Your Care at Home:Colostomy CarePage 1 of 3NarratorIf you’re leaving the hospital after a colostomy, you probably have a lot of questions. Living with a colostomycan be a big adjustment. Just learning more about how a colostomy works and how to take care of it mayhelp make it easier for you. My friend and I will help you.A colostomy is an opening to drain feces, or stool, from your large intestine into a pouch that you wear onyour body. The opening, which is called a stoma, is usually placed on the left side of your abdomen. Thereare two types, temporary and permanent. A permanent colostomy is usually in the lower part of your largeintestine. The feces that collects in the pouch should be well-formed with this kind of colostomy. Atemporary colostomy is usually a little higher up with the opening on your upper abdomen. Because it’s notas far along in your digestive system, the stool may be less well-formed than with a permanent colostomy.There are a few different types of colostomy pouches, the bag that holds your stool. Your doctor or nursewill help you decide what’s right for you, based on your colostomy, your lifestyle and what your insurancewill cover. Colostomy pouches are either open (and drainable) or closed (not drainable). “Drainable”pouches can be emptied and reused, but in time, you will need to replace them. Closed pouches areusually changed every day.About once a day, you’ll have to dispose of the stool in your pouch. If it’s a drainable pouch, you’ll empty itinto the toilet. If it’s closed, you’ll throw the entire pouch away or reuse it. Emptying your drainable pouchshould be done before the pouch is one-third full. Hold the pouch over the toilet and remove the clip if it hasone, but don’t throw it away. Now, turn the tail of the pouch inside out, making a cuff, and empty the pouchby squeezing from top to bottom. With your finger wrapped in toilet paper, wipe from the outside to theinside making sure the outside of the pouch tail is clean. Turn the cuff back and reapply the clamp orVelcro-like closure to close it.Remember, one-piece pouches should be replaced every three to five days or as directed by your doctor ornurse, but if you prefer to change yours daily, that’s fine too. Non-drainable pouches are usually replacedevery day, usually after a bowel movement. It’s up to you if you empty the pouch before you dispose of it, ornot.To dispose of a closed pouch, double bag it in two plastic bags and throw it away. Never flush the pouch, asit will stop up your toilet. Now let’s talk about how to attach a new colostomy pouch. Your pouch may beone-piece, attaching to your body as a single unit. Or it might be a two-piece pouch with one adhesive piecethat attaches to the body and a second piece, a pouch that fastens on to that.Before you start, gather your supplies, including a wastebasket, two plastic bags and a skin barrier.Measure and cut or mold the new skin barrier opening to fit your stoma if it needs to be sized. For a onepiece pouch, drainable or non-drainable, attaching it is the same. First, cut or mold the opening to fit yourstoma, or use a premeasured pouch, then make sure you take off the protective film from the barrier. If youare using a drainable pouch, make sure it’s closed before you apply it. Clean your skin, dry it well, and applythe pouch from the bottom up. Hold your hands over the barrier part for 45 seconds to make sure thebarrier molds and holds well to your skin. That’s it!Now let’s look at how to put on a two-piece pouch. Whether drainable or not, it works the same. With adrainable pouch, make sure the bottom of the new pouch is closed before you apply it. Now, cut or mold theopening to fit your stoma, or use the premeasured pouch, then remove the protective film from the skinbarrier. You can use your finger in the opening to soften it and keep it even.Then, with clean, dry skin, apply the barrier running your finger all around the skin barrier near the openingto make sure it’s sealed. Snap the pouch onto the barrier starting from bottom to the top. Press your handagainst the barrier for 45 seconds, to mold it to your skin. Then snap the end of the pouch to make sure thetwo parts are secure.Page 2 of 3We should also mention irrigation. If your colostomy is lower in your intestine, you may need irrigation tomake your bowel movements easier. Irrigation rinses your bowel with water to loosen your stool. Ask yournurse or doctor if you need it. Also call your doctor if you have: Abdominal pain, nausea, severe constipation or diarrhea A fever of 101° or higher Increased bleeding around the colostomy opening, some streaks of blood are normal, but not morethan that Also call if your skin becomes irritatedYou probably have a lot of questions about living with a colostomy. Before you leave the hospital, ask for areferral to home health to help with the adjustment. Most insurance companies should cover a visit or two.© The Wellness NetworkPage 3 of 3
