you need to find out about alternatives.

Body image is another frequent concern for people facing ostomy surgery. They may think they'll have to wear baggy clothes, or that they won't be able to get back into jeans or a bathing suit. In fact, with a well-constructed stoma and a properly fitting ostomy pouch, most people can wear the same clothes they did before surgery without the ostomy being noticeable.

Nor does an ostomy have to restrict your activity. I've known people with ostomies who flew airplanes and went scuba diving. After a period of recovery, you should be able to return to work and engage in usual day-to-day activities and hobbies. If you can't, talk to your doctor or a WOC nurse.

For those who were very sick prior to surgery, perhaps even homebound because of a disease, an ostomy can actually make daily living easier. For example, the ostomy may allow them to return to work, have a social life again, and be a more active family member.

A final topic I frequently discuss with people who have ostomies is diet. For most bowel surgeries, people are on a restricted diet for approximately two to four weeks following the procedure. Primarily, they can't eat foods that don't get completely digested, like fresh fruits, raw vegetables, nuts, seeds or popcorn.

After that initial restriction period, however, there usually aren't dietary restrictions. Those who have an ileostomy, which is created from the small intestine, have a slightly increased risk of dehydration. They should monitor fluid intake and drink about 64 ounces of water or electrolyte drinks daily. Otherwise, people with an ileostomy can usually eat a normal diet.

For more information about ostomies or to learn about advances in ostomy products, talk to a WOC nurse. If you don't know where to find one in your area, ask your doctor. Although adjusting to an ostomy can require a little time, the ostomy doesn't have to change the way you live.

—Laurie Maidl, Registered Nurse and Certified Wound/Ostomy/Continence Nurse, Colon and Rectal Surgery, Mayo Clinic, Rochester, Minn.