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A Guide To Living With A Stoma More For You


LIVING WITH A STOMA




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LIVING WITH A STOMA

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DISCLAIMER


100% accuracy at time of writing cannot be guaranteed.  A listing in this website is provided for informational purposes only, and does not mean it is an endorsement.  All companies listed are tried at the reader’s own risk.  All information provided is intended as a supplement to any professional help already

given.  Before acting on suggestions from anyone, ostomates are advised to check with a doctor or stoma care nurse that the course of action is suitable

for them. Whilst every care is taken, the author will not be held responsible.

PANCAKING


Pancaking takes place most commonly with a colostomy, when faeces output collects around the stoma, and does not drop or move down into the bottom of the pouch. The two layers of plastic from a pouch effectively stick together.  It is caused when the filter of the stoma pouch eliminates all the air in the appliance, creating a ‘vacuum/sucking in’ of the appliance.


It can make an unsightly bulge in the pouch and block the filter, and sometimes the faeces may squeeze between the flange and the skin.  Drainable pouches may be difficult to empty.


It is not an easy problem to solve.  Covering the filter with one of the sticky patches, which are

supplied in each box of stoma pouches, may help to minimize the problem, by preventing a vacuum forming inside the pouch.  Lubricating a pouch with baby oil, or one of the many products available from the various supply companies, may also help the motion to fall to the bottom of the pouch.  Obviously, care must be taken not to get any oil on the adhesive as this can reduce the effectiveness

of the seal.


PARASTOMAL


Parastomal means pertaining to the area of skin immediately around a stoma in the abdominal wall.  Usually the adhesive of the pouching system covers the parastomal skin.  


PARASTOMAL HERNIA


A parastomal hernia is a common complication, which may occur weeks, months or years after stoma surgery.  This type of hernia is a weakness in the abdominal wall, where the intestine protrudes through the abdominal muscles around the stoma.  It is seen as a bulge under the skin around the stoma.  It may be one-sided or all the way round.  Some causes include surgical technique, muscle weakness, coughing and straining.


The stoma patient sometimes experiences discomfort, problems with stoma appliances or clothing, pouch wear time and can find the appearance of the hernia very distressing.


Management may include fitting an abdominal support, e.g. hernia belt, and surgical repair may be required in more severe situations.


A rare complication is when the bowel segment becomes strangulated.  The patient may have

symptoms of an acute abdomen (bowel obstruction, ischaemic bowel, abdominal pain, distension, vomiting) and this would require urgent surgery.


See Bowel Obstruction.


PARASTOMAL INFECTION


There are two main types of infection, which could be found around a stoma - bacterial and candidal.


Bacterial infection is caused by staphylococcus aureus, and appears as a large, patchy erythematous crusty area with plaques.


Candidal infection is caused by candida - a yeast-like fungus, which is part of the normal flora of the intestine, but can spread to the skin in certain conditions (damp skin, e.g. from a leaking ostomy pouch).


In extensive infections, a white-coated appearance is evident.


See Infection.


PARENTAL NUTRITION


Parental nutrition is a way to provide a liquid food mixture through a special tube, i.e. the administration of a nutritionally-adequate solution into a large vein, usually in the chest (central intravenous line).  The solution usually contains high-concentration carbohydrate, protein, vitamins and minerals.  Fat may also be given.  A less concentrated solution can be given through a smaller vein, usually in the arm (peripheral parenteral nutrition, PPN).


It is also known as hyperalimentation or total parenteral nutrition (TPN).


PASTE


Stoma paste is a paste, which can be used to fill in cavities, crevices, dips and folds, around a stoma to provide a smooth surface and better seal.  Stoma paste is a filler, not an adhesive.




PATCH TESTING


Patch testing is a method whereby an ostomate can test if part of an ostomy pouching system is

causing an allergic reaction.  A small piece of the product is taped on the skin away from the stoma area.  Forty-eight hours later, the site is checked for redness, itching and swelling.  A further

forty-eight hours later, it is checked again for any delayed reaction.  If symptoms occur, the product should not be used.


PELVIC POUCH


See Ileoanal Reservoir.


PELVIS


The pelvis is the area of the body surrounded by the hips.  It includes the bladder, prostate, uterus

and other organs.


PERIANAL


Perianal refers to the area around the anus.


PERINEAL WOUND


A perineal wound is the large gap where the anus used to be.  It occurs when the rectum and anus are removed in a colostomy or ileostomy.  It heals slowly as new tissue fills the area.  It can be closed, loosely stitched, or left open by the surgeon.


It is also known as posterior wound.


PERISTALSIS


Peristalsis is a normal, progressive, wavelike movement of muscles in the GI tract, which occurs without voluntary control, in order to push food, digestive enzymes and waste material towards an outlet (anus or stoma).


PERISTOMAL


Peristomal means pertaining to the area of skin immediately around a stoma in the abdominal wall.  Usually the adhesive of the pouching system covers the peristomal skin.


PERISTOMAL HERNIA


See Parastomal Hernia.


PERISTOMAL MOAT


A peristomal moat is a hollow, which can be all round a stoma, or just partially around a stoma, and

can occur at any time after stoma surgery.  If this occurs, it is advisable to talk to a stoma care nurse about filling the moat with an accessory, e.g. stoma paste, seals, etc.





PERITONEUM


Peritoneum is the lining of the abdominal cavity, which encloses the abdominal organs.


PERITONITIS


Peritonitis is an infection or inflammation of the peritoneum.


