Colostomy Care Ostomy and Wound Care - Regina Qu'Appelle Health Region
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Colostomy Care
Ostomy and Wound Care
CEAC 0403
January 2019
*This document was designed to support patients of the former RQHR.
Notes:
_____________________________________________________
This booklet helps you and your family understand your surgery
and ostomy care. It is a resource for you to keep and refer to
_____________________________________________________
with questions.
_____________________________________________________
An Ostomy & Wound Care nurse visits you in the hospital after
your surgery. An ostomy nurse is a registered nurse who
_____________________________________________________
specializes in the care and teaching of people with an ostomy.
You will learn how to care for your ostomy during your hospital
_____________________________________________________
stay.
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
_____________________________________________________
Saskatchewan Health Authority
_____________________________________________________
Pasqua Hospital
Ostomy & Wound Care
_____________________________________________________
4101 Dewdney Avenue
Regina, Saskatchewan S4T 1A5
_____________________________________________________
Telephone: (306) 766-2271
Fax (306) 766-2152
_____________________________________________________
Office hours: Monday to Friday 8:00 a.m. to 4:00 p.m.
_____________________________________________________
An appointment is required.
_____________________________________________________
28 1
Medical Terms Customer Service Information
Ostomy - means “an opening made into”. Surgery creates an ConvaTec
opening from an area inside the body to the outside of the 1425 Trans Canada Highway, Suite 100
abdomen. There are many types of ostomies. Dorval, QC H9P 2V3
Phone: 1-800-465-6302
Stoma - the small piece of bowel that is seen on the abdomen Email: convatec.canada@convatec.com
www.convatec.ca
after surgery.
Hollister
95 Mary Street
Aurora, ON L4G 1G3
Phone: 1-800-263-7400 (Toll-Free)
www.hollister.com
Coloplast
2401 Bristol Circle, Suite 205A
Oakville, ON L6H 5S9
Customer Service - 1-888-880-8605
Email: ca_conspec@coloplast.com
www.coloplast.ca
Image courtesy of Blausen Medical
Ostomy Canada Society
Colon - large bowel 5800 Ambler Drive, Suite 210
Mississauga, ON L4W 4J4
Colostomy - surgical opening made in the large bowel. Telephone: 1-905-212-7111
Toll Free: 1-888-969-9698
Bowel or Intestine - both mean part of the digestive system, www.ostomycanada.ca
from the stomach to the anus (can refer to small or large
intestine).
Peristalsis - the forward movement of food or waste through the
digestive system.
Stool - the waste product after digesting food, also called bowel
movement.
2 27
Weyburn Co-op Pharmacy Digestive System
215 - 2nd Street NE, Weyburn, S4H 0V1
Phone: (306) 848-3682 This includes the mouth, esophagus, stomach, small bowel, large
____________________________________________________ bowel, rectum, and anus.
Drugstore Pharmacy 6760
115 Souris Avenue NW, Weyburn, S4H 3N6 Digestion begins in the mouth. Chewing and enzymes in the saliva
Phone: (306) 848-3409 break food down. The chewed food travels down the esophagus
____________________________________________________ and into the stomach where it is churned and mixed with gastric
Loucks Pharmacy juices before moving to the small bowel.
115 - 41 Broadway Ave West, Yorkton, S3N 0L6
Phone: (306) 786-6636 The small bowel is about 6 metres (22 feet) long and is divided
____________________________________________________ into 3 sections - duodenum, jejunum, and ileum. Digestion
Hearn’s Westview Pharmacy continues in the small bowel. Enzymes mix with the churned food
265 Bradbrooke Drive, Yorkton, S3N 3L3 and break it into smaller particles. Nutrients are absorbed into
Phone: (306) 783-4331 the bloodstream and used by the body for energy and nutrition.
____________________________________________________
Digested food moves on to the large bowel. The large bowel is
about 1.85 metres (6 feet) long and includes the ascending colon,
transverse colon, descending colon, sigmoid colon, rectum, and
anus. The large bowel reabsorbs water and salt from the waste
products and stores stool. Stool is stored in the rectum until you
feel the urge to have a bowel movement. Stool is passed out of
the body through the anus.
Image courtesy of Adobe Stock
26 3Colostomy Nordon Drugs Ltd.
