NewNew OstomyOstomy PatientPatient GuideGuide • Colostomy • Ileostomy • Urostomy • Continent Diversion A publication of Find A Local Support Group www.ostomy.org or call 800-826-0826 “I felt like I had tried every pouch on the market, then someone mentioned Nu-Hope. Ever since, I’ve been able to get out of bed and back on the golf course!” Never miss the moment Nu-Hope founder Edmund Galindo believed there had to be a way to get back to the links after his ostomy. Playing golf was one activity he couldn’t live without. After many experiments, Ed created a new kind of ostomy pouch and support belt that allowed him to get back swinging. “Just when you think there is no hope, there’s Nu-Hope!” Download Belt Guide: bit.ly/NuHopeBeltGuide nu-hope.com fb.com/nuhopelabs ® 1.800.899.5017 @nuhopelabs [email protected] LABORATORIES, INC. NewNew OstomyOstomy PatientPatient GuideGuide Ostomy Basics 6 What is an Ostomy? By Cliff Kalibjian 12 Ostomy A to Z By Cliff Kalibjian, Revised by Joanna Burgess-Stocks, BSN, RN, CWOCN 18 A Successful Recovery By Diana Gallagher, MS, RN, CWOCN, CFCN 20 Ostomy Reversals By David E. Beck, MD, FACS, FASCRS 22 Peristomal Hernias By David E. Beck, MD, FACS, FASCRS 24 Peristomal Skin Care By Joan Junkin, MSN, APRN-CNS, CWOCN Product Guide 26 One-Piece Vs. Two-Piece Adapted from Pouching Systems Patient Educational Sheet 28 Five Reasons Pouches Leak By Anita Prinz, RN, MSN, CWOCN 32 Peristomal Skin Products By Joy Boarini, MSN, WOCN Colostomy Care 36 Basic Colostomy Care By Leslie Washuta, RN, BSN, CWON 43 Colostomy Irrigation By Ian Settlemire, The Phoenix Magazine Editor 46 Beautiful Butterfly By Charles Redner Table of Contents Continues New Ostomy Ileostomy Care Patient Guide A publication of 48 Basic Ileostomy Care By Leslie Washuta, RN, BSN, CWON 54 The Pilates Pro By Ryan Hodgkinson 56 Short Bowel Syndrome By United Ostomy Associations of America This publication is funded by the nonprofit United Ostomy Urostomy Care Associations of America and by advertising. 58 Basic Urostomy Care It is distributed free By Joy Boarini, MSN, WOCN of charge to new ostomy patients, care givers and medical 60 Urostomy Pouching Systems professionals. By Leslie Washuta, RN, BSN, CWON Publisher, Editor, Advertising 62 Ballroom Dancer Ian Settlemire By Jadranka Vrsalovic Carevic [email protected] www.phoenixuoaa.org Continent Diversion Medical Advisor David Beck, MD 64 Continent Bowel Diversions WOC Nurse Advisor By Gregg I. Shore, MD, FASCS, FASCRS Linda Coulter, BSN, MS, RN, CWOCN 68 Continent Urinary Diversions Content has been reprinted By Roni Olsen from The Phoenix magazine, the official publication of UOAA. Subscriptions are a main source of funding for UOAA. Lifestyle To subscribe, call 800-750-9311, www.phoenixuoaa.org or return a subscription card in this 70 Dietary Considerations publication with payment. By Sharon Osgood, BSN, RN, CWOCN and Christina Handschuh, RD ©New Patient Guide 2020. No part of this publication may be reproduced without the prior written permission 74 Swim Confidently of the publisher. Printed in the U.S.A. By Ed Pfueller, UOAA Communications Manager Opinions expressed by authors are their own and not necessarily those of United Ostomy Associations of 75 Travel Tips America Inc., the publisher, the editorial By United Ostomy Associations of America consultants or advisers. The publisher makes no repre- sentation concerning the accuracy or 76 Intimacy truth of any matter or statement in any By Laura Herbe BSN, RN, CWOCN advertisement contained herein and disclaims all liability relating thereto. Advertising rates and requirements sent 78 Back to Work on request: [email protected] By Jeanine Gleba, UOAA Advocacy Manager and or 800-750-9311. Ed Pfueller, UOAA Communications Manager What is an Ostomy? Understanding the main types of ostomy surgeries used today By Cliff Kalibjian when the anal/rectal area needs An ostomy is a surgical creation removal due to severe disease or of an abdominal opening that serious trauma. enables a connection from an Common reasons for colostomy internal organ (such as the intestine) surgery include colorectal cancer, to the skin surface. In many cases, diverticulosis, Crohn’s disease or the purpose is to allow the elimi- anal cancer as well as birth defects nation of bodily waste products, or a nonfunctioning colon. such as feces. However, if higher A pouch can be worn to catch up in the gastrointestinal (GI) tract, stool, but colostomates may have an ostomy can be used for intake the option of irrigation to control purposes as well (i.e., feeding). when body waste exits the stoma. The opening of the ostomy on Water is passed through the stoma to the skin is called a stoma, a term of stimulate a bowel movement. See