PERMANENT COLOSTOMY


A permanent colostomy is the removal of part of the colon, usually including the rectum.  The end of

the remaining colon is brought to the surface of the abdomen to form a stoma.


See Colostomy and Stoma.


PERMANENT OSTOMY


A permanent ostomy is an ostomy, which is meant to last through the rest of a person’s lifetime.


See Ostomy.


POLYP


A polyp is tissue, which bulges from the surface of an organ.  Although these growths are not normal, there is often no cause for concern.  However, people, who have polyps in the colon, may have an increased risk of colorectal cancer.


POLYPOSIS


Polyposis describes a condition where there are a lot of polyps.


POSTERIOR WOUND


See Perineal Wound.


POUCH


A pouch is a waterproof bag, which is worn over a stoma to collect faeces or urine.


Depending on the ostomate’s personal preference, pouching systems may include a one-piece or two-piece system.  Both kinds include a flange (also known as skin barrier or wafer) and a collection bag.  The pouch (one-piece or two-piece) attaches to the abdomen by the flange, and is fitted over and around the stoma to collect the diverted output, either stool or urine.  The flange is designed to

protect the skin from the stoma output and to be as neutral as possible to the skin.


There are several types of pouches:


















See Appliance, One-Piece Stoma Pouch, Stoma Appliance and Two-Piece Stoma Pouch.


POUCH COVERS


Pouch covers are covers, which easily fit over the pouch, and protect and comfort the skin.  They are often made with cotton or cotton-blend backing.  Many pouches now include built-in cloth covers on

one or both sides, reducing the need for separate pouch covers.


POUCHITIS


Pouchitis is inflammation of the internal reservoir (J-Pouch or continent ileostomy), causing pain,

bloating and watery diarrhoea.  It can be often likened to the symptoms of ulcerative colitis prior to surgery.  It is treated with antibiotics.


PREBIOTICS


The words prebiotics and probiotics are often used interchangeably.  The two are related to one another, but they are very different.


Prebiotics are a special form of dietary fibre, not bacteria.  It is found naturally in certain foods, which actually helps feed probiotic bacteria, thus allowing it to thrive.  Prebiotics provide nourishment to the good bacteria already in the gastrointestinal tract, and create a hostile environment for bad bacteria.  A healthy balance of prebiotics and probiotics can provide positive benefits to health, especially when it comes to the colon.

See Probiotics.


PRE-CUT


See Pre-Sized.


PRE-SIZED


A pre-sized flange is a product, which has a hole already cut for added convenience.  The sizes are listed and should be selected based upon your stoma size.  These products are ideal if a stoma has a round shape.


PROBIOTICS


The words prebiotics and probiotics are often used interchangeably.  The two are related to one another, but they are very different.


Probiotics are live, friendly, good bacteria, such as lactobacilli and bifidobacteria, which are found naturally in the digestive system, and can also be added to the system by ingesting certain foods containing probiotic elements, e.g. some yogurts.  They will past through the digestive tract and are absorbed in the intestine.  They assist good bacteria flourish, and prevent bad bacteria from proliferating.  Probiotics help with the digestive process, and with the absorption of nutrients.  In addition, they help with the absorption of minerals.


Therefore, probiotics can supplement the good bacteria already found in the body and increase its effectiveness, providing a range of benefits in different areas of the body. They help to boost the immune system, and help fight infections and disease in the body.  Some probiotics are thought to

help digestion, and prevent or treat diarrhoea.


See Prebiotics.


PROCTOCOLECTOMY


A proctocolectomy is a surgical operation, where the colon (all or part) and rectum are removed.


It is also called a Coloproctectomy.


PROCTOCOLITIS


Proctocolitis is an irritation of the colon and rectum.


PROCTOLOGIST


A proctologist is a doctor, who specializes in disorders of the anus and rectum.


PROCTOSCOPE


A proctoscope is a short, rigid metal tube, which is used to look into the rectum and anus.


PROCTOSIGMOIDITIS


Proctosigmoiditis is an irritation of the rectum and the sigmoid colon.


PROCTOSIGMOIDOSCOPY


Proctosigmoidoscopy is an endoscopic examination of the rectum and sigmoid colon.


See Endoscopy.


PROLAPSED STOMA


A prolapsed stoma is a condition, where the bowel protrudes through the opening of the stoma, increasing its length.  It can vary in size from small to quite large.  It may not affect the way the stoma functions, but can cause pouch leakage.


It is an uncommon complication after ostomy surgery.  Contributing factors may be an excessively-large opening in the abdominal wall (surgical technique) and/or increased abdominal pressure (e.g. heavy lifting, coughing).  A prolapse occurs more frequently in transverse loop stomas.  If necessary, this can be surgically corrected.


See Loop Ostomy.


PROTECTOMY


A protectomy is a surgical operation to remove the rectum.






































Accessories, Pastes



Closed



Drainable




One-Piece System




Two-Piece System




Closed-end pouches are sealed at the bottom, and are usually discarded after one  use.


Open-ended pouches are called drainable and are reused after they are emptied.   This type of pouch requires a closing device, e.g. a clamp, tail clip or tap.


A one-piece stoma pouch system includes a skin flange and collection pouch, which  is joined together as a single unit, so that both are changed at the same time.


A two-piece stoma pouch system comes in two pieces - the flange is separate from  the pouch.  This system allows the pouch to be changed, whilst the flange remains in  place.

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GLOSSARY

P


Accessories, Pastes

Accessories, Seals And Washers