1610 Isabella Street East, Saskatoon, SK S7J 0C1
A colostomy can be formed in any part of the large bowel. Phone: (306) 374-1589
___________________________________________________
The type of colostomy is named by its location in the large Schaan Home Healthcare
bowel. #7-705 Central Avenue, Saskatoon, SK S7N 3A4
Phone: (306) 664-1190, Toll free: 1-833-667-6186
A colostomy can be permanent or temporary. Your surgeon ___________________________________________________
tells you which type you have. URO Medical Supplies
4002 Arthur Rose Avenue, Saskatoon, SK S7P 0C9
Colostomy stomas are created by the surgeon in 2 ways - end Phone: (306) 651-3330
or loop. Not all stomas are the same shape. ___________________________________________________
Jae’s Pharmacy Ltd.
An end stoma has 1 opening that stool and gas comes out of. 335 Centre Street, Shaunavon, S0N 2M0
Phone: (306) 297-1333
A loop stoma has 2 openings - 1 for stool and gas to come ___________________________________________________
out of and 1 to vent/drain mucous or old stool from the New Hope Pharmacy
remaining portion of the large bowel. PO Box 240, Stoughton, S0G 4T0
Phone: (306) 457-2522
If your rectum and anus were not removed during surgery, ___________________________________________________
you may feel rectal fullness and the urge to pass stool after Pharmasave 406
surgery. This is normal. You may relieve the feeling of rectal 390 Central Avenue North, Swift Current, S9H 0L4
fullness by using the toilet. You may pass mucous, old blood, Phone: (306) 773-7261
or stool that was not cleaned out of your bowel before ___________________________________________________
surgery and mucous after that. Rexall Drugs
780 Central Avenue North, Swift Current, S9H 0M3
Phone: (306) 773-4633
___________________________________________________
Pharmasave 416
30 - 3rd Street NE, Weyburn, S4H 0V9
Phone: (306) 848-3850
___________________________________________________
4 25Royal Drug Mart Descending or Sigmoid Colostomy
Box 370, Melville, S0A 2P0 You are able to use most of your large bowel.
Phone: (306) 728-5625 The stool is formed.
__________________________________________________ Constipation or diarrhea can still occur.
Pharmasave 407
PO Box 1198, Melville, S0A 2P0 Transverse Colostomy
Phone: (306) 728-4556 You are using less of your large bowel.
__________________________________________________ The stool varies from pasty to semi-solid in consistency.
Moose Jaw Rexall Drugs
735 Main Street North, Moose Jaw, S6H 0W7 Mucous Fistula
Phone: (306) 694-5556 If your rectum was not removed during the surgery, the
__________________________________________________ lower piece of bowel that is left in your abdomen may be
Pharmasave Drugs 424 brought to the skin surface.
212 Main Street North, Moose Jaw, S6H 3J8 The mucous fistula provides a way for mucous produced in
Phone: (306) 692-6433 the lower bowel to vent/drain out.
__________________________________________________
TLC Pharmacy
149 - 1235 Main Street North, Moose Jaw, S6H 6M4
Phone: (306) 972-7200
__________________________________________________
Pharmasave 408
Box 1290, Moosomin, S0G 3N0
Phone: (306) 435- 3345
__________________________________________________
Pharmasave 442
PO Box 702, Radville, S0C 2G0
Phone: (306) 869-2272
__________________________________________________
Pharmasave 404
PO Box 310, Redvers, S0C 2H0
Phone: (306) 452-3313
__________________________________________________
Image courtesy of Adobe Stock.
24 5The Stoma Sapara’s Drug Mart (PharmaChoice)
Box 1599, Esterhazy, S0A 0X0
To form your stoma, your surgeon folds the small piece of bowel Phone: (306) 745-6662
back like a cuff on a turtleneck sweater. Important things for you __________________________________________________
to know about your stoma are: Henders Drugs
1220 - 4th Street, Estevan, S4A 0W9
Appearance - pink to red Phone: (306) 634-3666
__________________________________________________
Texture - moist and smooth, like the tissue inside your mouth. Pharmasave
1239 - 5th Street, Estevan, S4A 0Z5
Blood supply - is very close to the surface of the stoma. It is Phone: (306) 637-3802
normal to see small traces of blood when the stoma is cleaned __________________________________________________
or rubbed. Pharmasave 412
Box 1030, Fort Qu’Appelle, S0G 1S0
Slight movement - may occur as the stool passes through the Phone: 1-888-858-3865
stoma (peristalsis). __________________________________________________
Saleski Pharmacy Ltd.
