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Peristomal skin complications can be more than irritating. That is the reason that #ostomates need to take care of #peristomal skin to keep it from getting infected due to the contact of #stomal output. But that doesn’t mean that caring for this part fo the skin should be a full time job.
In this article, we are going to talk about the ways you can ensure better ostomy skin care without consuming too much of your time on this practice.
Keep it simple
No other cleaning agent is as effective as water when it comes to peristomal skin cleaning. Make sure that you wash your hands before and after the pouch change. If you must use soap, make sure that it is without any lotions or cream because such ingredient-rich soaps can leave residue on the skin. This residue can turn out to be counterproductive for your skin because it makes adhesion almost impossible.
Ostomy skin barrier with ceramide
Ceramide for the skin is just like mortar is for brick wall. The main purpose of ceramide is to keep the cells in outer layer of the skin together. In other words, ceramide is an effective product that can help you ensure better health of your skin. A layer of ceramide on the ostomy pouch barrier’s side that has to go against peristomal skin can help you make sure that your peristomal skin remains safe and healthy while the ostomy pouch is attached.
Be proactive about persitomal skin complications (PSCs)
It is quite unfortunate that most of the people do not consider peristomal skin complications something worth paying attention to. They consider it a part of the #ostomy they have. Well, the simply suggestion that we can state here is that no matter how meager the PSCs may look, you are going to have to take them seriously. These complications can cause longer hospital stays because they can impact the quality of life in the same way the severe health conditions like cancer and heart problems do.
Replace the bag when you feel itching
An itching sensation in the peristomal skin area might now show any visual signs of irritation in the area, but it can be really bad idea to let this itching turn into something painful. This itching may be a sign of minor leakage. The immediate action to resolve this problem is to quickly change your pouch. But before you put on a new pouch, ensure proper cleaning of the area.
The success of your #colostomy depends on how well you recover from #surgery. This recovery doesn’t only restore your body strength and vitality, but it also gives you the confidence to lead a healthy and active life.
It starts with the initial recovery phase. This phase may last for 3-10 days. Your body tries to adapt to the bowel alteration. You may have to remain hospitalized for this short duration. During your hospital stay, your doctor and surgical staff monitor your #postoperative #recovery. The nursing staff will place a clear bag over your stoma to monitor its function.
Stoma nurse
The stoma nurse at the hospital will teach you how to care for your ostomy. It mainly includes how to empty and change your colostomy bag.
They will also train you to take care of your #stoma and the skin around it. The skin around the stoma is generally sensitive to the stoma output. This part of the skin can develop irritation when it comes in contact with the stomal output regularly. The nurse will tell you how to prevent and treat peristomal skin complications to ensure better adhering to the ostomy pouch.
The stoma nurse will visit you after your discharge from the hospital to make sure that you are doing well with the recovery.
Going home
Your doctor will allow you to go home after your initial recovery is over without any complications. It will take six to eight weeks for your bowel to fully recover from surgery. During this time, you may have to be mindful of your diet and other factors to avoid anything that may cause complications.
During its recovery phase, the colostomy is in its most vulnerable condition. It is generally not able to digest solid foods. You may also have to be mindful of the fiber intake because having too much of it can cause obstruction, which can be very painful. You may be able to eat some of the solid foods, but it is imperative to have a discussion about those foods with your doctor.
You may not be able to engage in strenuous physical activities for six weeks after surgery, but you may go for some exercises to keep your body healthy. The light walk is the perfect activity to start with, and you can increase intensity in your physical training regimen over time.
Life with a colostomy
With your bowel fully recovered after colostomy surgery, you can return to your preferred lifestyle, unless it is an unhealthy one. You can go back to your workplace. You may need to talk to your employer and coworkers about your condition, though. It will help you build a cooperative circle around you.
You may eat your favorite foods, but you will need to be mindful of the impact of those foods in your colostomy. Developing a diet plan and following it strictly can be plenty helpful.
You may return to your fitness training regimen, but you may not be able to lift too heavy objects, as they can cause strain on the abdominal muscles. You may want to talk about it with your healthcare provider.
