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How To Choose The Right Colostomy Pouch After Ostomy?

The colostomy pouch is considered a vital part of the routine life of patients who have undergone a surgical procedure called an ostomy. The procedure involves a surgically created incision or an opening in the abdomen to allow stools to be eliminated from the body.

It may take a long time for you to become comfortable with the changes brought about by ostomy into your life. Several questions and concerns may run through your mind when you are advised to undergo an ostomy.

And most of these questions are linked to the use of a colostomy pouch.

Most patients are concerned about how to choose the right colostomy pouch, how to use it, and how to care for it. It is also not uncommon for patients to be worried about how having a colostomy pouch would affect their routine.

If you are advised to undergo an ostomy, keep reading to learn all about this procedure and the colostomy pouch. We will discuss what ostomy means and the need to use a colostomy pouch as well as the ways to choose the right colostomy pouch to ease your routine after the procedure.

What Is An Ostomy?

 

Ostomy is a life-saving surgical procedure that is aimed at allowing bodily waste such as feces to pass through a surgically created opening in the wall of the abdomen. The opening leads to a prosthetic called an ostomy bag or a colostomy pouch on the outside of the body or a surgically created internal pouch.

An ostomy is basically of two types: an ileostomy and a colostomy.

Although ileostomies and colostomies are similar, they involve different parts of the bowel. An ileostomy starts in the part of the small intestine, usually the ileum, while a colostomy involves a part of the large intestine, usually the colon.

What Happens During An Ostomy?

 

During this procedure, the end of the colon is brought out through an opening in the wall of the abdomen forming what is called a "stoma". This is the opening through which feces would be eliminated from your body after the surgery instead of through the anus.

Unlike your anus, the stoma does not have any muscles and nerve endings. So, you would lose your ability to control your bowel movements. Hence, a bag, called a colostomy pouch, is placed over the stoma to collect the feces when it comes out.

Some patients need a colostomy pouch for a brief period of time after the surgery, while for some, it is a permanent change. A colostomy pouch can take some time to get used to. But most patients are able to adjust and return to their normal lives within a few weeks following the surgery.

Now that you have understood what an ostomy means and what happens during the procedure, let's learn why or when an ostomy is needed.

What Are The Common Indications For Ostomy?

An ostomy might be necessary for infants who have a birth defect due to which the passage of stools is blocked. Some other conditions such as cancer of the colon, diverticulitis, inflammatory bowel diseases, and incontinence of stools can also necessitate the person to undergo an ostomy.

The procedure may also be necessary in cases of serious pelvic or abdominal trauma resulting from injuries sustained during military services or accidents.

Ostomy is usually performed in adults as the incidence of diseases linked to the need for this procedure - such as cancer, diverticulitis, and inflammatory bowel diseases - is higher in older people.

However, irrespective of whether the procedure is performed on an infant or an adult, it does not create any adverse impact on the life expectancy of the patient, though it may affect the quality of his or her life.

The need to have a colostomy pouch after an ostomy to provide a way for the passage of stools out from the body can affect the routine life of patients in several ways. However, choosing the right colostomy pouch and being aware of the correct ways to use or care for it would help you avoid the inconveniences associated with the same.

Keep reading to learn more about colostomy pouch and how to use it so that having undergone an ostomy does not come in your way of achieving success or living your life in a satisfactory manner.

What Is A Colostomy Pouch?

A colostomy pouch is a plastic bag that collects the fecal matter from your digestive tract through an opening called a stoma created in the abdominal wall during ostomy.

 

During an ostomy, your surgeon will bring out a portion of your large intestine through the stoma and attach it to the colostomy bag, which can then collect stools as they pass through the gut.

A pouching system consists of different parts such as:

•     A wafer, flange, or skin barrier that is attached to the skin surrounding the stoma.

•     A pouch that is attached to the flange and collects stools as they pass through the stoma.

What Are The Different Types Of Colostomy Pouch?

 

Following an ostomy, you will have some choices about the type of colostomy bag you want to use. These types are referred to as the pouching systems. These pouching systems are available in a variety of sizes, materials, and styles.

It should be noted that not every system is suitable for all patients. Each colostomy pouch system works in its own way and hence, it is important to find the right pouching system for you based on your routine habits, and symptoms such that it will perform the best for you.

Let me share with you some of the common types of colostomy pouches so that you can choose the one that could be the most suitable for you.

One-piece system

This type of colostomy pouch tends to fit around the stoma snugly. It is attached to the skin with an adhesive. Some of these systems also have flushable liners.

