Top 8 Signs Your Peristomal Skin is Irritated or Damaged

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Learn how to spot peristomal skin irritation and damage.

 

After your ostomy surgery, your healthcare team likely taught you how to care for your peristomal skin and what it should look like when it is healthy. Ideally, it should be intact without irritation, rash, or redness. The skin around your stoma should look just like the skin on the other side of your abdomen, or anywhere else on your body, free of redness, irritation, or damage. Healthy skin should be the rule, not the exception.

However, if your peristomal skin is irritated or damaged, there may be some signs of a peristomal skin complication (PSC), such as:

  1. Discomfort, itching, soreness, or even pain around the stoma
  2. Recurrent leakage under your pouching system or skin barrier
  3. Excessive bleeding of your stoma – it’s normal for your stoma to slightly bleed after you wash it, but the bleeding should resolve quickly
  4. A bulge in the skin around your stoma
  5. Skin color changes from normal pink or red to pale, bluish purple, or black
  6. A rash around the stoma that is red, or red with bumps – this may be due to a skin infection or sensitivity, or even leakage
  7. Wart-like, pimple-like or blister-like bumps under the skin barrier – this type of irritation can happen any time, even if you’ve used the same product for months or years
  8. Any type of wound or scratch on the peristomal skin

Peristomal Skin Complications — Potential causes and what to do

Irritated and damaged peristomal skin can occur for a variety of reasons. It can be caused by anything from a poor-fitting pouching system, to frequent skin barrier changes, to an allergic reaction to anything that contacts the skin, such as soaps or products used to prepare the peristomal skin. Some studies report up to 75 percent of people with an ostomy experience a PSC.* Although it is a common issue, it should not be ignored.

If you experience any signs of a PSC, contact your stoma care nurse. You should work with your healthcare team to determine the exact cause and the appropriate solution.

For more information on maintaining healthy skin and other topics, click here to visit the Hollister Ostomy Learning Center.

 

* Rapp CG, L Richbourg, JM Thorne. Difficulties Experienced by the Ostomate After Hospital Discharge. JWOCN. 2007;34(1):70-79.

The information provided herein is not medical advice and is not intended to substitute for the advice of your personal physician or other healthcare provider. This information should not be used to seek help in a medical emergency. If you experience a medical emergency, seek medical treatment in person immediately.

Editor’s note: This educational article is from one of our digital sponsors, Hollister Incorporated. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

Top 5 Ostomy Concerns

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You may have questions about your ostomy, how to care for your stoma, and how to keep living the life you want to live – but you don’t have to figure it out on your own. Hollister Secure Start services offer free support for people living with an ostomy, regardless of the brand of products used. Below are five common questions we are asked from people in the ostomy community like you.

I’m having leakage under my pouching system.

To help solve the issue, we would ask several questions including the current pouching system being used, and the frequency of it being changed. Other questions that would assist us in problem solving might be—How are you preparing your skin before putting on your pouch? If the products are not being properly applied, it could cause adherence issues. Are you cleaning out your pouch or do you put anything in it? Most important, where is the leakage occurring? If it’s always in the same area, evaluate the area for any creases or uneven surfaces such as scar tissue, incisions, or your belly button that may cause an uneven surface under the barrier. If this is the cause, you might try a barrier ring as a filler to even out the surface area. However, make sure that the stoma size is correct in the barrier. You’ll know it’s a correct fit when the barrier fits where the skin and the stoma meet. There should be no skin exposed between the stoma and the opening of the barrier.

 

My skin is irritated and weepy.

This can be a problem for many people with an ostomy. A person should not have skin breakdown, open wounds, or a rash under the barrier. Where exactly is the skin breaking down? How long has it been going on? Is there a situation that may have led to this irritation, such as leakage or was your barrier removed too quickly? What product are you using to prepare your skin for the barrier? Try using stoma powder to absorb moisture from broken skin around the stoma, which may help allow the skin barrier to get better adherence. The cause of the skin irritation needs to be addressed in order to find solutions.