Bloating or accumulation of gas in the ostomy bag can be one of the significant disturbances for ostomates. It doesn’t only put pressure back on the stoma and intestines but it can be a real cause of embarrassment.
The term bloating refers to the sensation of #abdominal pressure that can increase the size of the abdomen. Abdominal #distention also refers to the same sensation but it results in abdominal girth. About 50% of the patients who complain about bloating also report abdominal distention. We can describe bloating in simple terms as a sensation of fullness, heaviness, and discomfort. This condition can range from mild to severe. While the exact reason for bloating remains unknown, it commonly happens to the patients with IBS (Symptoms of Irritable Bowel Syndrome). However, it may be too early to treat IBS as a standardized reason for bloating.
Ballooning refers to the accumulation of gas through the stoma into the ostomy bag. This gas, or flatus, is a combination of nitrogen, oxygen, carbon dioxide, hydrogen, and methane. These gasses produce as a result of colonic bacterial fermentation.
While normal gas release may not be an issue for both ostomates and non-ostomates, higher production of these gasses can be quite painful as well as embarrassing, especially for ostomates. Since the bag has to contain #stomal output, letting gasses accumulated in this bag to escape can have a ruining impact on the social life of an ostomate. And if the gasses are restricted from escaping, they can result in ballooning, excess of which can turn out to be significantly harmful to the stoma and the intestine behind it.
That said, preventing gas from accumulating in the pouch can be the best thing an #ostomate can consider. However, this prevention doesn’t refer to allowing the gas to release for the bag. Instead, it involves working on the root cause of it. For instance, a healthy and balanced diet does not result in the production of more gasses in the GI tract. Moreover, the way you eat and your exercising routine also contribute to how your GI tract produces, or not produces, gasses.
One of the most common bad habits that result in the production of gasses in the GI tract is swallowing more air. Several foods and beverages and the way people eat and drink them end up producing gasses, which can fill an ostomy bag like a balloon. Several activities such as smoking, drinking through a straw and chewing gum can also result in gas accumulation.
It means that the food intake and the method of that food intake are the primary contributors to whether or not your GI tract ends up producing gasses. Therefore, it is necessary to pay attention to the food and beverage intake. Furthermore, you need to talk to your ostomy care nurse to get proper guidance regarding how to avoid gas accumulation in your gut.
Measuring your stoma is one of the most crucial skills to know. Not only will it help you prevent leaks, but it will also allow you to extend the appliance wear time. It will ultimately help you save your #skin.
In this article, we will discuss how to measure your stoma.
Note that this guide is for people who have a round-shaped and adequately protruded #stoma. This guide will help people with colostomies, ileostomies, and urostomies. You may not get perfect results if your stoma is flush or overly protruded.
Similarly, if you have a loop ostomy, it will not be possible for you to benefit from a circular guide. You are going to have to be creative while measuring the stoma to create a perfect flange’s opening. One way to use a circular guide for a loop stoma is to use a half-circle. This way, you will be able to get the required shape of the opening.
Every skin wafer is different from the others. All wafers are made to swell when they come in contact with the stomal output, but the degree at which they swell may vary from brand to #brand. That said, you may want to create an opening slightly larger than your stoma. It will allow the flange to expand without strangling your stoma. It is crucial to get a flange that gives your stoma enough space to expand when waste contents pass out of it. You will, of course, need to make sure that the flange sticks well to your skin.
Change in the stoma size
The change in the size of the stoma is inevitable in the first few weeks after #surgery. There will be swelling in the stoma right after surgery. Over time, this swelling subsides, and the stoma settles to an almost permanent shape 6-8 weeks after surgery. It is the normal process to anticipate.
A stoma can also change its size due to certain changes in the body. For instance, there may be a change in the shape and size of the stoma when you gain or lose weight. Some conditions that may result in the change of the size of the stoma include a prolapsing and parastomal hernia. You can make an accurate opening to make the #flange fitting the shape and size of your stoma.
You may want to use the following supplies while measuring your stoma.
• A measuring guide. It will be particularly beneficial if you are using cut-to-fit #ostomy barriers.
• Ostomy barrier #scissors. These scissors help you create an opening that will not have sharp edges.
• A marker for tracing.
