Frequently asked questions
by ostomates

Your stoma, a start in a new life

Having a stoma implies several changes in your everyday life and you’ll need some time to adapt yourself to the new situation. It is important that you do not hide yourself. Talk about your situation with your family and friends, don't be ashamed.
Whenever you need help, seek advice from your ET nurse or doctor or talk to other ostomates.

When you come home after surgery, you may feel tired, and you should take a rest e.g. each afternoon. Try to avoid staying up all day as this can tire you out of the point where you cannot sleep at night.

Adapting to the new situation

Adapting yourself to the new situation

Depending on the reasons for your stoma surgery you may feel that you are on an emotional rollercoaster, being weepy sometimes for no apparent reason especially in the first weeks after the surgery. This is quite normal..
Having a stoma makes your body look and work differently, and there will be times when you find this difficult to cope with. 
It seems that during these first weeks all you can think about is having the stoma, and you find yourself thinking 'Is this how it will always be? ' But through time you will most likely become less conscious of your stoma bag. It's common to feel disgusted when dealing with the stoma output also. Most people are not used to having such close contact with their bodily functions, and so it can take quite a time to adjust to.

If you have a partner, they may also feel emotional about all that is happening to you, to both of you.

Talk to your E.T. nurse or another ostomate who will understand how you feel and may have useful ideas on how to deal with these challenges.

Choosing the right stoma bag

Choosing the right stoma bag 

At hospital you have been advised by your nurse or doctor which type of bag better fits to your stoma. One important thing to know is that there are different types of stoma bags available depending on your stoma and your preferences: closed colostomy bags, drainable ileostomy bags and drainable urostomy bags

Once you know how to handle your appliance properly you will be given the opportunity to choose the type of bag you will use daily. One of the first decisions you need to make is choosing between a 1-piece system and 2-piece system.

One-piece and two-piece ostomy system: 

One-piece system

In the case of a one-piece system, the skin protector and the stoma bag are bounded together. It has a lower profile than a 2-piece system which means the appliance is less visible under clothes in general and especially under swimwear. But at the same time changing the skin protector with every bag change can cause irritations on sensitive skin. Probably it could take more time to position a new 1-piece bag system around your stoma than only replacing a new bag on a wafer of a 2-piece system. 

Two-piece system

For a two-piece system, the wafer and the bag are separated, before being attached together through a coupling system. With such a system the wafer is kept on the skin for several days, whilst only the bag is changed when needed, which is gentler on the skin. As the wafer and stoma bags are ordered separately the two-piece bag system is more versatile: You have generally more wafer options within the same system as well as different sizes and types of ostomy bags that can be interesting for active people. Two-piece systems allow you to switch easily to a smaller stoma bag.

It’s up to you to choose between an adhesive or a mechanical coupling system. The first is using an adhesive which is similar to a tape, the second uses a connection similar to the way a lid is placed on a plastic container. 

Transparent or beige stoma bags or bags with split cover

You will have to choose between using a beige or a transparent stoma bag. A transparent bag allows you to see your stoma more easily, the beige one is more discreet.

Most people prefer using a transparent ostomy bag at the hospital before switching to a beige one once at home. 

If you wish to have both, discretion and the possibility of seeing your stoma when needed, you can choose also our split cover bags, which are beige bags with an inspection window.

This inspection window allows the visual control of both stoma and output. The availability may vary depending on the product range.

 

Pre-cut or cut-to-fit skin protector and wafer

You will have to see if you prefer using a pre-cut bag or a cut-to-fit one, where you can cut the skin protector/ wafer fitting it to the shape and size of your stoma.

- Cut-to-fit skin protector or wafer: Cut the skin protector or wafer to adapt it to your stoma.

- Pre-Cut skin protector or wafer: Ready to apply!

Convex or flat skin protector & wafer

Depending on your stoma, your choice will be a flat skin protector/ wafer or a convex one. Convex skin protectors are recommended for patients with flush or retracted stomas to avoid leakages. The convex skin protectors/ wafer ensure an optimum pressure distribution.

Frequently asked questions and answers

A stoma changes your life and with it a lot of questions arise 

Having a stoma implies a lot of questions especially about taking care of your stoma and how to manage your every day life in the best possible way. Below you'll find some answers to frequently asked questions.

More specific questions which you could have as colostomate or ileostomates are answered here.

If you are urostomate probably find further answers on this specific page.

Taking care of your stoma on a daily basis

Yes! You will need a little bit of training at first, but changing it on your own will allow you to remain completely independent. This will also help you if you are facing at a small leakage problem, you'll know what to do (clean with water and soap) in that situation without asking for help. By the end, 5 minutes will be all what you will need to prepare your equipment and to change your appliance. 