 

I am noticing an odor and I’m concerned others will too.

There can be an odor associated with emptying your pouch versus odor caused by leakage and we need to determine which one you are experiencing. A lubricating deodorant is a great choice for neutralizing the odor of the stool when the pouch is emptied. You might also consider a pouch that has a filter, which neutralizes odor caused by gas in the pouch. Make sure that no stool drainage gets on the outside of your closure system. If neither of these situations is the issue your barrier might be starting to lift off the skin, which can allow odor to escape and can be the beginning of a leakage.

 

My pouching system is not staying on. What can I do?

It may be a problem with your barrier seal. Make sure you have one that you can count on. Everybody is different when it comes to wear time. A good rule of thumb is to determine how many days you can rely on the product to provide a secure seal without experiencing leakage. Monitor the back of the barrier when you change the pouching system. If you see stool or urine from the stoma that has leaked under the barrier, it’s a sign that the barrier seal is compromised and the barrier can begin to lose adherence to the skin. If this occurs then the barrier should be changed. It’s important to change your product on a routine basis, which can be determined by the lack of stoma drainage under the barrier as well as the condition of your skin.

 

It is important that my pouching system is discreet. What can you recommend?

When a pouch fills with gas or drainage it will start to balloon out and might show under clothing. A pouch with a filter can help release the gas. Also consider emptying your pouch when it’s a third to a half full. When a pouch is full it could cause weightiness on the barrier, which might lead to leakage. When it comes to discretion, it’s important that you find the right pouching system for your body. Hollister offers both one- and two-piece systems. For a person with a colostomy or ileostomy, there are drainable and closed-end pouches in various lengths and options of transparent, ultra-clear and beige pouch films. Those with a urostomy can also choose from pouches with transparent, ultra-clear or beige film depending on the product they are using.

 

As always, it’s important to follow up with your healthcare professional or Wound, Ostomy, and Continence Nurse for clinical or medical advice.

 

Have a concern that wasn’t mentioned here?

Check out the helpful tips from Hollister Incorporated, Routine Care of Your Ostomy or go to Hollister.com and navigate to the Ostomy Care Resources to find accessory sheets, helpful brochures and videos.

 

Need someone to talk to?

Hollister Secure Start services is here to help! Call us today at 1.888.808.7456.

 

Nothing contained herein should be considered medical advice. Medical advice can only be provided by an individual’s personal doctor or medical professional.

Editor’s note: This educational article is from one of our digital sponsors, Hollister Incorporated. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

Enjoy your fruits and veggies

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from me+ Contributor, Sarah Biggart

You may have recently resolved to eat healthier adding fresh fruits and veggies to your diet. But wait, can you eat your way through the produce department?

Fresh fruits and veggies are a regular part of my diet. Through previous trial and error, I know there are some fruits and veggies I need to be careful of and some that I avoid. Salads and corn on the cob frequently appear on my plate. However, broccoli, kale and brussel sprouts, I eat sparingly.

As we all navigate life with an ostomy, we learn and gain knowledge along the way. Ostomy surgery allowed me to maintain my desired lifestyle. Food is such a central part of our society, with family gatherings and social outings often revolving around the table. Your ostomy should not deny you your seat at the table.

Here are some general diet guidelines:

  • Eat regularly
  • Drink plenty of fluids
  • Chew your food well
  • After surgery, try new foods one at a time, in small quantities. If there is a problem (such as gas), you can make simple adjustments that work for you.
  • Most importantly, enjoy your food!

For this article and more from ConvaTec click here.

 

Editor’s note: This nutrition information is intended for those with an ileostomy or colostomy. This article is from one of our digital sponsors, ConvaTec. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

Hollister is #AllinforOstomy!

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At Hollister Incorporated, we are proud to stand with the broader ostomy community to show how we are #AllinforOstomy.  People with ostomies, their families and friends worldwide are gearing up to celebrate World Ostomy Day on October 6, 2018—and you’re invited to join the excitement!