• Gauze to keep your stoma dry. You are going to need it when you are not wearing anything over your stoma. It is typically more beneficial if you have a #urostomy.
• Mirror. It will be helpful if your stoma is away from the scope of vision due to any reason.
Most cut-to-fit wafers come with markers that allow you to create an opening of the exact shape and size of your choice. You may want to learn about creating an opening from your ostomy care nurse.
First day of having an #ostomy shares resemblance with the first day at school from the learning point of view. You enter into a new phase of life where you need to learn many different things. Most of the people think of having an ostomy as nothing more than a liability that bounds you to carry a pouch that collects your waste. And so, they literally consider consider it an end to the healthy and active life.
But the matter of fact is that an ostomy doesn’t restrict you from what you normally do in your life. You can even go for the intense training if you have that passion. But yes, there is a challenge of managing your ostomy; and you are going to need to rely on your ostomy supplies to ensure perfection in this management.
Talking about the supplies, the pouching system is the first that needs to be discussed. In this article, we are going to talk about the one-piece and two-piece ostomy bags.
One-piece ostomy bags
A one-piece ostomy bag is a complete pouching system which includes combines the bag which has to collect the wastes and the base plate, also called a skin barrier or flange, with an adhesive layer. This bag is fitted on the skin around your stoma.
There are some advantages that you get with a one-piece ostomy bag.
• The first advantage is that it is a low-profile bag which can be concealed well under the clothes.
• Since the flange or skin barrier part of this #pouching system is inseparable from the bag, you get a peace of mind after ensuring proper adhesion between the bag and your peristomal skin.
• This pouching system is more cost effective as compared to two-piece ostomy pouching system.
And there are some disadvantages of this pouching system too.
• You are going to need to change the bag frequently because that’s how an ostomy can be managed. This frequent change can make the skin around your stoma more vulnerable to developing irritation.
• You get to clean and prepare your skin every time you attach the bag. And so, you have to spend a little more time in adjusting the bag in right position to make sure that the barrier’s borders are not causing any irritation on the stoma.
Two-piece ostomy bags
A two-piece ostomy bag is a pouching system that includes a bag or pouch and a skin barrier as two different elements. It means that you first have to attach a barrier on the peristomal skin and then attach the bag with this barrier. There are several other supplies that work only with the two-piece ostomy bag, making it a versatile ostomy management option.
A few advantages that you get with a two-piece ostomy bag include the following.
• You can let the barrier to remain attached with the skin for 3 to 4 days. It means that you will be able to keep your skin healthy more easily.
• Whether you want to use a small sized bag or a large sized one, it is entirely up to you.
• You will not need to spend a lot of time to change the bag. All you have to do is to remove the bag after it is filled and attach a new one or use the same one after emptying it.
There are some disadvantages of this bag too.
• This bag is bulkier than a one-piece ostomy bag.
• Leakage can occur at the point where bag and flange meet.
• Since you will not be changing the flange more often, you might not be able to notice if there is a leakage of stomal output happening behind the flange.
• This pouching system is more expensive as compared to one-piece ostomy pouch.
The main purpose of an absorbent #ileostomy gel packet is to turn the stomal output coming out of your ileostomy into a gel. It does so by getting dissolved when it comes in contact with the stomal output. All you have to do is to place the packet in a clean pouch. When your stomal output falls into the bag, it comes in contact with the gel packet which, in turn, starts turning that stomal output into a uniform gel.
The major benefit of your #stomal output turning into a gel is that the bag becomes easier to empty. The stomal output sloshing around in the bag can cause the bag’s filter getting clogged up, leading to the leakage of stomal output from the bag. The immediate benefit of using these packets is that they keep the stomal output into the bottom of the bag and, so, essentially away from the barrier and flange. This way, your #barrier ring will not come in contact with the stomal output.
Another type of absorbent gel is also available. This type of gel uses different formula, which is called Nu-Hope NU-SORB - Absorption Grains; and it doesn’t come packed in the packets which are to be placed in the ostomy bags. Instead, you are going to have to put the granules inside the ostomy bag; so it’s up to you how much granules you put in the bag.
