The 411 on Ostomies
More than 750,000 Americans are living with an ostomy. An ostomy is a surgically created opening that connects a hollow organ on the inside of the body to the outside of the body through the skin. Ostomies are needed in patients with different diseases such as some types of abdominal cancers. The actual opening is called a stoma.
Ostomates come from all types of ethnic backgrounds, social classes, and generations. They could be the person standing next to you in line at the store, your next-door neighbor or even your coworker. Ostomies are hidden under clothing so most people are unaware of their presence. There are many misconceptions about having an ostomy, so as a GI Cancer Nurse Navigator and Certified Ostomy Care Nurse (COCN), I would like to give you the facts.
GI Cancer and Sarcoma Nurse Navigator
Sarah Cannon Cancer Institute at Medical City Plano
There are four main functions of ostomies, the four Ds.:
- Divert –to reroute body fluids away from damaged/diseased areas to allow that part of an organ to rest/heal or as an elimination route when part of the organ was removed or damaged.
- Decompress - to relieve pressure and air accumulation due to a blockage.
- Drain – an outlet for fluids so they don’t accumulate in the body.
- Deliver - access into an organ for the administration of formula, fluids and/or medications.
Some ostomies require a collection bag called a pouch while others may require a tube.
The name of the ostomy reflects its location or purpose:
- Ileostomy, Colostomy and Cecostomy are all intestinal ostomies. Cecostomies have different purposes in adults and children.
- Urostomy and Vesicostomy are urinary ostomies.
- Gastrostomy and Jejunostomy are created primarily for administration of feedings and fluids.
- Tracheostomy relieves a blockage in the trachea (windpipe) and assists with breathing.
Ostomies can be temporary or permanent and some people may require more than one.
Living with an ostomy does not need to impact quality of life. Most people living with an ostomy adapt well. They still lead active lives and do many of the things they did before their surgery. There are challenges that can occur but most of these challenges are manageable. Most importantly, ostomies save lives and can actually improve quality of life.
There is a period of emotional and physical adjustment for people living with an ostomy. Many need emotional support and understanding from their families, friends, and community. You can show support by becoming knowledgeable about ostomies, being available to listen without judgment and treating the person living with an ostomy no differently than anyone else.
Navigating your Ostomy Journey
There are nurses who specialize in the care of patients with ostomies. These nurses may have different titles such as a WOC (wound, ostomy and continence) nurse or Enterostomal Therapist (ET). They may have credentials including CWOCN, COCN and OMS. They are invaluable resources for ostomy care and education.
Knowledge is power and education is your best tool in living well with an ostomy. Ask questions of your healthcare providers and request education from an ostomy specialist before and after surgery and when needed along your journey. You can also get information from support groups, online blogs and discussion boards, ostomy manufacturer websites and YouTube.
No matter what type of ostomy you have, there is always a chance of skin irritation caused by leakage of body fluids. These fluids are not meant to come in contact with your skin for long or frequent periods. Cancer treatment, in particular, can cause additional issues with the stoma and skin around it. You should monitor your skin and seek assistance if you have problems. You can also become dehydrated if you lose too much fluid. Monitor your output and seek medical help if you have signs and symptoms of dehydration.
If you have a bowel ostomy, you should chew your food well, eat small, frequent meals, and choose appropriate foods. If you have an ileostomy, some medications won’t absorb well and you should never take a laxative. If your output has decreased, you may have a blockage and should call your doctor. Print a copy of the Ileostomy Blockage card and keep it with you in your wallet. If you have a urostomy you will need to consume foods that make your pH more acidic. See the Ostomy Nutrition Guide for more details on the topics in this paragraph.
Please know that you’re not alone. Reach out to someone if you are struggling emotionally. There are in-person and online support groups for people living with ostomies.
Resources
American College of Surgeons: Home Skills