Caring for someone with a colostomy, or managing your own, can sometimes feel challenging. Many different factors can affect a person living with a stoma, from food and drink to skin conditions. Trying to anticipate all of these can feel overwhelming, but remember that support is available. If you’re ever unsure, always seek advice from a healthcare professional.Today, we’re highlighting some of the key factors that can affect a person living with a colostomy and outlining what basic stoma care involves.

What is a colostomy?

Let’s start right at the beginning: what exactly is a colostomy, and who might need one?

A colostomy is a type of stoma: a surgically created opening on the surface of the abdomen, which allows waste to leave the body and be collected in a bag or pouch.

A colostomy is the term used to describe an opening from the colon, also known as the large intestine. The stoma normally sits on the left side of the abdomen, and output is generally quite solid, resembling “normal” stool. Someone with a colostomy will usually find that they need to empty or change their bags between one and three times a day.

There is no one “type” of person who might have stoma surgery; many different conditions may lead to the need for a stoma. These may include cancer, Inflammatory Bowel Disease (such as Crohn’s disease), or trauma to the abdomen, to name a few.

You will need to have a different type of stoma depending on whether the damage is in your intestine or urinary system, and where it is. A colostomy would be needed if someone had damage or trauma to the colon, or large intestine.

What are the other types of stoma

Besides colostomy, there are two other types of stoma. Each type is positioned slightly differently on the abdomen.

Ileostomy

An ileostomy is an opening from the ileum (part of the small intestine) which usually sits on the right of the abdomen. Output from an ileostomy is more runny/mushy than that from a colostomy, and people with an ileostomy will generally find that they need to empty their bag three to six times a day.

Urostomy

A urostomy is formed using a section of small intestine. This is connected to the kidneys by attaching the ureters (small tubes that usually connect the kidney to the bladder) to it. This forms a passageway for the urine to flow through and out of the body. Often a person’s bladder is removed as well, and the stoma normally sits on the right side of the abdomen.

Changing a colostomy bag

Most people develop a routine that works for them when it comes to emptying and changing their bag. However, these are the basic steps.

A bag should usually be changed when it is around three-quarters full. Many people find it easier to do this while standing, as this helps prevent skin folds that could interfere with the seal.

To change a stoma bag, you’ll need an adhesive remover like this one, a flange/baseplate, rubbish bag, curved scissors, warm water and a towel.

1. The first step is to ensure that the hole in the flange or baseplate fits the shape of the stoma. Most suppliers will pre-cut these for you, but if not, you can cut the flange to fit your stoma using curved scissors.
2. Remove the bag, using adhesive remover spray along the edge of the flange or baseplate. Support your skin with your fingers to ensure that you aren’t pulling the skin.
3. Clean the stoma and surrounding area, patting dry rather than rubbing.
4. Apply the new flange or baseplate, by sticking the lower half to the bottom of the stoma and rolling it up. Hold it in place for at least 30 seconds.
5. Dispose of the old bag. You will usually receive disposal bags for free from your supplier.

Things to be aware of

Diet

It’s common for people with stomas to feel concerned about how food may affect their output.

Most individuals can return to a normal, healthy diet after surgery. In some cases, healthcare professionals may provide specific dietary advice to help reduce symptoms such as excess wind or watery output.

If you have concerns about your diet and how it may be affecting your stoma, consult a healthcare professional.

Bathing

It is completely up to the individual whether they want to keep their bag on or remove it while bathing or showering.

As it is important to keep the skin around the stoma clean in order to avoid any skin issues, the person with a stoma may prefer to remove the bag while showering. If this is the case, they may find it easier to co-ordinate their baths or showers to when the stoma is less likely to be active.

Skin

The skin around the stoma can sometimes become dry, red, or sore. This may be due to damage to the skin from the flange/baseplate, or due to output getting onto the skin.

There are many things that you can do to help this, and ongoing measures that can help to stop the skin from becoming sore in the first place.

The appropriate solution depends on the cause of the skin issue. If you’re not sure, it may be worth investigating the issue further. If none of these methods help, or if you’re unsure what is causing your skin to become sore, consult a healthcare professional.

If your skin is becoming sore due to the adhesive on the flange/baseplate, you can try using an adhesive remover spray, which helps to remove the bag more gently.

If your skin is sore due to output from your stoma getting onto your skin, it would be worth checking if the hole in the flange/baseplate is fitted to your stoma snugly, but not too tightly.

Leakage

If your stoma bag is leaking, consult a healthcare professional. There are many reasons why a bag may leak, including a change in the size or shape of the stoma. In any case, a healthcare professional will be able to support you in finding a solution.

Pancaking and ballooning

Pancaking occurs when stool collects around the stoma instead of dropping into the bottom of the bag.

Ballooning happens when gas builds up and inflates the bag.

If you experience either issue, seek advice from a healthcare professional, who can help you find practical solutions.In summary, while colostomy care can feel daunting at first, developing a consistent routine and understanding the factors that may affect your stoma can make it much more manageable. With the right products, practical knowledge, and professional support when needed, most people are able to care for their stoma confidently and maintain a full, active lifestyle. Remember, you are not alone: help and advice are always available if you need it.

Reference: Colostomy UK