Colostomy and ileostomy: what they are and how to care for the bag

Colostomy and ileostomy are two types of ostomy that consist of the connection of the intestine directly to the wall of the abdomen, to allow feces to escape into a pouch, when the intestine is no longer connected to the anus. This usually happens after surgery to treat bowel problems, such as cancer or diverticulitis, for example.

Depending on its location, the ostomy in the intestine can be divided into two major types:

Colostomy: is performed in the large intestine and usually releases soft or solid stools; Ileostomy: is performed in the final part of the small intestine and releases liquid stools.

Although most colostomies and ileostomies are temporary, as they are usually only used to facilitate healing of the intestine after surgery, some can be maintained for life, especially when it is necessary to remove a very large part of the intestine, which does not allow you to return connecting to the anus.

After surgery to create the colostomy, or ileostomy, it is normal for the area on the skin where the intestine was attached, which is known as the stoma, to become very red and swollen, as the intestine is injured, however, these signs are decreasing. throughout the first week with the treatments done by the nurse.

How to care for the colostomy bag or ileostomy

To change the colostomy or ileostomy bag, it is recommended:

Remove the bag, peeling off slowly so as not to hurt the skin. A good tip is to put a little warm water in the region to help it take off more easily; Clean the stoma and surrounding skin with a clean soft cloth moistened with warm water. It is not necessary to use soap but, if you prefer, you can use a neutral soap, which must be well removed with clean water before placing the new bag; Dry the skin well around the ostomy to allow the new pouch to stick to the skin. It is not recommended to use any cream or product on the skin without the doctor's recommendation; Cut a small hole in the new pouch, the same size as the colostomy / ileostomy and glue the pouch back in place.

The contents of the dirty bag must be placed in the toilet and then the bag must be thrown in the trash, as it must not be reused due to the risk of developing infections. However, if the bag is reusable, the manufacturer's instructions must be followed to wash it properly.

Bag with 2 pieces

There are also some types of colostomy bags, or ileostomy, that have 2 pieces and that facilitate the removal of feces, because the piece that holds the bag in the skin always remains glued, while only the bag is removed and replaced. Even so, the part that is stuck to the skin must be replaced, at least every 2 or 3 days.

When should you change?

The number of times the pouch must be replaced varies according to the bowel's own functioning, but the ideal is to change it whenever the pouch is 2/3 full.

Is it safe to use the bag on a daily basis?

The colostomy bag, or ileostomy, can be used without any problem in all daily activities, even for bathing, swimming in the pool or entering a jacuzzi, as the water does not affect the system. However, it is only recommended to replace the pouch before entering the water for hygiene reasons.

Some people may not feel comfortable using the bag all the time and, therefore, there are small objects, similar to lids, that can be placed in the colostomy and that prevent the stool from leaving for a certain period of time. However, it is necessary to know the intestinal transit very well to avoid excessive accumulation of feces in the intestine.

How to care for the skin around the colostomy

The best way to avoid skin irritation around the colostomy / ileostomy is to keep the pouch in the correct place, as this prevents the feces from coming into direct contact with the skin. Thus, the most important step is to correctly measure the colostomy / ileostomy and cut the hole in the bag to the right size.

However, other precautions that must also be taken are to wash the skin well after removing the bag and checking, with the help of a mirror, if there was any trash in the lower part of the colostomy / ileostomy, for example.

If the skin becomes very irritated over time, it is recommended to consult a dermatologist or speak with the doctor in charge to use a barrier cream that does not prevent the skin from sticking.

How should the food be

Each person reacts differently to food, and it is necessary to be aware of foods that cause disorders such as constipation, strong odor and gases. For this, you should try new foods in small amounts, observing the effects they cause on colostomy / ileostomy.

In general, it is possible to have a normal diet, but one must be aware of foods that favor the appearance of intestinal problems, as shown in the following table:

Problem	Foods to Avoid in Colostomy	Foods to Avoid in Ileostomy	What to do
Liquid stools	Green fruits and vegetables	Green fruits and vegetables	Consume fruits and vegetables preferably cooked, and avoid leafy vegetables
Constipation	Potato, white rice, yam, banana and white wheat flour	Potato, white rice, yam, banana and white wheat flour	Prefer rice and whole foods and drink at least 1.5L of water
Gases	Green vegetables, beans and onions	Green vegetables, beans and onions	Consume nutmeg and fennel teas
Odor	Boiled egg, fish, seafood, cheese, raw onion and garlic, alcohol	Green vegetables, cabbage, alcohol and raw onion and garlic only in excess	Consume odor-neutralizing foods, shown below

Foods that should be consumed to help neutralize the smell of faeces are: carrot, chayote, spinach, cornstarch, plain yogurt, whole curd without whey, concentrated parsley or celery tea, apple peel, mint and peel tea and guava leaf.

In addition, it is important to remember that skipping meals and not eating for a long time does not prevent the production of gases, and it is necessary to eat regularly to improve the functioning of the colostomy / ileostomy.