Whenever you need to replace your pouch, you would have to take off the whole thing and replace it with a fresh one.

Two-piece system

It has a base plate that fits around your stoma tightly. The bag is then attached to the base plate. You can change the bag as and when needed while the base plate needs to be changed once every 3 to 4 days.

Drainable bags

This colostomy pouch is suitable for those who have frequent watery stools. You can empty them through the opening at the bottom. You would need to change them once every 3 to 4 days.

Closed bags

These bags are more suitable for those who have hard and firm stools. You need to change the pouch twice a day. This system also has special liners on its inner side that can be flushed down the toilet.

Mini bags

These are small pouches you can wear only for a short duration of time.

How To Choose The Right Colostomy Pouch?

 

Here are some features you should look for in a colostomy pouch:

•     Odor resistance: Choosing a colostomy pouch with a high odor resistance will help you avoid the inconvenience caused due to the accumulation of feces into it, especially while being outdoors in the company of others.

•     The ease of use: It is best to choose a pouch that is easy to take off, put on, and replace in order to reduce the amount of time and effort spent on these activities on a daily basis.

•     A leak-proof seal: Chose a pouch having a leak-proof seal, which lasts up to 3 days so that you are assured of avoiding embarrassment caused due to the leakage.

•     Visibility: Most patients prefer to use a bag that is not easily noticeable under their clothes, especially when they do not wish to let anyone know they are having one.

•     Soothing material: Choose a colostomy bag made of material that is gentle on your skin and does not irritate the skin around the stoma

You should choose a colostomy pouch that best fits your needs. The style and size of the pouch, your bowel habits, and your routine also need to be taken into consideration.

Here are some examples that will help you choose the right colostomy pouch:

•     Most people use a reusable pouch on a daily basis while a single-use bag is preferred while traveling when they may not have access to facilities to clean the pouch.

•     Also, most patients prefer to use larger bags for night-time usage so that they do not have to get up frequently to remove, clean, and replace the pouch. The smaller ones are usually recommended for use during the daytime, especially if your routine involves visiting people, wherein you would like to avoid the colostomy pouch being noticeable by causing a bulge under your clothes.

•     The removal and placement of a one-piece colostomy pouch system takes a long time and needs more effort. Hence, a one-piece colostomy pouch system is suitable for those who pass stools less frequently.

•     A two-piece system is more preferred by those who have frequent bowel movements. This system has a flange that attaches to the skin around the stoma with the bag being attached to the flange. This design makes it easier for a person to remove, clean, and replace the pouch. Hence, if you have frequent bowel movements, it is best to choose a two-piece system.

•     Drainable bags are best to use if you have watery stools or when you are suffering from a bout of loose motions.

•     Closed bags are perfect for those who have hard doors and a low bowel frequency.

•     Mini bags can be used when you are on a short outdoor trip such as while visiting your doctor or going to a relative's place.

The 3 Best Colostomy Pouches

Here are the 3 best colostomy pouches for you to choose from. These pouches have been chosen based on the quality of materials, the ease of use they offer, and several other parameters that can reduce inconvenience and improve the quality of life of patients.

1.  ActiveLife One-Piece System

The ActiveLife One-Piece colostomy pouch from Convatec offers a flexible and lightweight system. It is designed to combine the skin barrier and the colostomy pouch into one simple and easy-to-manage system.

It is an opaque and drainable pouch that is designed to fit into a 1-inch stoma. The vinyl material will be gentle on your skin and help you avoid rashes and itching.

2.    Sur-Fit Natura

The Sur-Fit Natura colostomy pouch from Convatec is designed for one-time use. It is a small pouch having a quiet, odor-barrier film. It is an opaque pouch made of vinyl that will be mild on your skin.

If you travel often, it would be good to have a few of these colostomy pouches in your travel bag to avoid inconvenience while traveling and make your journey more pleasant.

3.  Sur-Fit Natura 12" Length Drainable

If you are looking for a two-price colostomy pouch, you can try Convatec Colostomy Pouch Sur-Fit from Natura. It has soft and fabric-like comfort panels and a quiet, odor-barrier film.

It is a drainable and transparent colostomy pouch made of vinyl. The wide tail opening of this pouch is designed to support easy drainage. It is perfectly suitable for those who need to empty their bag more frequently.

Caring For Your Colostomy Pouch: Frequently Asked Questions

 

Here are some common concerns related to the use of colostomy pouch and the ways to address them?

How often should I empty the colostomy pouch?

