New Colostomy...need advice please

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Tinamarie
Regular Member


Date Joined Feb 2009
Total Posts : 28
   Posted 5/26/2011 9:59 PM (GMT -6)   
I recently had an end sigmoid colostomy and had my rectum removed. I am about 2 1/2 mos past surgery, had to spend 17 days in the hospital due to complications with an abscess.

My recovery was tough because after my discharge from the hospital, they had me on mega doses of antibiotics for 28 days. Now things seem better. I have been eating better and my stoma was very active.

I have two things I'm hoping someone can help me with. One I am still scared about changing the wafers. When I went for my post op, the ET nurses said that the home care nurses were having me cut the opening too small, therefore stool was sitting under the wafer. They taught me how to train the stoma into a circle by stretching the smaller part of the oval into a circular form. However, when I had to change the wafer after the ET nurse, there was still stool under there. I am using Hollihesive Skin Barriers now and then a convex wafer, also using paste in between and stoma powder too. Dusting it off the surrounding area well. Sometimes things are fine and other times, there is still stool leakage under the opening. What am I doing wrong? It worried me that it happened after the trained ET nurse at Cleveland Clinic did a change and I had leakage.

Next thing is this is the first time I have gone so long with my stoma inactive. There is gas passing thru but no stool for the last 36 hrs. I've eaten enough so there should be output. Is it safe to take something like a stool softner or colace? Or is it better to take fiber supplements?

I'm just nervous about everything still. Still low on energy too....

Post Edited (Tinamarie) : 5/26/2011 11:15:57 PM (GMT-6)


summerstorm
Veteran Member


Date Joined Aug 2006
Total Posts : 6571
   Posted 5/26/2011 10:44 PM (GMT -6)   
You need to call the dr about the no output. If you go more than 8 hours you should call, for an ileo it may be longer for acolo but I think you still need to call.
As for the leakage less is more so I would stop the powder.
UC for 8 years, before finally kicking its butt and having a permanent ileostomy April 17 2007!
-I have gone to find myself, if i get back before i return, keep me here-
No matter what kind of day you are having, take five minutes to sing loudly and dance like a fool!

2b ColonFree
Veteran Member


Date Joined Nov 2008
Total Posts : 2603
   Posted 5/27/2011 2:48 AM (GMT -6)   
36 hrs with no output can be normal for a colostomy, esp if you say you're passing gas. one of the signs of an obstruction is that in addition to no output, there's also NO gas passing through. but since you're so short while after surgery, do give your surgeon a call. generally, if there isn't any abdominal pain, nausea or vomiting, and gas is still passing, then it's not likely to be an obstruction.

it is perfectly ok for you to take stools softners of any kind you want, but i recommend never to use anything with sena in it. miralax is good and safe, i recommend you try it first. it does take a few days to start working, but it is one of the safest stools softners. and since you still have most of your colon, there's no problem to try fiber either.

about the leakage, as summer said, try to quit with the powder. how long does the wafer hold for you before it leaks? if your skin is irritated and you must use the powder, use it, but just change the appliance more often till the skin is healed. the powder makes it harder for the wafer to stick well, so when there's no skin problems, better not using it at all. best of luck!
Hodaya
06/05/2007 - STARR procedure
colonic inertia w/pelvic floor dysfunction
08/16/2009 - total colectomy w/ileorectal anastomosis
07/08/2010 - loop ileostomy

Equestrian Mom
Veteran Member


Date Joined Mar 2008
Total Posts : 3115
   Posted 5/27/2011 7:01 AM (GMT -6)   
You may want to try an Eakin or Adapt Seal...they protect the skin better than regular paste. Can you try a moldable wafer? That may help with the fact that your stoma isn't round.

Since you have a sigmoid colostomy things will pass a little slower. Please talk to your surgeon before taking a stimulant or fiber...your body may just be adjusting to it's new way of going! Remember that antibiotics usually cause diarrhea, too.
formally known as OHIO76 ~ honoring my daughter's passion!
Crohn’s dx 1989
some terrible years before my temporary ileo in 2001
Proctocolectomy w/end ileo in 2008
...wish I knew then what I know NOW!

CrohnsPatient
Regular Member


Date Joined Feb 2008
Total Posts : 314
   Posted 5/27/2011 9:23 AM (GMT -6)   
You shouldnt be 'dusting off the powder' This is the powder your using for like skin breakdown when some gets behind the wafer right? You should have this white inch in sqaure almost like styrofowm type thing that comes in same type thing as barrier wipes. It will be mooist feeling on one end...when you put the powder on, you should be 'dabbing' the powder with this moist end of the sqaure(I forget the name of these things) this will activate it is what I like ot call it, and it goes from being a powder into being a thicker almost conjealed type substance which will actually act as a barrier. Because if your spraying the powder on and then dusting it off you really might as well not be putting any on. You said the nurse told you that your cutting it to small and thats why its leaking but that sounds like your cutting it to big, if its to small you'd feel it around the stoma and it would almost feel like muscle spasms in your stoma, it would hurt also because the stoma expanding and not having room to. You should be putting paste also no matter what and if you cut the whole to big somewhat then the paste will still seal it up anyway so you dont have to worry about that.

Dont be scared to change it, your only going to get better by changing it and getting the practice and learning what works best for you. Trust me when you get this situation under control you'll realize how much easier it is now that you have an ostomy.
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