Nerve endings - because there are no nerve endings in your PO Box 1000, Grenfell, S0G 2B0
stoma, you should not feel pain or sensation with cleaning or Phone: (306) 697-2600
when it functions. __________________________________________________
Dragan Drugs
Control - you do not have any control over the movement of PO Box 1419, Indian Head, S0G 2K0
stool or gas. Phone: (306) 695-3333
__________________________________________________
Dissolvable sutures (or stitches) are placed around the stoma. Kamsack Family Pharmacy
They break down and dissolve in 7 to 10 days. 504 - 3rd Avenue South, Kamsack, S0A 1S0
Phone: (306) 542-1333
Swelling - after surgery your stoma is swollen and larger than __________________________________________________
normal. You can expect your stoma to shrink in size as it heals Dirk Family Pharmacy Ltd.
for about 6 to 8 weeks after surgery. Box 190, Leader, S0N 1H0
Phone: (306) 628-3744
Rod or bridge - your surgeon may use a plastic rod or tube to __________________________________________________
support a loop stoma during the first 1 to 2 weeks.
6 23Baber’s Pharmasave Ostomy Management
Box 490, Balcarres, S0G 0C0
Phone: (306) 334-2424 The pouching appliance sticks/adheres to the skin around the
___________________________________________________ stoma and collects stool, contains the odor and protects the
Bengough Drugs Ltd. skin around the stoma.
PO Box 218, Bengough, S0C 0K0
Phone: (306) 268-2002 Wear time is the length of time the pouching appliance can
___________________________________________________ be left in place (without leakage).
Pharmasave
PO Box 27, Broadview, S0G 0K0 The pouching appliance needs to be changed 1 to 2 times per
Phone: (306) 696-2274 week.
___________________________________________________
Devi Pharmacy A pouching appliance should be changed if it leaks or if your
515 First Street North, Cabri, S0N 0J0 skin is irritated.
Phone: (306) 587-1001
___________________________________________________ You can bath or shower with your pouching appliance on or
Canora Pharmacy Ltd. off. If your pouching appliance is on, allow some extra time
Box 1360, Canora, S0A 0L0 to dry it completely before getting dressed. If you bath or
Phone: (306) 563-5411 shower without wearing a pouching appliance, ensure your
___________________________________________________ pouching supplies are ready to apply after. Bathing or
Pharmasave showering wearing only a wafer (removing the pouch) should
PO Box 1059, Carlyle, S0C 0R0 be avoided, as the wafer breaks down more quickly from
Phone: (306) 453-4466 direct contact with the water.
___________________________________________________
Carnduff Drug Mart You may trim hair around your stoma carefully with a razor
Box 669 Carnduff, S0C 0S0 (safety or electric) or scissors to make removing the wafer/
Phone: (306) 482-3637, 1-800-600-3637 pouch easier.
__________________________________________________
Galloway’s Pharmacy Ltd. Gradually return to your normal activities after surgery. For
PO Box 190, Central Butte, S0H 0T0 6 to 8 weeks after surgery, DO NOT vacuum or lift more than
Phone: (306) 796-2040 5 to 10 pounds (2 to 4 kg). For 6 months after surgery, DO
__________________________________________________ NOT lift more than 20 to 30 pounds (10 to 15 kg). Your
surgeon may give you instructions for activity.
22 7Ostomy Management (continued) Retail Outlets that Carry Ostomy Products
After healing from ostomy surgery, your abdominal muscle Note: The Saskatchewan Health Authority does not endorse any
wall may be weaker which may place you at risk for particular store. This is a partial listing and is not intended to be
developing a hernia. A hernia support belt and safe exercises a comprehensive list.
can be recommended by your ostomy nurse.
Contact retailer regarding ordering ostomy supplies.