While both types do the same job of turning liquid stomal output into a gel, the one without packets may be more effective due to its ability to dissolve instantly. The amount of absorbent gel which doesn’t come enclosed in packets can be controlled with the help of a scoop that you will get while buying the absorbent gel.
Using Absorbent Ileostomy Gel Packets
•The first step is to get a new bag or empty the existing one if it is drainable.
•You don’t need to open the packet. It will dissolve in its own.
•Place the gel packet inside the new close-end or a newly drained pouch.
•Attach the pouch with the skin barrier if it is a two-piece ostomy pouch.
An absorbent gel is made specifically to work when it is put inside the ostomy pouch. It means that you can put something in the pouch only if it is labeled safe for ostomy. Since the stomal output in the bag has a tendency to come in contact with the stoma, it might turn out to be harmful if the ostomy bag has something additional which is not meant to be put into the ostomy bag.
Bariatric surgery is very beneficial for people struggling with very high BMI and pathological conditions which are worsened by obesity. For people who have failed to reduce weight despite strict diet and exercise, bariatric surgery is the final recourse. Bariatric surgery results in an average weight loss of over 60% excess weight and improves a host of medical conditions such as hypertension, type 2 diabetes, sleep apnea, asthma, etc.
However, every surgical procedure has some risks involved with it and the same is the case with bariatric surgery. But an experienced and skilled bariatric surgeon like Dr. Sanjay Choudhary, who is theSenior Surgical Gastroenterologist and Bariatric Surgeon at Koda International Hospital Dubai will minimize the risks considerably and ensure that the patient does not suffer from complications. The rate of serious complications due to bariatric surgery is less than 5%. The modern laproscopic surgical procedure is minimally invasive which reduces the risk factors.
Some major risks associated with the bariatric surgery have been discussed here.
Dumping syndrome
Dumping syndrome may manifest in people who have undergone gastric bypass surgery. In this syndrome, the food particles are dumped into the small intestine from the stomach without digestion. Symptoms of early dumping syndrome include nausea, heart palpitations, sweating, fast heartbeat, abdominal cramps, bloating, dizziness and fainting. Early dumping happens within 15-20 minutes after eating. Symptoms of late dumping manifest 1-3 hours after eating. The symptoms include fatigue, hunger, sweating, confusion, tremors and heart palpitations.
Dumping syndrome can be treated by altering the diet in consultation with the doctor and nutritionist.
Anastomotic leaking
Anastomosis is the connection created between the stomach pouch and the intestine by gastric bypass surgery. When the connection does not heal, it starts leaking. This is known as anastomotic leaking. Digestive enzymes, acids and partially digested food to leak through the anastomosis.
The leaking can start within 3 days after surgery or can develop over many weeks have elapsed since the surgery.
Anastomotic leaking causes fever, stomach pain, nausea, vomiting, drainage from the surgical wound, low blood pressure, rapid heart rate or tachyardia, pain in the left shoulder and low urine output. Anastomotic leaking can cause bleeding and infection. It can also lead to the development of ulcers. Pneumonia can develop if the digestive juices reach the lungs.
The leak is either repaired or a new connection is created after treating the infection. A temporary stent can also be placed over the leak through an endoscope. Antibiotics are administered intravenously and the patient is fed through a tube connected to the intestine till the leak has healed.
Stomal Stenosis
Stomal stenosis, which means the narrowing of the opening between the stomach and intestine can occur due to gastric bypass. Stomal stenosis causes vomiting after eating or drinking.
You can also ask these questions to your doctor before go to surgery.
Our oldest "furbaby" her reg'd name is Pocket Mouse Mystique. We call her Tiq or Tiquey or Tiquer (pronounced like anTIQue) She is 7 1/2 years old and has always been a tiny little girl. She has a few problems including allergies, PRA (progressive retinal atrophy) and something called lipid stomal opacities (?) I think I have that right, in both her eyes.They can be seen on both eyes with the naked eye. They look like a circle of white circles. She sees, not well, and will one day probably be totally blind.I seldom get a good pic of her because she squints so much. This one I was pretty happy with because she looks alert and looking. I asked her where dad was and she sat up and looked for him lol