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pageVolume 34, Number 11 October, 2007
HOW DOES FIBER AFFECT ILEOSTOMATES
By: Kay L. Peck, MPH & Registered Dietitian, Napa Valley, CA. Via: Philadelphia UOA Journal and Greater Cincinnati ,OH Chapter
Whether or not to include fiber, and to what extent, should be based on the ileostomate’s tolerance of foods. The intestine has a remarkable capacity to adapt. Matter/digested food in the small intestine is quite watery, and after it moves into the large intestine, a good portion of the water is reabsorbed into the body.
Most fiber is indigestible material (from plants) that acts like a sponge, soaking up water and increasing the bulk of the intestinal contents—making matter move through the system more quickly. In a person with a colon, fiber is essential to preventing constipation and keeping a person “regular.” This is the main function of fiber. Another theory about fiber is that it promotes mucosal growth, thus keeping intestines healthier, promoting gut function. Usually, a person without a colon (ileostomy) doesn’t have a problem with constipation, and may have mostly watery stools or diarrhea. Again, over time, a person may adapt, especially if the last section of the small bowel (ileum) is still intact. So, consuming too much fiber, or too much “insoluble” fiber may aggravate a person’s diarrhea or watery stools. If this is the case, limiting insoluble fiber (bran, popcorn hulls, seeds, nuts, skin/seeds/stringy membrane parts of the fruits and vegetables) may be helpful.
However, another type of fiber (soluble) may be beneficial to the ileostomate. The function of soluble fiber is to make intestinal contents “thicker” and can actually prevent diarrhea. This fiber is found in oatmeal, barley, dried beans, peas, Metamucil and in the pulp of fruits and vegetables. Most foods have a combination of both types of fiber, but the above examples show the differences.
Just as a side note, I worked with a lady years ago who had “short bowel syndrome” - all of her colon and a significant part of the small bowel were removed. She found that adding pectin (Certo—used to make jam and jelly) to her daily diet helped to minimize diarrhea. She added a little to some applesauce every day.
COLOSTOMY AND CONSTIPATION
Via: Greater Cincinnati, Metro MD & Vancouver Ostomy High Life
Way back before surgery, did you go to the bathroom after a hot cup of coffee, milk, cold juice, whiskey or beer? Well, whatever made you feel that need then can make you feel the need now. Check it out. See if your irrigation can be helped by some of the things you used to do. Of course, if you have had your colostomy for a number of years, your previous habits may not be the same now. Your body can, however, be trained as it was before, and you can adapt yourself to certain habits which can help you to be in control. A glass of hot water or juice, or a cup of coffee before a morning irrigation may initiate gut reaction. Also, a glass or two of water, after the water return starts, is usually helpful. If you irrigate before going to bed, a glass of ice water or a cup of hot coffee should get you started. If you have not drunk much water during the day, it would be wise to drink an extra glass or two to make sure your tissues will not absorb so much, or you may be left with little or no return.
But what if you don’t irrigate? Part of the difficulty in elimination of waste matter experienced by colostomates is due to lack of bulk in the diet. Consumption of white bread, pastry and highly refined foods does not provide the roughage and bulk necessary for proper evacuation of the colon. The deficiency can be overcome in part by the simple addition of bran to the diet. Bran can be made into muffins adding raisins and molasses to taste.
Diet. There is no such thing as a colostomy diet. A colostomy is not an illness, so try to eat the same foods you
have eaten and enjoyed in the past. If you are on a diet for a condition such as diabetes or high blood pressure, of course you should stay on that diet. Foods can be acidic or alkaline, bland or spicy, laxative-like or constipating. Individuals react differently to food. Try to return to your former, normal diet. Those foods which disagreed with you in the past may still do so. Chew well and see the effect of each food on your colostomy output.
To maintain good health, the body requires carbohydrates, proteins, fat, minerals and vitamins. Water is not nutritious but is absolutely necessary. Having a balanced diet is a fitting way to maintain good nutrition and keep bowel activity normal. Every day your body needs meats or fish, dairy foods, vegetables and fruits, cereals and bread, and liquids. Talk to your physician or ET nurse if you have problems.
REDUCING YOUR RISK OF PNEUMONIA
Via: Sherman Area & Golden Spread Ostomy Association, Amarilla, TX
Although certain organisms are more contagious than others. It is unusual to “catch” pneumonia from someone else. You usually develop pneumonia because your own immunity is weakened.
To fortify your natural resistance to pneumonia; get vaccinated. Because pneumonia can be a complication of the flu, getting a yearly flu shot is a good way to prevent pneumonia. In addition, get a vaccination against pneumococcal pneumonia at least once after age 65 or if your
doctor recommends it sooner for your condition.
Wash your hands. Your hands come in daily contact with germs that can cause pneumonia. Wash your hands frequently to decrease your exposure.
