United Ostomy Association, Inc.
Evansville, Indiana Chapter
Re-Route

 
Contents:

CONTROLLING ODOR
GASTRIC REFLUX
TIPS FOR THE UROSTOMATE
TENDER LOVING CARE - YOUR STOMA NEEDS IT TOO!
IS IT ALWAYS NECESSARY TO USE SEALANT ON MY SKIN?
OSTO - TIP
CARTOONSVILLE

Re-Route Archive

Volume 29, Number 5  February, 2002

CONTROLLING ODOR
Via: Pensacola FL Stoma-Gram
An important part of a new ostomate’s rehabilitation is learning to control odor; it is important to feel good about oneself and be secure in relationships with others. The osotomate can be extremely sensitive to odors and the reactions of those around him or her, especially family and friends. Colostomies tend to emit more odor than ileostomies because of the bacterial abundance in the colon. Most sigmoid and descending colostomies are routinely irrigated, so persistent odor is less of a problem than with a transverse colostomy where semi-liquid drainage tends to be rather malodorous. Ileostomates experience almost continual peristaltic waves which sweep the ileum and prevent stagnation of the intestinal contents, thereby eliminating the major cause of odor, I.e., bacterial growth. Extreme and persistent odor from an ileostomy could be an indication of a secondary problem, such as a stricture or blockage. Urine has a characteristic odor, but a foul odor could be a sign of infection due to overgrowth of bacteria. Certain foods will affect the odor of both feces and urine. Avoiding such odor-producing foods will help. External and internal deodorants are available, but two important aspects of odor control are good personal hygiene and appliance care. For fecal ostomies, use odor proof pouches. Change the pouch immediately if a leakage occurs. Eliminate from your diet such odor producers as cabbage, onions, fish, spicy foods and eggs; do eat parsley and yogurt. Internal deodorants that can be taken by mouth include bismuth subgallate tablets which help control odors by absorbing toxins. Ostomates should consult their physician before taking these tablets. Urinary ostomates should clean their pouches periodically with such agents as Uri Kleen, etc. Vinegar solutions have fallen into disfavor because they tend to damage certain manufacturer’s pouches. Avoid eating asparagus and onions; do eat parsley and drink cranberry juice. Deodorants are not used because they would mask the odor which could signify the presence of an infection. With proper care of the appliance, personal hygiene and dietary precautions, odor should not be a problem for ostomates.

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GASTRIC REFLUX
By: Bob White, Via: S Brevard (FL) Ostomy Newsletter
A recent article in the Annals of Internal Medicine purports to deal with the possible association between certain drugs and the incidence of esophageal adenocarcinoma (cancer in the esophagus) as a result of gastric reflux. It is, unfortunately, more likely to confuse the layman than to educate him. First, incidents of esphageal cancer demonstrably are on the rise among men in America and Western Europe. It has a 5-year survival rate of 11%. Gastrointestinal reflux—the backward flow of stomach fluids into the esophagus—is a risk factor in this cancer. Second, the research group, from Sweden and the Harvard Center for Cancer Prevention, theorizes that certain drugs may loosen the sphincter at the base of the esophagus, making reflux more likely. Third, the drugs include nitroglycerin, asthma medications such as albuterol and aminophylline (a bronchodilator), and Valium. The research considered the cases of 600 people with the cancer, between 1995 and 1997, as compared with a control group of healthy men who had taken the medicines in question. The rate of cancer was almost four times more common in those who had taken the drugs daily for more than five years. Then, the researchers concluded that the findings “could be seen” as “reassuring” for users of the drugs, because “our data suggest that persons who use these drugs (for short periods) may be at little increased risk. A logical rebuttal might hold that, if you use these drugs on anything approaching a daily basis, and you are experiencing the symptoms of gastric reflux (they’re hard to miss!) be sure your physician knows about the situation.