Greek origin, meaning “mouth.” For “Colostomy Irrigation” on page 43. gastrostomies and jejunostomies, the stoma, indeed, often functions Figure 1. A colostomy is created when Loop and Barrel Colostomy as a mouth so that a person can the colon (large intestine) is brought In a loop colostomy, a section of receive nutrients that they wouldn’t through the abdominal wall. colon is brought through the abdom- otherwise be able to eat or drink. For inal wall in a way that results in two other ostomies, usually in the lower The sections below review the openings. One is “inline” and will parts of the GI tract, such as ileos- major types of ostomies as well expel stool. The second opening is tomies and colostomies, the stoma as the most common continent disconnected and no food matter or effectively functions as an anus, procedures for bowel and bladder waste will pass through it; however, requiring many people with these diversion. it will secrete mucous. These are types of ostomies to wear special sometime referred to as a mucous types of pouches to hold waste. Colostomy fistulas. Statistics on ostomies remain A colostomy (Figure 1) is a surgi- A loop colostomy can essen- somewhat elusive in the United cally created opening in the colon, tially be managed as one stoma, States, which in part have to do also known as the large intes- even though it technically has two with reporting/coding processes tine, that is brought through the openings. It’s best to work with that are used for tracking various abdominal wall to create a stoma. a knowledgeable ostomy nurse medical procedures. Estimates of Intestinal waste will exit the stoma to help set up a secure pouching the number of people with ostomies into a pouching system. system, which will likely be needed in the U.S. range anywhere from In most cases, the colostomy for at least two to six months, after about 750,000 to 1 million with is made from the descending or which a reversal may be considered. approximately 100,000 new sigmoid colon (area above the Another somewhat similar ostomy surgeries performed each rectum), with the stoma on the left surgical option is what’s called a year. Many of these are temporary, side of the abdomen. Because most double-barrel colostomy. Instead meaning that the person is expected of the colon still remains, output is of only partially cutting the intes- to eventually – often within a year solid and not very irritating to skin. tine and creating a loop stoma – have the procedure reversed Colostomies can be permanent with the two openings, the surgeon (they’ll have a follow-up surgery to or temporary, depending on the fully severs the bowel (typically in remove the ostomy and reconnect reason they were created. Perma- the transverse area if in the colon), the intestine). nent colostomies are necessary usually due to a bowel segment 6 - OstomyNew Patient Basics Guide Save More by Paying Less for Your Supplies MUCH LESS! Up to 50% less depending on where ostomy supplies are purchased. Call us for an estimate the next time you buy ostomy supplies. 1-800-453-8898 We beat any advertised price by 5% www.parthenoninc.com I www.devrom.com 3311 West 2400 South • Salt Lake City, Utah 84119 Superior customer service for over 50 years! www.parthenoninc.com • [email protected] PhoenixDig-CashAd.indd 1 4/13/17 4:05 PM between the two ends that needed “barrel” (the mucous fistula) to be a bowel disease (i.e., Crohn’s disease removal. One end is connected colostomy stoma. or ulcerative colitis) and familial to the active digestive tract and For some individuals, it may not polyposis, a hereditary condi- will expel stool, while the other is be necessary to bring the end of tion where polyps (small growths) connected to the bypassed area of intestine connected to the bypassed develop throughout the colon at a bowel and will only pass mucous. bowel to the skin surface as a young age and can easily turn into Both ends of intestine will be mucous fistula. If there is no chance cancer. brought through the abdominal of narrowing or blockage down- Drainage is often liquid-like wall. If placed right next to each stream, the end of the intestine can after surgery, but the small intestine other, they will resemble a double- be sewn shut and placed inside eventually absorbs more fluids and barrel gun, hence, the name. the body. Mucous generated in the electrolytes as the colon had once Placement of double-barrel stomas bypassed segment of bowel can done, and output becomes thick or mushy. Proper hydration, however, is still essential, and people with ileostomies are generally advised to consume potassium rich foods (e.g., bananas, potatoes, oranges) and not go out of their way (unless otherwise advised) to limit sodium (salt) intake.