There are many problems a person with a stoma can experience, some are simply a nuisance, some are a major problem and, unfortunately, some are very serious. However, it should to be acknowledged, that one person’s nuisance can be another’s major problem!
Some of the problems experienced by ‘ostomates’ are outlined below:
Skin problems are very common and can fall into all of the above three categories, i.e. nuisance, major problem, and, very serious. They can vary from simple skin irritation to conditions where the person is actually unable to wear a bag because of the condition of their skin.
There are many causes of skin irritation, for example:
If you are experiencing persistent skin problems your Stoma/Specialist Nurse should be consulted and these problems sorted out BEFORE they reach a point where they become a serious problem.
Because of the constant pressure exerted on the adhesive flange by the Baseplate, the bag maintains a better seal for longer therefore less bag changes are required.
The presence of excessive wind in the bag, as well as being uncomfortable, can cause the adhesive flange of the bag to loosen, resulting in a leak.
Excessive wind can be caused by consuming certain foods and drink. If it is a reoccurring problem try keeping a note of the food or drink you consumed prior to the bag ballooning. For example, if it occurs following a curry meal, or drinking a particular type of drink, try cutting it out for a while to see if it reduces the ballooning.
Some people are simply susceptible to this condition, but for others it can be caused by their eating habits. Try some of the following:
You can also try peppermint tea or tablets, or charcoal tablets. If ballooning is constantly excessive, try a bag with a double filter system.
Odour issues can be a very real problem for people living with a stoma. However, the reality is, whether you have a bag or not, ‘faeces smells’. Even, so called, ‘normal people’, also have an issue with this, particularly using toilets in other people’s homes.
IMPORTANT; if you get a sudden odour, check your bag immediately for a leak! Some common foods increase odour issues for some people, for example:
It is advised that consumption of the above foods and liquids be decreased, or cut out completely, for a period of time to see if it reduces or eliminates the problem, and then reintroduced slowly.
There are also odour neutralisers available, in the form of sprays, or drops that are inserted into the bag.
Pancaking, (or ‘pattycaking’ as it is called in the US), occurs when the faecal matter sits on or around the stoma and fails to drop into the ostomy bag. As more faecal matter comes out there is nowhere for it to go so it often pushes its way under the adhesive flange and causes a leak.
It is normally caused by a ‘firmer stool’ which is ‘stickier’ and attaches itself to the sides of the bag. Certain foods can also cause this. It is a difficult problem to solve, but try some of the following:
Most of the above solutions can only be used when a new bag is being fitted. The STOMAPROTECTOR device, with the ‘keyhole’ shaped plate at the back of the Cover prevents the faecal matter from congregating round the stoma all of the time it is being worn. It operates by forcing the faecal matter down into the bag.
Some general information; if you have an Ileostomy the output will generally be ‘loose’ and can resemble diarrhoea. This is normal, but if it is more ‘watery’ than usual and lasts this way for more than 24 hours medical help should be considered.
Some foods can also cause diarrhoea, for example:
Excessive alcohol consumption, stress, or an underlying medical condition can also be factors.
It is extremely important to keep well hydrated by increasing your fluid intake, and in the case of people with an Ileostomy, salt intake as well.
Eating marshmallows, unripe bananas or smooth peanut butter can help to solidify the output. There are also ‘solidifying agents’ available on the market which can be inserted into the bag to solidify the output.
This condition is generally associated with a Colostomy bag.
Below are a couple of simple remedies to try before seeking medical help:
If you find that the bag has not filled up for a longer period than normal, or it contains a lot of watery fluid, you could be experiencing a blockage. If your stoma swells in size, or if the colour changes to a deep red, you could also be experiencing a blockage.
If you are experiencing stomach pains, nausea, or vomiting, you should consult with your doctor or Stoma Nurse.
A hernia is a weakness in the wall of the abdomen that causes a bulging, a swelling or a lump to form. When the weakness occurs where a stoma is attached to the abdomen, it is called a Parastomal Hernia.
There is conflicting information about the occurrence of a Parastomal hernia; some souses say that it happens to between 5-10% of people with a Colostomy, and between 3-10% of people with an Ileostomy, while other say it can be as high as 50%. I was also at a lecture given by a Medical Consultant who said, “It is not IF you will get a hernia, it is WHEN! While it is difficult to predict who will develop a Parastomal Hernia, certain factors are known to cause it to occur. For example, a Parastomal Hernia can be caused by lifting heavy objects, being overweight, or can be a side effect of taking steroid drugs, which can weaken the muscles.
A Parastomal Hernia may cause some abdominal discomfort. It can feel like tightness, fullness, or a heavy feeling in the abdomen; that is not painful, but can feel uncomfortable. Most hernias can be managed without surgery. Support belts and appliances are the most successful aids.
A Parastomal Hernia may change the size and shape of your stoma which may leave you more prone to leaks. This may cause you to review the bag you are using. Also, because it now protrudes from your abdomen you may also have to review how you keep the bag in place.
In extreme cases, surgery may be required. This can occur if the Hernia interferes with how the stoma functions, i.e. causes strangulation or obstruction.
Please consult with your Stoma Nurse if you experience any significant changes to your stoma.
NOTE: Although it is not a claim made for STOMAPROTECTOR, at this time, the fact that a constant gentle pressure is exerted round the stoma while wearing it means it performs the same function as a support belt.
I hope you found this information helpful and good luck with living with your stoma.
Brendan Magee.
