Caring for your
ostomy is an important part of maintaining your
quality of life. You will need to:
You may also
irrigate a colostomy, which helps you control when you
eliminate waste. Irrigation requires your doctor's approval and
Wound, ostomy, and continence nurses (WOCNs) are
available in some medical centers to help you learn how to care for your
This topic covers care for a
colostomy or ileostomy only. It does not cover care
ostomy is a surgical procedure. When a part of the
digestive system is diseased or damaged and not able to work normally, a hole
is made in the abdomen and a portion of the small or large
intestine is brought to the surface of the skin. This
opening is known as the ostomy, and the end of the exposed intestine is known
as the stoma. A
colostomy and ileostomy are cared for in a similar
manner with similar products.
When you have a colostomy or ileostomy, waste leaves the
body through the stoma, the end of the intestine that is attached to the
abdominal wall, instead of the
anus. Since there is no muscle around the stoma, you
are not able to control when waste or gas passes out of the body. An odor-proof
plastic pouch (an ostomy pouch) surrounds the stoma to collect the waste. It is
held to your skin with an adhesive. Pouching systems may be one-piece or
Other accessories may include:
When you have had an ostomy, you are not able to
control waste leaving your body.
When you have had an ostomy, you are not able
to control waste leaving your body. An ostomy pouch collects the waste as it
leaves your body. One exception is a continent ileostomy, in which a pouch and
a valve are made in the lower end of the small intestine (the ileum). The
surgeon then connects the valve to an opening (stoma) in the skin of the lower
abdomen. After this surgery, you can insert a tube into the valve to release
stool from the intestines.
Continue to Why?
You need to
care for your ostomy because:
One reason you need to care for an ostomy is to
prevent skin irritation.
Proper care helps prevent skin
Without proper care, skin irritation can
develop, making it difficult to keep a good seal between the skin and the
Continue to How?
Proper care for your
ostomy includes learning how to empty and replace the pouch and knowing what to watch for.
Some people choose
irrigate a colostomy. Irrigation is a procedure in
which you stimulate and flush the intestines at a regular time to control when
you eliminate solid wastes.
Note: If you are caring for an infant or child
with an ostomy, the same information and procedures generally apply. But the
ostomy pouch will be smaller and will most likely need to be replaced more often.
Different adhesives may be used to attach the pouch because a child's skin is
more sensitive than an adult's skin. Your wound, ostomy, and continence nurse
(WOCN) will help you learn how to care for your child with an ostomy.
Irrigation is not appropriate for children.
Ostomy pouches can be
drainable or closed. A drainable pouch opens at one end to allow you to empty
it. A closed pouch is disposed of and replaced with a new one as needed.
The pouch fills with waste and gas. It is best to empty the pouch
when it is one-third to one-half full. This prevents the pouch from getting too
full and heavy and pulling off. Many people routinely empty the pouch each time
How often you change your ostomy pouch depends on many things, including the type of stoma you have and what you prefer. Some pouching systems are changed daily. Others are changed every 3 to 7 days. You may need to change your pouching system more often if there is a leak in the pouch or
itching or burning under the barrier. The pouch itself is usually emptied or replaced
after each bowel movement.
If the skin under your pouch is red, irritated, or itchy,
you need to treat your skin. Follow these steps:
If you continue to have skin irritation, consult your
wound, ostomy, and continence nurse (WOCN) or another nurse or a doctor.
Irrigating a colostomy
allows more control over the elimination of waste, because it stimulates the
intestine to function at a regular time. It is typically done at the same time
every day or every other day. If you irrigate, you may need only a cover or pad
over your stoma and may not need an ostomy pouch.
Children do not
Only a colostomy can be irrigated. You cannot
irrigate an ileostomy.
To irrigate a colostomy, you need to have
all of the following equipment and supplies ready, including:
A two-piece pouch system is usually used for
irrigation. A nurse or doctor will show you how to irrigate your colostomy. The
basic procedure is as follows.
Here are some things to watch for. Call your doctor if:
An adult should change the pouching
How often you change your ostomy pouch depends on many things, including the type of stoma you have and what you prefer. Some pouching systems are changed daily. Others are changed every 3 to 7 days. You may need to change your pouching system more often if there is a leak in the system or itching or
burning under the barrier.
You should empty or dispose of your pouch when:
Emptying the pouch when it is one-third to
one-half full prevents the pouch from getting too full and heavy and pulling
You should empty the pouch when it is one-third to
one-half full. Doing so prevents the pouch from getting too full and heavy and
Continue to Where?
Now that you have read this
information, you are ready to care for your ostomy. If you have any questions
about caring for your ostomy, contact your doctor or a wound, ostomy, and
continence nurse (WOCN).
Return to topic:
Other Works Consulted
Deitz D, Gates J (2010). Basic ostomy management, part 1. Nursing, 40(2): 61–62.
Deitz D, Gates J (2010). Basic ostomy management, part 2. Nursing, 40(5): 62–63.
October 8, 2012
E. Gregory Thompson, MD - Internal Medicine
& Arvydas D. Vanagunas, MD - Gastroenterology
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