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TIPS FOR THE UROSTOMATE
Via: Ostomy Outlook, Stillwater, OK
Check the pH of your urine about once a week to be sure the urine is acidic, with a pH of less than 6.0. Always wash your hands before working with your appliance or stoma, to avoid introducing bacteria into the stoma. Reusable or disposable appliances that are not cleaned adequately or are worn for long periods of time can cause urinary tract infections from bacterial growth in the pouch and urine. Signs and symptoms of a urinary tract infection include fever, chills, bloody urine, cloudy or strong-smelling urine, and pain in the back and kidney area. If you experience these symptoms, see your physician!

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TENDER LOVING CARE - YOUR STOMA NEEDS IT TOO!
Via: Boston (MA) OAB BULLETIN, & S. Brevard (FL) OSTOMY NEWSLETTER
Most ostomy patients would agree that there is no substitute for TLC. That is one of the reasons that the specialty of ET nursing exists. It ensures that nurses with a special sense of caring and with special education are taking care of the ostomy patient’s needs. Once you are discharged, remember that your stoma needs TLC also. A few pointers might be helpful. Generally speaking, it is good to set aside a time for giving priority to stoma care. It might be during your morning shower, after breakfast, or at bedtime. It’s important to make it fit into your routine. Don’t change your schedule for the stoma. Make it change for you. Having a regular time for pouch changing, etc. helps put some order into your schedule. It will also ensure that leakage or other problems can be kept to a minimum. If you know that your pouch always leaks on the fourth morning for instance, then begin changing it on the third night, if that time is convenient. Don’t be rough with your stoma. It’s not unusual for it to bleed a little when washed. Just be careful not to be too brisk with the washcloth or whatever you use, as that might cause excessive irritation. Eat a well-balanced diet; following special instructions from your physician, dietician, ET, etc. Drink sufficient water and fluids unless you are medically restricted. Persons with ileostomies and colostomies should chew their food very well. Avoid eating too many hard to digest and gaseous foods at one meal. Urostomy patients need to be sure to have sufficient fluids, unless told otherwise by the doctor, as fluids help prevent infections. Rinsing the pouch daily with a solution of 1/3 white vinegar and 2/3 water helps prevent crystals from building up on the stoma, and the wash will also keep the inside of the pouch acid. Acid conditions prevent growth of bacteria. Patients can usually shower with the pouch off or on unless instructed otherwise. Water will not hurt the stoma. Peristomal skin especially needs TLC. A properly fitting pouch, changed regularly, usually accomplishes this. Never tape the pouch if it is leaking. Change it!! If you have frequent leakage and have to change too often, call your ET to make an appointment for re-evaluation. Perhaps another type of pouch would be better suited, or perhaps your stoma and peristomal skin need re-assessment. There might be some new products that will work for you. Don’t hesitate to make an appointment.

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IS IT ALWAYS NECESSARY TO USE SEALANT ON MY SKIN?
Via: The Right Connection & Southern Nevada’s Town Karaya
Skin sealants such as Skin-Prep by Smith & Nephew, Skin Gel Wipes by Hollister, Allkare by ConvaTec and Bard Skincare Protective Film are available in different forms, such as small wipes, sprays or applicator bottles. These products contain a plastering agent as their main ingredient and are used to provide a thin protective film on the skin surface. This film helps prevent injury to the surface layer of the skin during appliance removal. It also acts as a moisture barrier. For people with dry skin, the film actually improves appliance adhesion. Skin sealants also contain variable amounts of isopropyl alcohol. Because of the alcohol content of the sealant, burning and stinging often occur when the sealant is applied to damaged skin. Therefore, skin barrier powder should be used rather than a skin sealant on irritated skin. It is also important to know that skin sealants may not be recommended for use under certain skin barriers. The protective film may reduce the adherence of the barrier.

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OSTO - TIP
If you find your stoma gurgles a lot, try this: At meals, eat the solid foods first, then take your beverages. Do not eliminate your beverages. Daily intake of fluids is needed to prevent dehydration.

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