ILCO Udruženje pacijenata Srbije sa ILEOSTOMOM, KOLOSTOMOM I UROSTOMOM

ILESTOMA

The word Ileostoma derives from the Greek word "ileum" (final part of the small intestine) and "stoma" meaning opening.
Ileostoma is a surgical bringing of the healthy part of small intestine to the surface of the stomach where it is being fixed and where it forms an opening for elimination of the contents of the intestine.
Ileostoma can be divided into:
Temporary - lasting only a couple of months
Permanent - where the patient lives with it all his/her life. There are reported cases of patients with temporary stoma where the patient opts for permanents stoma, since he/she refuses another surgery.
Stoma is usually done on the right side of the body, even though, exceptions are not rare. It is according to surgeon's opinion that stoma is done on one side or the other.
The content as a result of bowel movement that is expelled into the bag is liquid and obviously quite aggressive. A patient can have several bowel movements a day.
We can say from our experience that there is no singular pattern as far as regime of Ileostoma is concerned, i.e. each patient is a case for himself.
Some patients do not have any difficulties in eating beans, cabbage or garlic, whereas others experience a sense of bloating and therefore eat less or no abovementioned food at all.
It is paramount to take 2-3 liters of liquid a day.
Very often patients loose a great deal of electrolytes (calcium and other minerals), so they have to make sure the intake of those minerals is a proper one.
Stoma patients need to increase their intake of salt, from normal 9mg up to 12-15 mg. We do not suggest diet with a small amount of salts.
Constipation can be caused by:
Incorrect intake of liquids, salts, food being cut into large pieces and not chewed properly, stress, tiredness, etc.

KOLOSTOMA

The word Kolostoma derives from two Greek words; "kolon" meaning large intestine, and "stoma" meaning opening. We talk about kolostoma when the open side of the large intestine is brought to the stomach surface and gets fixed there in order to form an opening to enable faecal matter to evacuate.
Kolostoma can be divided into:
Temporary - lasting only a couple of months
Permanent - where the patient lives with it all his/her life. There are reported cases of patients with temporary stoma where the patient opts for permanents stoma, since "he/she got already used to the stoma bag" and he/she refuses another surgery.
Kolostoma is usually done on the LEFT SIDE of the stomach; exceptions are possible according to surgeon's opinion.
As there are no muscles and nerves left, we are not able to control our bowel movements.
If stoma was performed on the left side, most of the intestinal tract works properly and patients have one bowel movement per day.
If Kolostoma was performed on the RIGHT SIDE of the stomach faecal matter becomes liquid and the patient has frequent bowel movements during the day.
Right after the surgery the very first bowel movement results in soft and liquid faecal matter, therefore it is always suggested to the patients to eat bran cereals because they absorb the liquid and the faeces
become more solid. One should not exaggerate with cereals, 2 spoons once or twice a day, together with yoghurt or juice are enough. Too many cereals can bloat, cause gases, cramps and causing more frequent emptying of the stoma.

Beer causes intestine to work and excrete faster and therefore the faecal matter becomes more liquid.
To avoid this, you should take a spoonful or two of bran cereals before having a beer.

Unpleasant odours and gasses can be minimized or eliminated with yoghurt or buttermilk.

Analgesics slow the work of intestines down and can cause constipation. You can get rid of this problem by increasing the intake of fruit and vegetables, bran cereals, and if you do not succeed, you should consult your doctor.

UROSTOMA

Derives from two Greek words "Urin" and "Stoma" - opening.
We talk about it when the necessity arises to move the flow of the urine from the bladder in a different way.
A new opening - stoma is made of a part of the small intestine or of the urethra that was brought to the stomach surface.
Patients with urostoma are the one with most disadvantages, since they have no interruptions in urinating. Urine comes spontaneously out in drops, sometimes in a flow, so that the patients need to go frequently to the toilette and change the stoma bag.
Very often, urostoma patients are confronted with bacteria and urinary infections, therefore they need to make urine analysis more often. In order to defeat urinary infections, they need to take at least 2-3 l of liquids a day, so the quantity of urine from the body is about 1600 - 1800 ml. Once you notice that your urine is denser than usual, you need to increase intake of the liquids, especially teas, such as parsley, hibiscus.
You also need to take regularly potatoes, fruits, to drink fruit juices rich in vitamin C (500 - 1000 mg) a day, as well as consulting your GP.
Urine causes skin irritations, infections of urinary tract and building of crystals around stoma opening.
If you already have crystals around the stoma opening, you can remove them with a piece of surgical gauze dipped into a glass filled with water where you have diluted a spoon of vinegar.
Urine has unpleasant smell especially if you eat carrots, fish, spices, but you can get rid of it by drinking plenty of yogurts, milk, and blackcurrant juice.
Our advice - do not forget to ask your GP to give you a card which allows you precedence in a waiting room.
Our patient with urostoma for more than 5 years is willing to give you further advices and information,
Mr. Milan Malenica, technician, ph. 011/161729, cell. 064/433688