5 minutes is all you need to prepare your equipment and to change your stoma appliance.
Get into the habit of always taking the few items required to wash with you; a spare bag and, at the beginning, some spare clothes as this will avoid any accidents or discomfort. Your stoma is not a wound, it is a mucous membrane, therefore the daily care is a simple clean up that is done with bare hands using water and soap. To be as independent as possible at home, it is recommended to perform the change of stoma applicanc yourself.


Suggested Bathroom Wash Kit Contents:
1. A good pair of quality surgical scissors. Preferably with rounded edges.
2. A Razor.  Not necessary if there is no hair growth around your stoma.
3. A pen to draw the stoma template onto your new bag or flange.
4. A small mirror to check the positioning of the appliance on the underside of stoma.
5. A supply of disposal bags.
6. Cleaning wipes.
7. If you are using a 1 piece system; a new bag
8. If you are using a 2 piece system; a new bag and/or a new wafer
9. All your pastes and creams (if used).
10. A clothespin to hold up your clothes when changing bag.

The current equipement is not biodegradable and therefore cannot flushed in the toilets. Used ostomy bags can be placed in a plastic bag closed in the most airtight manner possible and then throw away the bag in the garbage with household waste. Regarding drainable bags, it is advisable to empty them before disposing of them.

Before you  left the hospital, your E.T. nurse had given you at least a week supply of stoma products. Probably they gave you specific advice about obtaining further supplies at home; each nurse’s practice may be slightly different regarding this.

Order new supplies when you start your last box, this way you will never run short. But don’t accumulate supplies, they can be damaged by moisture and temperature changes. You can get your supplies from the local chemist, from delivery services or directly from the manufacturing companies.

Note:
You can obtain samples of stoma appliances to try out. Your E.T. nurse can give you the free phone numbers of the manufacturers (or by email through their website). Tell them what kind of stoma you have and they will send you samples. If you try various pouches, keep a written note of the ones you like and those you don't. If you choose to use any new appliance, just give your E.T. nurse a phone call if you require the ordering information.

 

You can choose between whether you prefer to shower with or without a bag, both are possible. Our stoma bags and wafers are waterproof*. 
In all cases, avoid using products such as shower gels or bubble bath as they leave a greasy film on the body making it harder for the equipment to hold properly. This can lead to possible irritations.
Choose products with a neutral pH, preferably without fragrance and without colorant.

Additional tips for colostomates and ileostomates:

If you decide to keep your stoma bag while taking a shower, remember to close the filter to maintain its effectiveness.

Be aware that if you decide to shower or bath without your stoma bag, possible stool output can occur

Please find more information in our dedicated website area.

 

*) Data on file available upon request

Yes! However right after the surgery you may at first feel more comfortable in loose fitting clothes as your abdomen will be swollen and you will still be feeling a bit sore. This will gradually settle during the first couple of months, after that you will then be able to start wearing the type of clothes you want as the stoma bag will be perfectly hidden under your clothes. You might feel a little self-conscious about the bag the first few times you go out, but no worries this is perfectly normal! With time and as you go back to your usual lifestyle this feeling will gradually disappear.

You can be fitted for a girdle which will be made-to-measure. You should be able to wear tight fitting clothes and swimwear. Ask your E.T. nurse to advise you about the best mini bag for you.

If your operation was done in emergency or if the location of your stoma was not marked before the operation some slight adjustments to the waistline may be needed. Again ask your E.T. nurse for advice.
 

If the daily care is carried out simply, the risk of irritation is lesser. Keep  in mind that the adhesive part of the pouch is also a skin protector meaning that its role is both to keep the bag in place, but also to protect your skin. 

So changing it daily doesn't constitute a risk of irritation. Irritations are often due to leaks or improper care. However, there are ways of reducing the risk of irritation to the minimum: 

- Clean your stoma with water and soap- neutral pH, perfume free soap.

- Do not use disinfectants or alcohol.

- Look for allergic reactions around the adhesive for example.

- You can also use skin protective products such as B. Braun Askina® Barrier Film

- If you have itchy watery stools, fill the gap of uncovered skin using a protective paste such as B. Braun's Superfiller.

- Finally, you can also choose to use protective rings which makes the appliance user-friendly while maintaining a good skin protection.

A leakage problem is strong inconvenience, know that there are numerous reasons behind a leak. You must therefore quickly contact an E.T. nurse in order to determine the actual cause of the leak and to remedy it immediately. Depending on your type of stoma and the nature of your stools, the consequences of these leakage problems will differ.

You can also try to find the cause:

- Is your wafer or bag properly centered?

- Has the protective paper of your skin protector / wafer or bag completely come off?

- Is your appliance adapted to the size and shape of your stoma?

- Did you properly dry your skin when you attached the skin appliance?

