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Colostomy is a type of ostomy that consists of the connection of the large intestine directly to the wall of the abdomen, allowing feces to escape into a pouch, when the intestine cannot be connected to the anus. This usually happens after surgery to treat bowel problems, such as cancer or diverticulitis, for example.
Although most colostomies are temporary, as they are usually only used to facilitate the healing of the intestine after surgery, some can be maintained for life, especially when it is necessary to remove a very large part of the intestine, which does not allow to return to connect to the anus.
After the colostomy surgery, it is normal for the area on the skin where the intestine was attached, known as the stoma, to become very red and swollen, as the intestine is injured, however, these signs will decrease over the first week with the treatments done by the doctor. nurse.
When colostomy is indicated
Colostomy is indicated by the doctor when changes in the large intestine are identified so that feces cannot be eliminated correctly by the anus. Thus, colostomy is indicated after surgery for bowel cancer, diverticulitis or Crohn's disease.
Depending on the portion of the affected large intestine, an ascending, transverse or descending colostomy can be performed, in addition to being temporary or permanent, in which the affected portion of the intestine is removed permanently.
As the colostomy is performed in the large intestine, the feces released are usually soft or solid and are not as acidic as what happens in the ileostomy, in which the connection between the small intestine and the abdominal wall is made. Learn more about ileostomy.
How to care for the colostomy bag
To change the colostomy bag, it is recommended:
- Remove the bag, peeling off slowly so as not to hurt the skin. A good tip is to put a little warm water on the area to help it peel off more easily;
- Clean the stoma and the surrounding skin with a clean soft cloth moistened with warm water. It is not necessary to use soap, but if you prefer, you can use a neutral soap, which must be well removed with clean water before placing the new bag;
- Dry the skin around the colostomy well to allow the new pouch to stick to the skin. It is not recommended to use any cream or product on the skin without the doctor's recommendation;
- Cut a small hole in the new bag, the same size as the colostomy;
- Paste the new bag back in the correct location.
The contents of the dirty bag must be placed in the toilet and then the bag must be thrown in the trash, as it must not be reused due to the risk of developing infections. However, if the bag is reusable, the manufacturer's instructions must be followed to properly wash and ensure that it is disinfected.
Bag with 2 pieces
There are also some types of colostomy bags that have 2 pieces and that facilitate the removal of feces, because the piece that holds the bag in the skin always remains glued, while only the bag is removed and replaced. Even so, the part that is stuck to the skin must be replaced at least every 2 or 3 days.
When should the bag be changed?
The number of times the bag must be replaced varies according to the bowel's own functioning, but the ideal is to change it whenever the bag is 2/3 full.
Is it safe to use the bag on a daily basis?
The colostomy bag can be used without any problem in all daily activities, even for bathing, swimming in the pool or entering the sea, as water does not affect the system. However, it is only recommended to replace the bag before entering the water for hygiene reasons.
Some people may not feel comfortable using the bag all the time, so there are small objects, similar to lids, that can be placed in the colostomy and that prevent the stool from leaving for a certain period of time. However, it is necessary to know very well the intestinal transit itself to avoid excessive accumulation of feces in the intestine.
How to care for the skin around the colostomy
The best way to avoid skin irritation around the colostomy is to cut the opening of the bag to the right size, as this prevents the feces from coming into direct contact with the skin.
However, other precautions that should also be taken are to wash the skin well after removing the bag and checking, with the help of a mirror, if there is any trash in the lower part of the colostomy.
If the skin becomes very irritated over time, it is recommended to consult a dermatologist or speak to the responsible doctor to use a barrier cream that does not prevent the skin from sticking.
How should the food be
Each person reacts differently to food, and it is necessary to be attentive to foods that cause disorders such as constipation, strong odor and gases. To do this, you must try new foods in small amounts, observing the effects they cause on the colostomy.
In general, it is possible to have a normal diet, but one must be aware of some foods that can favor the appearance of intestinal problems, such as:
Problem | Foods to avoid | What to do |
Liquid stools | Green fruits and vegetables | Consume preferably cooked fruits and vegetables, and avoid leafy vegetables |
Constipation | Potato, white rice, yam, banana dish and white wheat flour | Prefer rice and whole foods and drink at least 1.5L of water |
Gases | Green vegetables, beans and onions | Consume nutmeg and fennel teas |
Odor | Boiled egg, fish, seafood, cheese, raw onion and garlic, alcohol | Consume odor-neutralizing foods, shown below |
Foods that should be consumed to help neutralize the smell of faeces are: carrot, chayote, spinach, cornstarch, plain yogurt, whole curd without whey, concentrated parsley or celery tea, apple peel, mint and peel tea and guava leaf.
In addition, it is important to remember that skipping meals and going a long time without eating does not prevent the production of gases, and it is necessary to eat regularly to improve the functioning of the colostomy.