The Run for Resilience Ostomy 5K

Now in its fifth year, UOAA’s annual Run for Resilience Ostomy 5K has grown nationwide and our team at Hollister Incorporated will be right beside UOAA as the Diamond Sponsor of the event. A total of nine events are planned on Saturdays October 6 and 13 ranging from Durham, North Carolina, to Portland, Oregon. Much more than a walk/run, the Run for Resilience has become a family-friendly event that people look forward to all year. Many races feature a DJ, kids’ activities, a division for people with ostomies, and awards. Donations go directly to UOAA.  www.ostomy5k.org

Wear a Stoma Sticker – Share the Love

Stoma Stickers are a great way to educate, start a conversation, or show support for people living with or caring for ostomies. To show yours off, place the sticker over your clothes, on the lower right or left side between your hip and navel, where ostomies are typically located. Then, take a photo and share it on social media with the hashtags #AllinforOstomy and #WorldOstomyDay to help raise awareness and show your support!  Request your free sticker at www.stomasticker.com

Join a free educational webinar

We have developed a virtual conference that promotes skin health. Webinars will be available through the month of October starting on World Ostomy Day, and include the following.  Sign up for a webinar at hollister.com/worldostomyday

  • How to Use the Peristomal Skin Assessment Guide for Consumers
    psag-consumer.wocn.org
    A brief walk-through of how to use this important free resource from the WOCN society for teens and adults living with an ostomy. Led by Laurie McNichol, MSN, RN, CNS, GNP, CWOCN, CWON-AP, FAAN with Christine Kim, ileostomate since 1994 and founder of OstomyConnection.
  • Itching: The Invisible Peristomal Skin Concern
    A two-part series on causes and management.
  • It Begins with Skin: A Global Perspective
    A short film featuring clinicians and people living with stomas from around the world.

(Editor’s note: Hollister Incorporated is a Diamond Sponsor of this year’s Run for Resilience Ostomy 5k to celebrate World Ostomy Day. Their support helps make these UOAA ostomy awareness events possible)

 

Care and Support After Your Ostomy Surgery: Coloplast® Care

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If you are facing a potential surgery leading to an ostomy, you naturally will have many questions and concerns. It is important to voice your questions and concerns to your healthcare professional. Gather as much information as you possibly can while you are in the hospital. Having a friend or family member with you can be helpful as they can also assist in remembering information and understand how you will need to care for your body and pouching system after you leave the hospital.

However, despite education offered both before and after surgery, statistics show that as many as 46% of patients still feel underprepared when they’re discharged from the hospital. If you have already had your surgery and are back home, feeling a lack of confidence, ill-equipped, or underprepared, you are not alone.

Many ostomates are unsure of how to care for themselves and their pouching system following their surgery. That is why WOC nurses recommend that ostomy patients be connected to additional resources after they’ve left the hospital.

Coloplast Care is a comprehensive support program that gives people with an ostomy personal support throughout their life.

Having the support of Care, you’re not travelling the journey of living life with an ostomy by yourself. – Keagan

There are so many questions that you don’t know to ask until you start life as an ostomate. Coloplast Care helped me stay focused on what was important. – Mike

Coloplast Care covers everything from the Basics, such as: ‘What is an Ostomy?’ and ‘Before Surgery’, to ‘Routines’ and ‘Lifestyle’. Not only are there helpful articles and real-life stories from others on the website and through emails, individuals are partnered with a dedicated advisor for personalized support.

One of the best parts of Care is that you can actually speak with a person. They were listening to what I was trying to do and what my concerns were, and coming up with different solutions they felt would work for me. – Mike

Having the ability to access the Coloplast Care website is a great resource. The reality is that your healthcare provider isn’t available 24/7 around the clock. – Keagan

Gathering the right tools, resources, and community around you following your ostomy surgery will determine your ability to succeed and live a full life as an ostomate. Whether figuring out what to wear to the beach, how to prevent leakage, or learning how to use your appliance, there are resources available to you 24/7. You are not alone in this new chapter of your life.