Extra ostomy supplies should be carried with you in your
purse or car. For airplane travel, you should carry some extra
prepared pouching appliances with you and the rest of your Medical 1 Physician and Health Care Supplies
supplies in your luggage (scissors are not permitted in your 2365 - 2nd Avenue, Regina, S4R 1A5
carry-on bag). Phone: (306) 352-8874
_____________________________________________________
Jolly’s Medical Supplies
Ostomy pouching appliances are odor proof if:
120 Victoria Avenue, Regina, S4N 0P3
the pouch is changed regularly
Phone: (306) 522-3833
the pouch is emptied when 1/3 full
_____________________________________________________
the pouch has no flaws or pinholes
Pharmasave Glencairn
the tail portion of the pouch is kept clean
1695 Dewdney Avenue East, Regina, S4N 4N6
a reliable seal is obtained.
Phone: (306) 791-7878
_____________________________________________________
To empty the pouch:
Shoppers Drug Mart
Landmark Centre, 4130 Albert Street, Regina, S4S 3R8
1. Unroll the interlocking fastener by lifting at the corners and
Phone: (306) 777-8040
unraveling the fold 3 times.
_____________________________________________________
The Medicine Shoppe Pharmacy
2. Open the tail end by pushing both ends of the outlet
2310 - 9th Avenue North, Regina, S4R 8C5
together with your thumb and forefinger. Empty contents
Phone: (306) 543-5555
into toilet.
_____________________________________________________
Shoppers Drug Mart 433
3. Pouch tail may be wiped clean with tissue or mild soap and
Box 10, Assiniboia, S0H 0B0
warm water. Roll tail up to close and press firmly on
Phone: (306) 642-7370
interlocking fastener.
_____________________________________________________
8 21Saskatchewan Aids To Independent Living (SAIL) Medications
Ostomy & Wound Care registers you with the SAIL Ostomy It is important to tell your health care provider and pharmacist
Program for reimbursement of your ostomy supplies. You receive about your ostomy before taking any new medication. The type
confirmation of your registration by mail. of ostomy you have may affect the medication prescribed.
Certain vitamins, antibiotics, and other medications may affect
At the time of ostomy supply purchase, SAIL pays 50% of the cost the color or consistency of stool.
and you pay the remaining 50%. Concerns related to SAIL
reimbursement should be directed to your vendor. You can still experience diarrhea or constipation with a
colostomy. Medications containing codeine may cause
Note: constipation. Consult your doctor, pharmacist, or ostomy nurse
You may be eligible for additional reimbursement if you have for advice with managing or preventing constipation. Stool
additional health insurance coverage through your employer or a softeners may be necessary.
private insurance program such as Blue Cross, Group Medical
Services, or Veterans Affairs Canada. After receiving the
Nutrition
statement from your pharmacy, the paid receipt can be
submitted to your private insurance program for consideration.
Colostomy surgery does not require you to make any
changes to your diet.
Non-Insured Health Benefits (NIHB)
Eat a well balanced diet following “Eating Well with Canada’s
If applicable, once you provide the ostomy nurse with your treaty Food Guide”.
number, we can provide you with a prescription for ostomy
supplies. Introduce foods that may cause gas or odor one at a time.
Give problem foods a second chance before taking them out
Disability Tax Credit of your diet.
Individuals with a permanent ostomy may be eligible for a Eat regular meals. Small frequent meals are usually tolerated
disability tax credit. Inquire with your financial advisor or best. Skipping meals causes the bowel to produce more gas.
Revenue Canada.
Eat slowly and chew your food well.
https://www.ostomycanada.ca/dtc
Drink 8 to 10 glasses of caffeine free liquid per day.
20 9Food Tips for Individuals with a Colostomy Follow up Appointments
Foods That May Cause Gas Routine outpatient clinic check ups with an ostomy nurse are
Dried peas Lentils Broccoli
recommended after discharge from the hospital as follows:
Brussel sprouts Cabbage Turnips
2 week appointment _________________________
Cauliflower Eggs Melon 2 to 3 months
Cucumber Peppers Onions 1 year
Chives Pickles Sauerkraut
Please call Ostomy & Wound Care at 306-766-2271 to make an
Beer Chewing gum Carbonated beverages
appointment. Appointments are necessary.
