A Little Ostomy Test

1. Your appliance has been on for 2 days and you experience a burning, uncomfortable sensation around your stoma. You:
   1. Ignore it. It seems to come and go anyway.
   2. Wait until the designated day to change your appliance.
   3. Take a cool bath.
   4. Change your appliance immediately.

The answer is d. Ideally, your appliance may stay on for five to seven days. However, if you experience burning or itchiness around the stoma, discomfort or pain around the stoma or discoloration of the adhesive, change your appliance regardless of the day. These signs usually indicate leakage. Stool or urine on the skin is very irritating. In addition, itching or irritation under the pouch can be due to dehydration. If you are pretty sure the appliance is not leaking and there is nothing externally wrong with it, try drinking a few glasses of water instead of removing the appliance. Don't be a hero. When it bothers you, change.

2. When you remove your appliance, you notice the skin around the stoma is reddened. To treat it, you:
   1. Apply cool compresses for a short period of time before reapplying your appliance.
   2. Apply a protective powder such as Stomahesive or Karaya to reddened skin areas, remove any excess, and continue with reapplying your appliance.
   3. Apply a soothing cream or ointment to the reddened skin areas.
   4. Use an alcohol wipe on your peristomal skin.

The answer is b. It is important to observe the skin around the stoma. Use a mirror to help observe the skin and stoma. If the skin appears reddened, irritated or weepy, you may require a protective powder. You may need to change your appliance every two or three days until the skin heals. While creams and ointments may be a reasonable solution for skin irritation in other areas of your body, they may not be useful around your stoma because your appliance will not adhere to moist or oily skin. Cool compresses may be soothing but cannot heal the skin. Alcohol will dry the skin which may cause it to itch. As an added note, hair growth around the stoma can be quite painful when removing the appliance. Remove excess hair with an electric razor or scissors. A straight edged or safety razor should not be used because of the risk of irritation to the skin and cutting the stoma. Ostomy adhesive removers may help reduce hair pulling when removing the pouch.

3. Your neighbors invite you to a pool party. You:
   1. Decline the invitation since you cannot swim with an ostomy.
   2. Limit your fluid and food intake for 12 hours prior to the party so your stoma is not active.
   3. Accept the invitation.
   4. Go in the pool and then worry that your prosthesis will probably leak.

The answer is c. If you enjoyed swimming before the operation, continue to swim after. For extra security while swimming, you may want to picture-frame the adhesive part of your appliance with paper or waterproof tape or apply a skin sealant, for example - Sween prep, directly over the adhesive. Printed rather than solid colored bathing suits help to camouflage the outline of the appliance. Some women prefer bathing suits with skirts and some men prefer boxer-style trunks, but snug fitting suits may be worn. A lightweight panty girdle may be worn to hold the appliance firmly in place. If you have an ileostomy, limiting food and drink will not stop your ostomy from functioning. When the stomach is empty, the discharge is liquid, highly acidic and gassy. Skipping meals or limiting fluid intake leads to dehydration and/or electrolyte imbalance.