Do not smoke. Smoking damages your lungs’ natural defenses against respiratory infections.
Take care of yourself. Proper rest, diet, and moderate exercise can help keep your immune system strong.
Although most cases of pneumonia do not prove fatal, you do not want to mistake pneumonia for a cold of flu and leave it untreated.
WHAT’S UP?
Via: Minot Area & GB News Review
We have a two letter word we use constantly that has more meaning than any other. That word is “UP”.
It is easy to understand UP, meaning toward the sky, or toward the top of the list- - but when we waken, why do we wake UP? At a meeting, why does a topic come UP? Why do participants speak UP? And, why are officers UP for election? And, why is it often UP to the secretary to write UP a report? The word is not needed, but we use it anyway; we brighten UP a room, light UP a cigar, polish UP the silver, lock UP the house, fix UP the old car.
At other times, it has special meanings: people sit UP, stir UP trouble, line UP for tickets, work UP an appetite, think UP excuses, get tied UP in traffic. To be dressed is one thing, but to be dressed UP is something special. It may be confusing, but a
drain must be opened UP because it is stopped UP. We open UP a store in the morning and close it UP at night. We seem to be mixed UP about UP, it’s true— but just don’t give UP !!!!!
A UROSTOMY EXPERIENCE TO SHARE
By: Becky Redmond, Via: Belleville, Regina Ostomy News
I have been reading articles on your site for a couple of years. I had an unusual and frightening experience concerning my urostomy last week that I thought might be of interest to your readers.
I have had my stoma for four years now and have had no complications or problems. For the past six months, I had noticed that the skin around my stoma was white and irritated. I tried several different things to clear
it up, changing different brands of flanges, changing the flanges more often, drinking more water and cranberry juice, and using different powders but nothing seemed to clear it up. I knew I should get in to see the doctor, but with starting a new job this summer, I couldn’t afford to take time off. So I just put up with it, hoping that once I had enough time saved up at work, I could get in for an appointment.
Last Thursday, while at work, I went to empty my pouch and it was full of bright red blood. I noticed two small blood clots. This really got my attention and I went directly to the phone and called the doctor who had performed my surgery four years ago. The nurse said she would get hold of him and have him call me back at work. Meanwhile, I continued to work. I started drinking a lot of water and drank a bottle of cranberry juice, thinking this would clear things up. After lunch in the early afternoon, I again went in to empty my pouch and this time, it was not only full of bright, red blood but so full of huge blood clots that my pouch wouldn’t even drain!
I was so scared that I went immediately to the phone and told the nurse that I had an emergency situation and needed to talk to the doctor. I ended up at the emergency room and had a urologist come in to look at it. When I took off the pouch, the blood had coagulated so thick, the doctor couldn’t see the stoma. He peeled off the flange and blood was spurting from a severed artery next to the stoma. He said that
because the skin around the stoma had such severe erosion, it caused the breakdown by the artery and it broke loose. He had to put in several stitches to close the artery. I had lost quite a bit of blood, but not enough to keep me in the hospital, so I was released and went home. I was told my urine would clear up by later that evening, which it did. It took several days for me to get over the panic of what had happened.
Because of this ordeal, I made an appointment with an ostomy nurse. She told me that she recommends people with urostomies wear a convex flange. It keeps the urine from pooling around the stoma area. And, she showed me how to use Stomahesive
Powder and paste on the white, moist areas surrounding my stoma. I have also
scheduled an appointment with my doctor to have him check what the emergency
room urologist did. I was told that in twenty-five years of practice, this was
only the second time the urologist had ever seen this happe
OSTOMY FACTS
UOA Findings, Via: Space Coast Shuttle Blast
Cancer is the leading cause of ostomy surgery, and colorectal cancer alone affects over 130,000 Americans per year.
People with an ostomy have to deal with body altering surgery and fears relating to having an ostomy and managing their appliances, worrying about odor, spillage, social activities, isolation, rejection, feeling unclean, and the ability to be normal again.
The average age of a person with an ostomy is 68 years. Approximately 57% of people with an ostomy are women and women use substantially more pouches than men.
Two-thirds of all people with an ostomy are Medicare beneficiaries.
Only 20% of ostomy supply dealers accept Medicare assignment on all ostomy appliances.
OSTOMY HINTS & TIPS
If your pouch doesn’t stick well, are you applying it right after showering in a high-humidity bathroom? Skin must be perfectly dry to receive and hold the appliance. Also, oily products, such as Dove Soap, can cause the wafer to loosen and fall off.
If you are beginning a new medication for any reason, keep a close eye on your appliance. Contact your doctor immediately if you suspect the medicine is going straight in and out.
When taking liquid medicines, do not use a tablespoon instead of the measuring device that came with the medication. Tableware can give as much as 20% larger dose than desired.
Washing ostomy bags with Woolite will keep them soft and odorless.