Alcohol Fried foods Prunes and raisins
Radishes Strong cheeses Beans Ostomy & Wound Care is located on Level 0 (basement) of the
Pasqua Hospital.
Foods that May Cause Odor
Office hours: Monday to Friday 8:00 a.m. to 4:00 p.m.
Dried peas Beans Some spices
Fish & seafood Garlic Some medications
Please bring the supplies necessary to change your pouch to the
appointment. There is no need to change your pouch before.
Asparagus Turnip Some vitamin
preparations
Lentils Onions
Donations
Strong cheeses Eggs
Donations of unused ostomy products are gratefully accepted for
(Roquefort)
distribution to third world charities. Donations can be dropped
off at Ostomy & Wound Care at the Pasqua Hospital.
Foods that May Help Control Gas and Odor
Fresh parsley Yogurt Buttermilk
10 19Supplies You Need to Purchase Skin Care
Type of Ostomy: The skin around your stoma (or peristomal skin) should look
like the rest of the skin on your abdomen.
_____________________________________________________
After surgery the stoma and your abdomen are swollen. As
Supplies and order numbers: you heal your stoma gets smaller. The opening in the wafer
should be cut smaller to reflect the decrease in the stoma
_____________________________________________________ size. About 1/8” of skin should show between the stoma and
edge of the opening on the wafer.
______________________________________________________ The stoma and peristomal skin are cleansed with warm tap
water every time the pouching appliance is changed.
______________________________________________________
If necessary, an adhesive remover can be used to remove
______________________________________________________ any adhesive residue from your skin. After using adhesive
remover, the skin needs to be cleansed again, to ensure the
______________________________________________________ new wafer adheres to your skin.
Skin irritation, such as a rash, an open sore, blistering or
______________________________________________________ redness may occur anywhere that the pouching appliance or
stool comes in contact with your skin. The cause of the skin
______________________________________________________ irritation must be identified before the irritation can be
treated. Common causes are:
______________________________________________________ leakage of stool on the exposed skin
perspiration
______________________________________________________ allergic reaction or sensitivity to product.
______________________________________________________ If your skin is moist or irritated, a small amount of ostomy
powder may be applied. Wipe off the excess powder. The
______________________________________________________ powder absorbs moisture to make a dry surface for your
next pouching appliance.
_____________________________________________________
Wet or weeping skin can prevent a pouching appliance from
_____________________________________________________ adhering to the skin. If your skin is irritated and weeping, you
may need to change your pouching appliance more often.
_____________________________________________________ Contact your ostomy nurse if the irritation does not resolve
or if you have questions.
18 11Intimacy 7. Set the wafer and pouch aside.
Following surgery, it is normal to have concerns about your 8. Remove your old appliance. Place in garbage bag.
altered body appearance. People may have concerns about
the effect the ostomy may have on sexual relationships. 9. Wash the stoma and surrounding skin with warm water. Pat
the skin dry.
Concerns should be discussed with your partner, surgeon,
family doctor and/or ostomy nurse. Open discussion with your 10. If the skin around your stoma is irritated, apply a small
partner will help you understand each other’s feelings and amount of ostomy powder. Dust off excess powder.
help in your adjustment.
Sexual relations may be resumed when approved by your 11. Centre the prepared wafer over the stoma and gently press
surgeon and when you feel physically and emotionally ready. onto your skin. Rub your finger over the barrier adhesive
It takes time to adjust to the changes in your body. close to the stoma to ensure barrier adhesive seals to the
skin.
If the rectum has been removed, depending upon the reason,
there may be some degree of sexual impairment due to 12. If your wafer has tape, remove the paper from the tape
possible nerve damage in the perineal area. This damage, if border. Smooth the tape onto your skin.
present, may be temporary or permanent. Discuss concerns
you may have with your surgeon. 13. To attach the pouch, line up the flange rings of the wafer to
the pouch. Slip your fingers under the flange ring on the
The following suggestions may help when you are involved in wafer to pinch and snap the two together.
an intimate relationship:
Empty your pouch prior to sexual activity. 14. Place your hand over the wafer for 2 minutes, to warm the
barrier adhesive. The adhesive becomes stickier as it warms
Wear a smaller “mini” pouch or fold and tape your pouch. to your body temperature.