For a few days to weeks after the ostomy, you may need to empty the bag several times a day. However, over a period of time, your regular bowel movements would return following which you may need to empty the bag once or twice a day.

How To Change A Colostomy Bag?

1.    Wash your hands with antibacterial soap and water, preferably warm.

2.    Peel the bag gently from the stoma.

3.    Remove the bottom of the pouch and empty it into the toilet or discard it into a disposal bag.

4.    Clean the stoma using gentle soap and warm water.

5.    Dry it thoroughly.

6.    Prepare the next bag (and the flange if you are using a two-piece pouch system).

7.    Attach the bag to the outside of the stoma using adhesive.

How Often Do You Need To Remove Or Change A Colostomy Pouch?

It is advisable to remove, clean, or change your colostomy bag when it is about one-third to one-half full. This would help prevent the pouch from pulling away from your skin or its plate and causing leakage.

How often you would need to change the bag would also depend on its size. A smaller bag needs to be emptied and cleaned more frequently than a larger bag. Hence, a smaller bag is usually used during the daytime.

A larger bag often lasts more time without the need for emptying and hence, is good for overnight use.

Dietary Restrictions To Follow While Using A Colostomy Pouch

An ostomy may require you to restrict your intake of certain foods in order to avoid gas, bloating, and bag inflation or explosion.

The foods that are more likely to cause severe constipation, gas, diarrhea, and incomplete digestion include asparagus, broccoli, beer, cauliflower, beans, carbonated beverages, Brussels sprouts, and peas. It is best to avoid these foods or eat them sparingly.

Moreover, chewing food thoroughly and increasing your intake of water are also great ways to avoid bloating and gas.

How To Keep Your Colostomy Bag Concealed From Others?

Most people would not notice your colostomy bag unless you tell them so. Here are some ways that will help you keep your colostomy bag concealed from others:

•     Select a colostomy pouching system, which works the best for you.

•     Empty the pouch once it is one-third full so that it does not create a bulge under your clothes.

•     Use stoma pouch deodorants or air sprays to reduce odor while emptying the bag.

How to take care of the skin?

The skin surrounding the stoma is known as the peristomal skin. It may appear red and even bleed occasionally. These symptoms are common in people who have a colostomy pouch. However, if bleeding continues for long, it is good to seek the advice of your doctor.

A pouch that does not fit well is more likely to irritate your skin. Hence, make sure the pouch is connected to the stoma correctly.

Keep this area dry and clean.

If the skin appears wet, itchy, bumpy, and painful, contact your doctor for the early diagnosis and timely treatment of infections.

What precautions need to be taken when you have a colostomy pouch?

•     Avoid lifting heavy items as it may lead to leakage of feces from the pouch.

•     You might need to visit a restroom more frequently to manage your pouching system. Bear this in mind while traveling or making plans for a vacation.

•     Carry extra bags and supplies while traveling

•     Take care when using a seat belt, such that it does not put pressure on or lie across the stoma.

•     Avoid foods that can cause flatulence.

•     Take extra care while playing with children or pets to avoid damaging the pouch

•     Choose high-waisted clothes including underwear

When accessories will be needed to take care of the colostomy pouch?

•     Wipes to keep the area clean

•     Stoma paste to help attach the bag to the skin

•     Stoma powder to absorb moisture and ensure the bag stays in place

•     Belts to keep the bag attached securely

Conclusion

An ostomy surgery is a bowel diversion procedure that re-routes the passage of unwanted intestinal contents including feces from the bowels.

Choosing the right colostomy bag based on your bowel habits, and routine and taking good care of the pouch would help you avoid the inconvenience attached to using these systems.

Colostomy bags, when chosen correctly, would not interfere with your daily activities and allow you to carry on with your routine life with ease. Hence, undergoing an ostomy or having a colostomy pouch should be viewed as the start of a new "normal" rather than feeling anxious over it.

References:

 

https://www.webmd.com/colorectal-cancer/colostomy-bags

https://www.ostomy.org/what-is-an-ostomy/

https://www.nhs.uk/conditions/colostomy/

https://www.cancer.net/navigating-cancer-care/how-cancer-treated/surgery/types-ostomy/how-live-with-ostomy-bag

https://www.nhs.uk/conditions/colostomy/living-with/

https://www.mayoclinic.org/diseases-conditions/colon-cancer/in-depth/ostomy/art-20045825

https://www.cancer.org/treatment/treatments-and-side-effects/treatment-types/surgery/ostomies/colostomy/types-of-colostomies.html