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

 
Contents:

WATER - YOUR BODY'S BEST FRIEND
STOMAL SHAPES AND LEAKAGES
MINIMALLY INVASIVE RELIEF FOR ACID REFLEX
ATTITUDES
QUESTIONS AND ANSWERS
CARTOONSVILLE

Re-Route Archive

Volume 26, Number 9  June, 1999

WATER - YOUR BODY'S BEST FRIEND   Via: Tacoma WA. Newsletter & S. NV's TOWN KARAYA
The body is 70 percent water by weight.  This is why it is so important to drink enough water every day.  Also, drinking enough water will help to maintain or acquire water balance, meaning that the amount of water entering the body equals the amount leaving it.  It is recommended that an active person should drink at least the equivalent of 8 to 10 eight-ounce glasses of water each day.  This can be taken in, not only by drinking water, but also through other sources, such as a variety of beverages and foods that have a high water content.  As you drink more water and approach the state of water balance, your body stops retaining water and your natural thirst increases.  In other words, the water is now being flushed freely through your system, so your body turns on the thirst signal as a stimulus for you to replace the water that is being excreted.  A good indication that you are in water balance or close to it, is a natural, periodic thirst. According to the American Dietetic Association, eight-to-ten glasses of water a day is the amount needed by an average-size person in order to stay hydrated.  The average person loses about ten cups of fluid a day through breathing, perspiring, and just keeping the body going.  Milk, juices, soups, herb teas and decaffeinated coffee can count toward your total.  Caffeinated beverages don’t count because they actually use the body’s water supply.  If you don’t get enough fluids, you become dehydrated.  Some people get headaches.  In extreme cases, dehydration can be deadly.

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STOMAL SHAPES AND LEAKAGES  Via: L. A. Ostomy News an GB News Review
Are you aware that stomas sometimes change shape?  This can happen when you change from a standing to a sitting position.  Mirrors are handy gadgets –  take a look!  The stoma that is nearly round when you are lying down or standing may be oval when you sit down.  This may be a source of a leaking problem and merits some thought. Remember, the stoma is a portion of the intestines brought to the surface of the abdomen.  The healthy red color of the stoma means there is a good blood supply. The natural lubricant of the intestines is mucous.  No adhesive will stick to the stoma because of the mucousal  lining.  Therefore, any part of the faceplate that comes in contact with the mucous on the stoma automatically will refuse to stick.  Thus, the seal around the stoma does not change even though the stoma shape changes.  This means that if the stoma is oval in a sitting position, perhaps the opening on the faceplate should be oval.  This particularly applies to people who are sedentary most of the day.  This is not an absolute rule, but a consideration if you find a leakage problem.

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MINIMALLY INVASIVE RELIEF FOR ACID REFLUX  Via: S. Brevard Ostomy Newsletter as Excerpted from article by Bruce E. Alper, M.D
When the ring-like muscle or sphincter at the base of the esophagus opens at the wrong time and allows the contents of the stomach to splash up into the esophagus, one feels a burning sensation.  If allowed to continue, considerable discomfort and serious complications can result.  Conservative treatment by both OTC and prescription medications only treat the symptoms, not the underlying cause.  In addition, some patients whose reflux is so extreme, can find no medication that brings relief. "If patients don’t respond to conservative treatments, or if their conditions are diagnosed as chronic," says Dr. Bruce Alper, of Medical Associates of Brevard, in Melbourne, "there is now a new laparoscopic technique called Nissen Fundoplication that is minimally invasive, involves far less discomfort for the patient, and dramatically reduces the recovery time, compared with traditional open-incision abdominal surgery, which requires a relatively lengthy hospital stay." The technique involves wrapping the top portion of the stomach around the lower part of the esophagus, effectively creating a new valve, or sphincter, at the juncture of the esophagus and the stomach.      The advantages of the procedure are, first, that it is a cure for the disorder, eliminating the necessity for continual expensive medications.  Second, it usually permits the patient to return to eating anything they want.  Spicy or acidic foods no longer have to be avoided.  Third, and perhaps of most importance, it permits patients to sleep on their backs again, without awakening to regurgitation. Unfortunately, if a patient waits too long to have the surgery and severe damage has occurred  to the esophagus, it may no longer be possible to offer this procedure," cautions Dr. Alper.  "In the face of severe damage, the patient may need open surgery to resect or alter the destroyed esophagus.

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ATTITUDES  Via: Snokomish Insight & The Ostomist,, Greater Seattle
Are you worried about your appliance showing under your clothes or your stoma protruding enough to show?  People today lead busy lives at a fast pace.  Everyone is very concerned with their own happenings.  Aren’t you?  By the way, what is the color of your bus driver’s hair? Did the sales clerk wear a dress or slacks today?  What color was the bank teller’s tie? Give up?  Then forget about uncalled for worries and enjoy your every day.  Remember….your attitude about your image will affect the attitude of your family and friends. The first step on the ladder to adjustment must be taken by YOU!

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Questions and Answers
Is it safe for colostomates to take codeine?
Codeine affects muscle contractions and has unwanted effects.  It should be taken only on a doctor’s advice.  Also, colostomates who take antihistimines during the sneezing season may find that these drugs have a tendency to slow down intestinal action and the irrigation process becomes slower.  Some report relief from the drug reaction by increasing the fluid intake the day they irrigate, or by eating laxative food.
Should I wash fruits and vegetables with soap and water?
Cold water, yes;  soap or detergent , no.  Scrubbing with water (and perhaps a brush) will remove nearly all dirt, as well as bacteria and some pesticide residues, if any are present on the surface of fruits and vegetables.  There’s no evidence that soap is better than plain water at cleaning produce.   In  addition,   soap    can leave its own residues, which can cause nausea or diarrhea.  Soft items such as mushrooms or strawberries are most likely to retain a soapy aftertaste.  Some liquid cleansers claim to be "organic" and most claim (or imply) that they have a special ability to remove pesticides.  No evidence has been found to support this.  These cleansers are a good way to send money down the drain.
How often are stomal revisions required?
The need for reconstruction of a colostomy occurs infrequently, probably less than 5%.  The need for reconstruction of ileostomies on the other hand occurs much more frequently, probably between 10% and 15%.  This is due to a number of reasons: First of all, average age of ileostomates is much younger than that of colostomates, so they must live with their ostomies for a much longer period of time during which factors can arise necessitating stomal revision (e.g. massive weight gain, trauma, unrelated disease and the like). Secondly, many of the diseases for which ileostomies are done tend to recur and can sabotage a beautifully made functional stoma.  Our old nemesis, Chrohn’s Disease, is the greatest offender in this regard. Finally, ileostomies are simply more "finacky" than colostomies, due to the looser and caustic character of the stool at that point in the intestinal tract.  Thus  they  will cause  problems  unless   things  are proper.
What is a revision? 
The term applies to a surgical correction of the stoma.  This may be a small procedure done in out-patient surgery, or it may be a procedure requiring hospitalization. Four common reasons for revisions are:  a tight stoma; a prolapse, when the stoma becomes very long and large; a retraction, when the stoma becomes so short that it is below skin level; or in the case of a hernia so near the ostomy that it interferes with management.  But please bear in mind that these conditions may be present without causing much trouble – in which case a revision is not needed.

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