HYGIENE

You can take shower several times a day. Disc would not come off. After taking shower dry the disc with a towel properly and dry it further with a hairdryer. You might use a new bag.
You need to replace the bag in following situation:
It has come off or you have a rush below the disc (that means that the disc has lost its property, the one of sticking and nourishing). TAKE THE DISC OFF and take a shower without it.
Your disc should usually last for about 3 or more days. In changing the disc you have to clean the skin around the stoma and the stoma itself with mild baby soap and warm water. NEVER USE ALCOL OR SPIRITS., since these can dry the skin and damage it. Rinse the soap water and dry properly. Put gauze on the stoma or a piece of toilet paper, so that eventual urine and feaces does not come out. As you are aware stoma has no muscles and nerves and therefore we can not control urine or feaces. If the skin around stoma becomes irritated (red) - you need to put a special ointment for irritated skin around stoma (bare in mind that every program has its own ointment). Do not use baby cream by Dr. Pavlovic, St.John's worth oil, (hypericum preforatum), soft wet tissues because they might influence adhesiveness of the disc. Put the ointment around stoma and leave it for 20 minutes. Remove the residue of the ointment with a dry cloth, gauze or toilet paper. The ring around stoma has to be a few millimeters wider than stoma itself. In case your skin has scars or uneven surfaces or the stoma is at the same level with the stomach, there is an ointment, sticks (available in each program) that are put with wet finger, left for a minute and eventually you place the disc on the skin.
Our experience tells us that patients have been using the same size of aids as they had right after the surgery, but the truth is that stoma does get smaller with the time.
Since stoma hasn't got any muscles or nerves, she is swollen after the surgery, but this again calms with the time. We suggest the use of smaller size - and do ask your surgeon when you go for your check up.

FOOD HABITS

Right after the surgery you need several weeks before your intestine starts working properly, even though each case is a different one. Cramps and pain in abdominal area will eventually cease.
Once you change your body weight, your stoma changes with it, so it is advisable to keep the constant body weight. If you prefer loosing weight, do it slowly.
You should not loose more than a kg per week, since you have to allow your skin, your subcutaneous tissue, as well as stoma to adapt to the new body mass.
After the surgery you should eat more frequently and the sizes of food portions should be smaller.
If you want to encourage your bowel movements in the morning, one of the best thing is to drink large
quantity of tea IN THE MORNING (preferably with some honey)
This habit enables the activation of the stoma and you are then able to change your bag. Some patients do not require further changing of the bag until the evening. (kolostoma). Stoma's activity decreases after emptying the contents.
We advise you to drink a lot of liquid, 2,5 - 3 liters a day, eat plenty of boiled vegetables, boiled chicken meat, veal, fish. You can adopt macrobiotics. To maintain good metabolism you should eat FRUITS IN THE MORNING. Peel the skin or consume tinned fruit. Drink yoghurt. We suggest taking alcohol in very small quantities.
AVOID:
- soft drinks and black tea
- smoked meat, sausages
- all kinds of beans (beans, peas, cabbage, cauliflower, cucmber)
- if you really have or want to, do it in very small quantities
Our tips:
Against CONSTIPATION - if you have consumed nuts, corn, pop-corn, sour cabbage, smoked meet - put some dry plums into a glass of water in the evening. Drink the water in the morning and eat the plums.
If your STOMA HAS BECOME LARGER - you must have eaten something that had caused it, so the stoma has swollen and you have irritating feeling around the opening.
Drink a cup of warm milk or mint tea and relax.
DO NOT SMOKE - in any circumstances, especially on empty stomach, as cigarettes smoked on empty stomach cause diarrhea.
To avoid gases and unpleasant odours, drink yoghurt or buttermilk




