2010 has been an amazing year for Ostomy Guide! Our little fledgling blog has grown tremendously and we’ve had the thanks and blessings of many ostomates who were seeking for more resources, support, and community online. We look forward to 2011 and all of the exciting things it will bring.
But for now, I’d like to sum up the year with the year’s most popular Ostomy Guide content:
Number 1 Topic: Traveling
In 2010, we saw many reactions, concerns, and changes in how airport security handles…well, us. This has been by far the most popular topic of the year, as these security policy changes have changed the way all of us perceive air travel; changes that affect those with medical needs the most, including ostomy. Here is some travel-related content on Ostomy Guide:
Number 3: Ostomy News of 2010
There was a lot of news about Ostomy this year. Below are some of the most interesting tidbits:
Number 4: Product Catalogs
This year, we added online catalogs for Hollister, ConvaTec, and Coloplast to first help individuals locate the right supplies in the wide spectrum of Ostomy products, and secondly to help identify their compatibility, product codes, and HCPCS numbers. Since we don’t list prices or sell items on Ostomy Guide, we’ve linked relevant products to the Ostomy Guide sponsor, STL Medical Supply, so you can get more detailed descriptions, prices, and product reviews from individuals who have used them. Here are links to each of these product guides:
Hope you enjoyed this roundup…and…
What is a Hernia?
A hernia is when there is a rip/tear in muscle tissue that causes a portion of the abdomen (particularly, the intestine) to bulge through. This causes pain when standing up, moving the abdomen, or any kind of tension on the abdomen including coughing, sneezing, laughing, bending over, picking up objects, etc.
What is a parastomal hernia?
Having a stoma can develop into an ostomy specific type of hernia called a parastomal hernia. Since a Stoma passes through the abdomen, it can compromise the strength of the muscular abdomen wall. These weakened muscles can come away from the stoma, weakening its integrity and causing the intestine to bulge.
A stoma hernia is typically not painful, but can be very uncomfortable and unnerving, not to mention more difficult to mange and care for. As the stoma grows, it can become more difficult to attach ostomy wafers and pouches. It can also eventually lead to intestinal twisting/kinking that can cause serious damage to the intestine by cutting off blood vessels. (This, of course, requires immediate medical attention as being left untreated can be very dangerous.)
What Causes Parastomal Hernia?
Coughing, sneezing, heavy lifting and being overweight all put pressure on the abdominal wall & a stoma. Over time, muscles can weaken to the point a stoma begins to protrude and push out due to the pressure of the guts behind it.
There are many possible origins for parastomal hernia to develop. Some are related to surgery and a poorly placed stoma or a developing infection around the border. Other causes are related to an individuals health, such as being overweight, heavy lifting, or any kind of physical strain, or a combination of these factors.
How common is parastomal hernia?
In the 1990′s, the United Ostomy Association found that a hernia is one of the most common complications for Ostomy patients. Ostomy hernias happen to about 30% of all stomas. It’s more common with Colostomy than Ileostomy and Urostomy.
How is Parastomal Hernia treated?
Surgery is the most common repair for any type of large hernia.
Typically, if the hernia is not recurring, doctors will recommend a Hernia Belt and appliance changes before recommending surgery. A hernia belt is designed for individuals with small hernias or those where surgery can be risky or further compromise one’s health. A hernia belt is a firm, wide belt that helps support the stoma and muscle tissue around it externally.
As for surgery, doctor opinions vary based on their preferences for proper care and an individual’s needs. There are two options for the surgeon:
In some cases, Option 1 isn’t applicable; either hernia is too large or the surgery is too risky. And some surgeons will choose to re-locate the stoma first and install mesh if the problem persists.
However, today, often a mesh is implanted instead of stitches. This is the ideal method of repairing a hernia.
A mesh is laid across the herniated muscle tissue, helping to hold the muscle together and increasing its strength & integrity. The mesh also speeds recovery times over other methods and and reinforces the tissue; patients can often be mobile again within a matter of days.
An Ostomy certainly increases the risk of a hernia. Discuss with a doctor and nurses for the facts and tips to manage your individual stoma – even if you do not recognize any pain. As with any hernia, this lessens the chances of developing a more cumbersome and large hernia requiring surgery.
Most folks generally don’t think too much about what/how they eat and how it affects their waste (short of feeling ill or diarrhea). The reasons for this are simple – it’s generally a minor duty or inconvenience in a typical day, just like sleeping or eating or personal hygiene.
When it comes to what foods to eat, one thing is certain: nobody understands how foods affect digestion or how food travels through the body like an Ostomate does.
That’s because for an ostomate, there is no control when a pouch fills with waste and gas without the intelligent management of diet & nutrition. With this in mind, one needs to consider questions about their diet so pouching needs become more predictable and therefore can be handled with optimal health and minimal complications: What makes things move too quickly? What stops things from moving (food blockages)? Are there foods that can’t be digested properly? What causes pouch output to be more liquid or more solid? Which foods create more odors? Which foods produce more gas?
Being able to answer these questions for yourself will make life much easier!
Chew Yer Food – It helps digestion and slows your eating down a bit. It’s a good general diet tip anyway; you’ll know more reliably when you’re full so you don’t overeat and swallow less gas-producing air. Like your mother always aid: Don’t talk with your mouth full. You will also have less likely chances for intestinal blockages around the stoma.