- Are you feeling discomfort due to too much peristomal hair?

- Could you have let a drop of stool or urine fall between the skin and the appliance?

- Could you have placed your fingers on the skin protector?

- Are the wafers or the stoma bags damaged from poor storage?

- Pay attention to changes in temperature (they must be preserved in their original box, in a room at 18 °C that is not humid).

- Has care been performed with the product that could cause irritation or dryness of the skin and preventing good adhesion of the equipment?

- Has the skin protector or wafer been in place for too long, or it is used?

- If you are urostomate: Is your urine too alkaline or too acidic right now (check the pH) (see the question on urinary tract infections) and could it be destroying the skin protector too quickly?

- Is your stoma located in a fold or on an irregular surface?

Knowing the reason behind the leak will help you and your E.T nurse find the solution. If the leaks persist, don't hesitate to consult your stomatherapist, who can provide advice and, if necessary, change the equipment.  

After your surgery, you may think that going out with friends, participating in parties or other events isn't anymore possible with your stoma. Far from it! Continuing your social life is actually very important to your recovery and will help you to gain back self-confidence. 

Exercises such as cycling, hiking or skiing are strongly encouraged. However, avoid any sports that put too much stress on the abdominal muscles such as weight lifting, rowing, fighting sports or rugby as it may injure your stoma.

You should start exercising progressively in order not to strain your stoma too much especially right after your surgery. Avoid any activity including any heavy lifting that put too much stress on the abdominal muscles as your abdomen has been made more fragile by the stoma also.

Actually, practicing a sport activity and maintaining an active life style are the key factors to your recovery and will help you to gain back your confidence.

Tip: Wearing a belt or a protection band is sometimes useful.

 

Start driving when you feel comfortable while performing an emergency stop without hurting your abdominal muscles or wound (this can take up to 8 weeks). To be safe, the first time you start driving either start with a short distance or ask another insured driver to come with you in case you are unable to continue.

Having a stoma shouldn't prevent you from travelling, but you will need a bit of preparation to make sure that everything goes smoothly. At the beginning, start by going away for a weekend or going back to a familiar place where you will be able to relax.

Following these simple guidelines will help you go on vacation with peace of mind:

- Check that you have adequate insurance, which covers any pre-existing illnesses.

- Ensure you have adequate toilet facilities within your accommodation. 

- Pack the needed material for the length of your vacation, take on a bit more then usually needed to be on the safe side.

- For your comfort empty or change your stoma bag before boarding on a plane or train etc. 

- Plan your best opportunity to empty or change your appliance

- For longer breaks send appliances in advance to your destination or have them delivered to you while you are there. 

- Divide supplies between hand luggage and your suitcase, in case you lose them. 

- Bring your prescription with you to have the references of your products. 

Prepare a bag:

- Scissors

- A new stoma bag (preferably already cut to your current size)

- A disposal bag and a few wipes

- Clothespin to hold your clothes while changing the appliance

- A small packet of wet wipes (in case you have no access to water)

- A second skin wipe (if used)

 

Additional tips for colostomates and ileostomates:

- Take a couple of drainable bags in case you have diarrhea. 

- Mini bags are available for swimming and sun bathing. Most standard bags have a mini version that will suit you. See your E.T. nurse for further advice.

- Avoid alcohol and fizzy drinks on the plane and drink plenty of water.

- To avoid over production of wind before flying eat yoghurt daily and avoid yeasty foods.

- If the local water should not be drunk avoid salads and ice in drinks.

 

Additional tips for urostomates:

For long trips and for more comfort pack a urine leg bag.

There is no reason why your stoma should prevent you from working unless your doctor or E.T nurse says otherwise for a specific reason and your job is compatible with your stoma (physical efforts needed, place of work…). A lot of people are able to resume their previous employment within three months depending on their surgery and type of work. But every person is different, take the time you need.

Before going back to work think about the practical things. For example think about how you will change or empty your stoma bag in the toilets at work. Think of the time you will need, the equipment you will need and look to see if there is a specific toilet that would be best to use (one that may be larger, or that has a hook on the door, a shelf, a window, or simply one that is less used). 

Also think about who you will tell and how much you want them to know. Remember no-one except your employer needs to know unless you want to tell them. The decision is yours.

If you are worried about going back to work, ask you employer if you can start by working part time. Start by working only in the morning, or only in the afternoon or on certain days of the week. Talk with your employer to find out what works best for you both. 

Of course! You can customize your ostomy bag any way you want using different materials (duct tape, fabrics, ..). You can even find videos and tutorials on the web by searching “fashionable ostomy”, or “homemade ostomy bags” or "stoma bag covers". If you use airtight materials, make sure that the filter is not blocked.
 

More information