				ILESTOMA The word Ileostoma derives from the Greek word "ileum" (final part of the small intestine) and "stoma" meaning opening. Ileostoma is a surgical bringing of the healthy part of small intestine to the surface of the stomach where it is being fixed and where it forms an opening for elimination of the contents of the intestine. Ileostoma can be divided into: Temporary - lasting only a couple of months Permanent - where the patient lives with it all his/her life. There are reported cases of patients with temporary stoma where the patient opts for permanents stoma, since he/she refuses another surgery. Stoma is usually done on the right side of the body, even though, exceptions are not rare. It is according to surgeon's opinion that stoma is done on one side or the other. The content as a result of bowel movement that is expelled into the bag is liquid and obviously quite aggressive. A patient can have several bowel movements a day. We can say from our experience that there is no singular pattern as far as regime of Ileostoma is concerned, i.e. each patient is a case for himself. Some patients do not have any difficulties in eating beans, cabbage or garlic, whereas others experience a sense of bloating and therefore eat less or no abovementioned food at all. It is paramount to take 2-3 liters of liquid a day. Very often patients loose a great deal of electrolytes (calcium and other minerals), so they have to make sure the intake of those minerals is a proper one. Stoma patients need to increase their intake of salt, from normal 9mg up to 12-15 mg. We do not suggest diet with a small amount of salts. Constipation can be caused by: Incorrect intake of liquids, salts, food being cut into large pieces and not chewed properly, stress, tiredness, etc. KOLOSTOMA The word Kolostoma derives from two Greek words; "kolon" meaning large intestine, and "stoma" meaning opening. We talk about kolostoma when the open side of the large intestine is brought to the stomach surface and gets fixed there in order to form an opening to enable faecal matter to evacuate. Kolostoma can be divided into: Temporary - lasting only a couple of months Permanent - where the patient lives with it all his/her life. There are reported cases of patients with temporary stoma where the patient opts for permanents stoma, since "he/she got already used to the stoma bag" and he/she refuses another surgery. Kolostoma is usually done on the LEFT SIDE of the stomach; exceptions are possible according to surgeon's opinion. As there are no muscles and nerves left, we are not able to control our bowel movements. If stoma was performed on the left side, most of the intestinal tract works properly and patients have one bowel movement per day. If Kolostoma was performed on the RIGHT SIDE of the stomach faecal matter becomes liquid and the patient has frequent bowel movements during the day. Right after the surgery the very first bowel movement results in soft and liquid faecal matter, therefore it is always suggested to the patients to eat bran cereals because they absorb the liquid and the faeces become more solid. One should not exaggerate with cereals, 2 spoons once or twice a day, together with yoghurt or juice are enough. Too many cereals can bloat, cause gases, cramps and causing more frequent emptying of the stoma. Beer causes intestine to work and excrete faster and therefore the faecal matter becomes more liquid. To avoid this, you should take a spoonful or two of bran cereals before having a beer. Unpleasant odours and gasses can be minimized or eliminated with yoghurt or buttermilk. Analgesics slow the work of intestines down and can cause constipation. You can get rid of this problem by increasing the intake of fruit and vegetables, bran cereals, and if you do not succeed, you should consult your doctor. UROSTOMA Derives from two Greek words "Urin" and "Stoma" - opening. We talk about it when the necessity arises to move the flow of the urine from the bladder in a different way. A new opening - stoma is made of a part of the small intestine or of the urethra that was brought to the stomach surface. Patients with urostoma are the one with most disadvantages, since they have no interruptions in urinating. Urine comes spontaneously out in drops, sometimes in a flow, so that the patients need to go frequently to the toilette and change the stoma bag. Very often, urostoma patients are confronted with bacteria and urinary infections, therefore they need to make urine analysis more often. In order to defeat urinary infections, they need to take at least 2-3 l of liquids a day, so the quantity of urine from the body is about 1600 - 1800 ml. Once you notice that your urine is denser than usual, you need to increase intake of the liquids, especially teas, such as parsley, hibiscus. You also need to take regularly potatoes, fruits, to drink fruit juices rich in vitamin C (500 - 1000 mg) a day, as well as consulting