Cover the pouch with a pouch cover, cummerbund, fancy
lingerie or crotch less panties. 15. If used, add an ostomy belt to snug up your appliance. This
helps the barrier adhesive adhere to your skin.
Try different positions that are comfortable for you and
your partner. 16. Wash your hands with soap and water.
Ongoing concerns should be discussed with your family doctor
or surgeon. A discussion with a professional specializing in
sexual counselling may be of benefit. Your family doctor or
surgeon can refer you, if you wish.
Resource courtesy of: https://nswoc.ca/colostomy-guide/
12 17Changing a Two Piece Colostomy Appliance Ostomy Canada Society
Change the pouching appliance 1 to 2 times per week or when This nonprofit, volunteer organization helps people who have or
any leakage occurs. DO NOT wait. expect to have a fecal or urinary diversion. These members have
personal experience living with an ostomy.
1. Gather the following supplies:
soft wash cloth to clean your skin The Regina & District Ostomy Society hold meetings on the second
warm tap water Tuesday of every month at 7:00 p.m. except during January, July
wafer (taken out of package) and pouch and August.
pattern, pen, and scissors
ostomy paste, strip or ring Meetings are held at Community of Christ Church Hall, 4710 8th
ostomy powder Avenue (corner of Arthur and 8th). New members are welcome.
garbage bag
The group talks about common issues, exchanges ideas, helps to
2. For cut-to-fit appliance only: support each other, and facilitates group discussions and
educational sessions.
Using the pattern, trace the stoma opening on the back of
the wafer (body side). A newsletter is published. Included in the annual membership fee
is a subscription to Ostomy Canada magazine.
Cut out the stoma opening using scissors. Smooth the edge
of the hole with your finger. The Regina & District Ostomy Society Visitor Program is available
to anyone who may require ostomy surgery or has a new ostomy.
3. Remove the backing from the barrier adhesive. These visitors have taken extra training to provide information
and support focused on day to day life with an ostomy.
4. If used, apply paste, strip or ring around the hole opening
Websites:
onto the barrier adhesive.
http://www.ostomycanada.ca/
5. If your wafer has tape, fold back the edges of the paper
covering the tape border to allow easier removal, once the http://www.reginaostomy.ca/
wafer is on your body.
6. Close the bottom of the pouch:
Fold the tail up 3 times. Press firmly along the entire
length of the Velcro strip until you feel them seal
together. Tuck the tail of the pouch into the pocket.
16 13Changing a One Piece Colostomy Appliance 6. Close the bottom of the pouch:
Change the pouching appliance 1 to 2 times per week or when Fold the tail up 3 times. Press firmly along the entire
any leakage occurs. DO NOT wait. length of the Velcro strip until you feel them seal
together. Tuck the tail of the pouch into the pocket.
1. Gather the following supplies:
soft wash cloth to clean your skin 7. Set the appliance aside.
warm tap water
pouching appliance 8. Remove your old appliance. Place in garbage bag.
pattern, pen, and scissors
ostomy paste, strip or ring 9. Wash the stoma and surrounding skin with warm water. Pat
ostomy powder the skin dry.
garbage bag
10. If the skin around your stoma is irritated, apply a small
2. For cut-to-fit appliance only: amount of ostomy powder. Dust off the excess powder.
Using the pattern, trace the stoma opening on the back 11. Centre the prepared appliance over the stoma and gently
(body side) of the pouching appliance. press onto your skin. Rub your finger over the barrier
adhesive close to the stoma to ensure barrier adhesive seals
Cut out the stoma opening using scissors. Smooth the edge to the skin.
of the hole with your finger.
12. If your appliance has tape, remove the paper from the tape
3. Remove the backing from the barrier adhesive. border. Smooth the tape onto your skin.
4. If used, apply paste, strip or ring around the hole opening 13. Place your hand over the appliance for 2 minutes, to warm
onto the barrier adhesive. the barrier adhesive. The adhesive becomes stickier as it
warms to your body temperature.
5. If your appliance has tape, fold back the edges of the paper
covering the tape border to allow easier removal, once the 14. If used, add an ostomy belt to snug up your appliance. This
appliance is on your body. helps the barrier adhesive adhere to your skin.
15. Wash your hands with soap and water.
14 15You can also read
