When your doctor tells you or someone in your family that you will need to use a colostomy bag, you may feel a little scared and anxious. It's normal to have questions like, "How will I cope with this?", "What will other people think?", "Will I never be able to live like I used to?" But don't worry. This isn't as difficult or life-changing as you might think. If you're properly informed, you can live your life normally with this. Let's talk about everything in a simple and clear way.
First of all, what is a colostomy bag?
Simply put, this is a special bag that helps you pass waste, or stool, from your body after surgery. Normally, we pass stool through the anus. However, due to certain medical conditions (such as colon cancer) or when part of the colon is severely damaged, doctors perform a surgery called a colostomy .
What happens here is that the end of your colon is taken out from under the skin of your abdomen and a small opening is created. This pink, round opening is called a stoma . Your stool now comes out of this stoma. But unlike our rectum, this stoma does not have muscles or nerves to control the stool. So we cannot control when we want to pass stool. That is why this colostomy bag is attached over the stoma to collect the stool that comes out automatically.
Some people have to use this bag temporarily, that is, until their intestines heal. Others have to use it for the rest of their lives. Whatever the reason, after a while, most people get used to it and adjust to their normal lives again.
Difference between Colostomy Bag and Ostomy Bag
You may have also heard of an "ostomy bag." What's the difference between the two?
Ostomy is a general term for any opening that is surgically created to allow waste to pass out of the body. This opening is called a stoma. So, any bag that a person with an ostomy uses to collect waste is an "ostomy bag."
A colostomy is a type of ostomy surgery. This means that every colostomy bag is an ostomy bag, but not every ostomy bag is a colostomy bag.
This will become clearer to you when you look at the table below.
| Ostomy Type | Where is the stoma made? | What comes in the bag? |
|---|---|---|
| Colostomy | Large Intestine | Stool |
| Ileostomy | Small Intestine - Ileum | Stool (usually loose) |
| Urostomy | Urinary System | Urine |
There are several types of colostomy bags.
There is no one size fits all bag. There are different types to choose from depending on your needs and lifestyle.
- One-piece system: This system has both the bag and the skin-attaching part in one. When changing the bag, you have to completely remove it and put on a new one. These are very easy to use.
- Two-piece system: This consists of two parts: a base plate/wafer that attaches to the skin and a bag that attaches to it. The bag can be changed as needed, and the base plate should be changed every two to three days.
- Closed bags: These are best if your stool is thick. When the bag is full, you just remove it and put a new one in. You should change it about twice a day.
- Drainable bags: These are best if your stool is watery. You can empty the waste through a hole in the bottom of the bag, close it again, and reuse it. You only need to change the entire bag every two to three days.
- Mini pouches: These are very small bags that can be used for short periods of time, such as when swimming or exercising.
Don't worry, your doctor or a Stoma Care Nurse will help you choose the bag that best suits you.
How do you live a normal life with a bag?
This is the biggest problem that many people have. Although it may feel a little strange at first, these tips will help you.
Will you tell others about this?
Talking to your closest friends, family, and best friends can help ease the burden on your mind. It's also a good idea to talk to someone you trust at work, as you may need help.
Can you see the bag outside? Can you hear a sound?
This is something that many people think is unnecessary. Ask someone you trust to check if the bag is visible under your clothes. A properly fitted bag will not be visible under clothes. Emptying the bag when it is one-third (1/3) full will make it less visible and less likely to leak. Sometimes there may be a small noise when the air comes out of the stoma, which is normal.
Can I wear whatever clothes I want?
It's definitely possible! You can make the bag invisible under your regular clothes. Loose clothing that doesn't put pressure on the bag will be more comfortable for you in the beginning. Now there are special underwear and even swimsuits made just for this.
Will it affect sex life?
It's normal to feel a little uncomfortable and embarrassed at first. But don't let this get in the way of your sex life. Empty and clean your pouch before having sex. If necessary, talk to your doctor about a small stoma cap that you can use only during sex.
Can you exercise?
Yes. You can do anything from light exercise to very vigorous activity. However, if you are doing any exercise that puts pressure on your stomach, such as lifting weights, ask your doctor about a special support garment or stoma guard to protect your stoma.
Things to be careful about when eating and drinking
Yes, by being a little careful about what you eat, you can greatly reduce discomforts like gas, bloating, and diarrhea .
| Situation | Foods to Avoid or Limit |
|---|---|
| The first few weeks after surgery | |
| In the early stages (eat easily digestible foods) | High-fat dairy foods (skimmed milk, ice cream), high-fiber foods (beans, raw vegetables, fruits), fatty meats, carbonated drinks, alcohol. |
| Foods that cause odor | |
| If there is a problem with odor when emptying the bag | Alcohol, asparagus, beans, broccoli, cabbage, eggs, fish, garlic, onions. |
| Foods that cause gas (air) | |
| If you have a problem with bloating | Aged cheese, beans, beer, cabbage, carbonated drinks, coffee, onions, raw fruit, spinach. |
The most important thing is to try new foods at home, one by one. Then you will know for yourself whether the food is good for your body or not.
How to change a colostomy bag
A nurse at the hospital will show you exactly how to do this, but remember these basic steps.
1. If you need to empty the bag you used, put the waste in it in the toilet.
2. Wash your hands thoroughly with soap and dry them with a clean towel.
3. While gently pushing the skin around the stoma back with one hand, gently pull the pouch away from the skin with the other hand. Never pull forcefully.
4. Place the removed bag in a plastic bag and tie it shut.
5. Clean the skin around the stoma with warm water and a soft cloth or wipes. Then let it dry thoroughly.
6. If necessary, measure the size of the stoma and cut the wafer of the new pouch to that exact size. Alternatively, you can use a pre-cut pouch.
7. Place the opening of the new bag exactly over the stoma and press gently for about 45 seconds to ensure it adheres well to the skin.
8. If you are using a resealable bag, close the bottom of it tightly with a clamp.
9. Put the bag containing the waste in the trash can and wash your hands thoroughly again.
Take-Home Message
- It's normal to feel scared when you first hear about a colostomy bag. But it's something that can improve your quality of life and be manageable.
- Talk to your doctor or stoma care nurse to choose the type of bag that is best for you.
- Keep the stoma and the skin around it clean and dry. If you notice any redness, itching, or pain, tell your doctor right away.
- By being mindful of your diet, you can control discomforts like gas and bloating.
- Don't be shy about talking openly with your doctor about any physical or mental problems you may have in this regard.
- Over time, this will become a part of your daily life. Give yourself some time for it.
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