your GP. Urine causes skin irritations, infections of urinary tract and building of crystals around stoma opening. If you already have crystals around the stoma opening, you can remove them with a piece of surgical gauze dipped into a glass filled with water where you have diluted a spoon of vinegar. Urine has unpleasant smell especially if you eat carrots, fish, spices, but you can get rid of it by drinking plenty of yogurts, milk, and blackcurrant juice. Our advice - do not forget to ask your GP to give you a card which allows you precedence in a waiting room. Our patient with urostoma for more than 5 years is willing to give you further advices and information, Mr. Milan Malenica, technician, ph. 011/161729, cell. 064/433688 HYGIENE You can take shower several times a day. Disc would not come off. After taking shower dry the disc with a towel properly and dry it further with a hairdryer. You might use a new bag. You need to replace the bag in following situation: It has come off or you have a rush below the disc (that means that the disc has lost its property, the one of sticking and nourishing). TAKE THE DISC OFF and take a shower without it. Your disc should usually last for about 3 or more days. In changing the disc you have to clean the skin around the stoma and the stoma itself with mild baby soap and warm water. NEVER USE ALCOL OR SPIRITS., since these can dry the skin and damage it. Rinse the soap water and dry properly. Put gauze on the stoma or a piece of toilet paper, so that eventual urine and feaces does not come out. As you are aware stoma has no muscles and nerves and therefore we can not control urine or feaces. If the skin around stoma becomes irritated (red) - you need to put a special ointment for irritated skin around stoma (bare in mind that every program has its own ointment). Do not use baby cream by Dr. Pavlovic, St.John's worth oil, (hypericum preforatum), soft wet tissues because they might influence adhesiveness of the disc. Put the ointment around stoma and leave it for 20 minutes. Remove the residue of the ointment with a dry cloth, gauze or toilet paper. The ring around stoma has to be a few millimeters wider than stoma itself. In case your skin has scars or uneven surfaces or the stoma is at the same level with the stomach, there is an ointment, sticks (available in each program) that are put with wet finger, left for a minute and eventually you place the disc on the skin. Our experience tells us that patients have been using the same size of aids as they had right after the surgery, but the truth is that stoma does get smaller with the time. Since stoma hasn't got any muscles or nerves, she is swollen after the surgery, but this again calms with the time. We suggest the use of smaller size - and do ask your surgeon when you go for your check up. FOOD HABITS Right after the surgery you need several weeks before your intestine starts working properly, even though each case is a different one. Cramps and pain in abdominal area will eventually cease. Once you change your body weight, your stoma changes with it, so it is advisable to keep the constant body weight. If you prefer loosing weight, do it slowly. You should not loose more than a kg per week, since you have to allow your skin, your subcutaneous tissue, as well as stoma to adapt to the new body mass. After the surgery you should eat more frequently and the sizes of food portions should be smaller. If you want to encourage your bowel movements in the morning, one of the best thing is to drink large quantity of tea IN THE MORNING (preferably with some honey) This habit enables the activation of the stoma and you are then able to change your bag. Some patients do not require further changing of the bag until the evening. (kolostoma). Stoma's activity decreases after emptying the contents. We advise you to drink a lot of liquid, 2,5 - 3 liters a day, eat plenty of boiled vegetables, boiled chicken meat, veal, fish. You can adopt macrobiotics. To maintain good metabolism you should eat FRUITS IN THE MORNING. Peel the skin or consume tinned fruit. Drink yoghurt. We suggest taking alcohol in very small quantities. AVOID: - soft drinks and black tea - smoked meat, sausages - all kinds of beans (beans, peas, cabbage, cauliflower, cucmber) - if you really have or want to, do it in very small quantities Our tips: Against CONSTIPATION - if you have consumed nuts, corn, pop-corn, sour cabbage, smoked meet - put some dry plums into a glass of water in the evening. Drink the water in the morning and eat the plums. If your STOMA HAS BECOME LARGER - you must have eaten something that had caused it, so the stoma has swollen and you have irritating feeling around the opening. Drink a cup of warm milk or mint tea and relax. DO NOT SMOKE - in any circumstances, especially on empty stomach, as cigarettes smoked on empty stomach cause diarrhea. To avoid gases and unpleasant odours, drink yoghurt or buttermilk