Visit Coloplast Care to enroll and get your support program started.

 

Mike and Keagan have been compensated by Coloplast to provide this information.

Editor’s note: This article is from one of our digital sponsors, Coloplast. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.

Ostomy Diet Guidelines After Surgery

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Chances are you will be able to return to your normal diet not too long after your operation. It is good to keep in mind that foods that were good and healthy for your body before your operation are still good for you. A well-balanced diet is recommended for most individuals.

Although your ostomy nurse more than likely will give you tips and advise you on your health and diet, here are some alternative helpful suggestions for maintaining a proper diet after your surgery.

Follow the advice of your surgeon, dietitian, and/or WOC nurse regarding any dietary restrictions right after surgery or on a long-term basis.

Start Small

Ease your way back to proper nutrition with small quantities of food. It is recommended to eat 3 or more times per day in smaller quantities and portions. Try to eat these meals at the same time each day to help regulate bowel movements. Eating more frequently and in smaller quantities will help aid your body’s ability to process food and help with unnecessary gas.

For the first several weeks after your surgery, eating simple and bland soft foods will be easier to digest. Keep in mind that chewing your food well also adds to the ease of digestion – the more broken up it is, the easier it will be to process. Take your time with introducing high-fiber foods back into your diet as these will be harder to digest and can cause blockages. Ileostomates are often encouraged to avoid high-fiber foods to prevent risk of obstruction. Always follow the advice of your surgeon, dietitian, and/or WOC nurse regarding any dietary restrictions right after surgery or on a long-term basis.

If you are trying new foods, it is advised to try them slowly and one at a time. This will help you to have a better understanding of how your body works with the new foods and if any will cause excess gas, constipation, strange odors, or diarrhea. Slowly incorporate them into your diet and make note of how your body responds to them. Remember that every body is different and what affects someone else may not affect you in the same way. This is why it can be helpful to keep a journal or diary of how your body responds to different foods.

Drink Lots of Liquids

It is important to drink lots of liquids with an ostomy. If you have an ileostomy, more specific ileostomy dietary guidelines will be helpful. Dehydration can happen as you lose more fluids daily after an ileostomy, due to the fluid not being reabsorbed into the large intestine. Make sure to hydrate even more on hot and humid days or if you are participating in active sports. (Sports drinks and other high electrolyte drinks can help with this.)
Coffee and tea are fine to drink, but water and juices are still better sources of liquid, so be careful not to use coffee or tea as a substitute for water.

Can I Drink Alcohol With my Ostomy?

Alcohol is fine in moderation, you may want to try one drink (or even a half) and wait and see how it affects your body. Like other carbonated beverages, beer may cause extra gas and uncomfortable bloating but every body is different and what affects one person may not affect you in the same way.

Ostomy Problem Foods

Even though you can still enjoy most of the foods you loved before surgery, there are some foods to be aware of after your ostomy, specifically foods that are hard on digestion and can cause blockages. The following is a list of common foods that can cause problems, as they don’t break down easily:

  • Nuts
  • Seeds
  • Popcorn
  • Dried fruit
  • Mushrooms
  • Raw-crunchy vegetables

Eat these foods in small quantities and be sure to chew them well. If you think you have a food blockage, you should call your doctor or ostomy nurse. Having an ostomy certainly doesn’t mean you have to completely change your diet. By steering clear of a short list of problem foods and making sure to stay hydrated, you can get back to enjoying the foods you love.

To learn more about proper nutrition with an ostomy, visit Coloplast Care online.

Follow the advice of your surgeon, dietitian, and/or ostomy nurse regarding any dietary restrictions right after surgery or on a long-term basis.

Editor’s note: This educational article is from one of our digital sponsors, Coloplast. Sponsor support along with donations from readers like you help to maintain our website and the free trusted resources of UOAA, a 501(c)(3) nonprofit organization.