Question: Coping with Severe Colostomy Complications

I recently received a call from an individual who has been facing severe complications with his colostomy, which was necessitated by colitis and a significant case of Diverticulitis. He’s experiencing allergic reactions to the bag’s covering, stoma sinking, regular leakage, skin irritation, and issues with diet. I’m seeking advice on how to address these complex challenges.

Response: Recommendations for Managing Colostomy Complications

Dealing with colostomy complications can be overwhelming, but there are several steps and resources that can be utilized:

  1. Allergic Reactions to Pouch Covering: For those allergic to the standard pouch covering, alternatives are available. Contacting ostomy appliance manufacturers like Hollister, ConvaTec, and Coloplast is recommended. They may offer suitable products or suggestions and provide access to a Nurse Specialized in Wound, Ostomy, and Continence (NSWOC) for free advice.
  2. Stoma Sinking and Leakage: If the stoma sinks into the skin, causing regular leakage, a belt might help, though caution is advised if the skin is damaged. It’s essential to consult with a NSWOC nurse to explore other solutions beyond powder. Advocating for regular NSWOC visits through homecare or local representatives is advisable. If travel is feasible, two NSWOC nurses in the Barrie area can be contacted through this link.
  3. Pouch Adherence Issues: Excessive use of powder or damaged skin may hinder proper pouch adherence. Exploring different pouch configurations from major appliance manufacturers can be beneficial. If the pouch is frequently falling off, assessing the amount and consistency of effluent is crucial.
  4. Pain with Convexity: Once the skin around the stoma heals, using a convex pouch with a belt might become more comfortable and effective in preventing leaks.
  5. Dietary Concerns: For loose stools, a dietitian consult is recommended. The BRAT diet (Bananas, Rice, Applesauce, Toast) can help, but professional guidance is vital, especially for someone with a colostomy. This can be arranged through the local hospital or homecare, and online consultations might be an option.

It’s important to remember that each case is unique, and ongoing support from healthcare professionals is crucial in managing these challenges effectively.

Warm Regards,

Karen Bruton, RN BScN MCISc-WH WOCC(C)
Nurse Education Consultant – FNIB
Indigenous Services Canada, Government of Canada


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