Eat Adequate Portions and Do It Often – Avoid overeating in one sitting and avoid skipping meals, both of these activites can result in producing excess gas.
Stay In Shape – Stay in shape and you’ll avoid a lot of stoma problems. Being overweight puts unnecessary pressure on your guts and your stoma.
Drink Lots of Fluids – Fluid loss is especially common in those who have lost much of their large intestine, so drink lots of water.
Make Scheduled Alterations to Diet – When you find foods you can digest well, test trying different types of foods and adding them to your diet one at a time. This way you’ll notice the changes that particular food can cause. Which leads into the next tip…
Monitor Movement – Keep a log of what you eat and when, and then make a note of the condition of your stoma and pouch output. This way you can start to see patterns and determine the best diets with all the foods you like. If you notice a change in pouch output, try a food several times to be sure its a consistent change and you’ll have a pretty good idea of how it affects you.
Generally it’s accepted that fiber aids digestion, but especially with illeostomy (small intestine), undigested fiberous foods can cause complications and food blockages. So can not checking your food enough. (See the tips above).
Some examples of foods that can cause these blockages are: corn, dried fruit, hotdogs/sausages, pineapple, skins from fruits and vegetables. If you or your child experiences belly cramps, watery stool, a swollen stoma, or nausea it could be a sign of food blockage, consult a nurse and physician.
Ostomy odor is created by bacteria breaking down certain foods, turning it into odorous waste and also sometimes creating odorous gases. This gas, like the stool, also makes it way into a pouch, filling it with air that must be released to prevent pressure from developing a leak, or worse, a pouch blowout.
While some pouches have integrated filters or can have a filter added to them, it is also a good idea to avoid odor-causing and gas-forming foods. Below are some examples of foods that affect most individuals:
Some foods that do cause odors:
Asparagus, coffee, garlic, prunes, beans, cucumbers, green peppers, radishes, brussel sprouts, eggs, milk, turnips, cabbage, fish, onions, vitamins/certain drugs, alcoholic beverages.
Some foods that help decrease odors:
Buttermilk, parsley, yogurt, cranberry juice, spinach.
Some foods that produce more gas:
Apples, soda, dairy products, onions, asparagus, drinking straws & chewing gum (you’ll swallow more air), melons, beans, mushrooms, corn, broccoli, spinach, nuts, cabbage.
One final note about digestive odors: Another product that may help with gas and odors are Devrom Tablets. Taken up to four times daily, they help control the odors of digestive gases with bismuth subgallate. This is, of course, not meant as a replacement to intelligent dieting, but if certain foods you enjoy make you gassy then a couple of Devrom tablets right before you eat should do the trick.
Some foods will also change the consistency of the stool, and depending on the type and adhesion of a skin barrier you’re using, more liquid can harm the adhesion of the barrier and cause it to leak, never a pleasant experience! Here are some examples of foods, take note how they affect you:
Some foods that will thicken pouch output:
Yogurt, bananas, milk (preferably boiled), creamy peanut butter, breads, cheeses, pastas, potatoes, rice.
Some foods that thin pouch output:
Fruits and fruit juices, chocolate, green beans
Sometimes diarrhea happens, which for anyone results in fluid loss and loss of two essential minerals needed for good health: potassium and sodium. Dehydration is always a concern with diarrhea for anyone, and fluid retention can be even more serious for an Ostomy patient. When diarrhea happens, it’s good to get plenty of fluids along with potassium and sodium to stay healthy, so the foods below should be considered:
Some more foods high in potassium:
Milk, Chicken, beef, fish, pork, turkey, lima beans, V8 Juice, apricots, bananas, avocado, tomato juice, potatoes, broccoli, grapefruit juice, oranges and orange juice, watermelon, strawberries.
Foods high in salt:
Salt is definietly not hard to find. Simple table salt will get you sodium, along with most pre-packaged foods, canned soups, and seasonings.
This guide from the University of Pittsburg Medical Center (and the source for some of the data in this article) gives many suggestions on foods that are safe for those with diarrhea and ostomy, along with a beverage recipe to help keep you hydrated and make sure you’re not losing potassium and sodium: http://www.upmc.com/HealthAtoZ/patienteducation/Documents/OstomyNutrition.pdf
Here’s the recipe:
Reading news this week I found an article about Elvis Presley’s health condition before his death. His friend and physician, Dr. George Nichopoulos, wrote a new book called “The King and Dr. Nick” and discusses Elvis’s hereditary bowel paralysis.
Elvis was always believed to die of a heart attack, likely from the buffet of drugs he was taking, but his doctor of 12 years leading up to his death now believes with new research it was actually chronic constipation that killed him in the end, brought on by bowel disease, and even his bloated appearance was because of his bowel condition.
While treatment has probably changed since for Elvis’s death in the 1970′s, bowel paralysis was treated with a colostomy back then. His digestive system was a real mess, according to the autopsy when he died, and it’s unfortunate he was too proud to succumb to a pouch to live (a lot) longer than he did. Because the nature of his illness was rather embarrassing and Elvis was too proud, he didn’t get the surgery.
Even the King of Rock and Roll was not impervious to bowel disease. It can happen to anyone, and when it does, we’re faced with the decision of surgery or illness. So if all the secrets about Elvis are now out of the bag, and people finally agree that he is indeed dead, there is one final lesson we can learn from the King of Rock and Roll: Never be too proud to admit when we’re sick.