No Bowel No Problem!

If you’ve had surgery to remove portions of bowel that are diseased or cancerous or injured, you’re not alone. In this post I will be explaining to those who don’t know or have been wanting to know more about colostomy, ileostomy, and how to support someone with a stoma and that includes getting a massage.

When the bowel is rerouted through a hole in the abdomen it is called a stoma. Through the stoma, bowel movements go through a collection bag (pouch) taped to the abdomen. Now , if you’ve had a colostomy that means your colon has been surgically attached to the wall of your abdomen. If you’ve had an ileostomy, you had a surgery to connect the ileum (small intestine) to the abdominal wall. Stomas may be permanent or temporary. Temporary would be for the purpose of allowing the bowel to heal from injury or infection.

Common Conditions to Necessitate Bowel Rerouting:

• Crohn's disease

• ulcerative colitis

• blocked bowel

• cancer

• familial adenomatous polyposis

• injury

With urostomies (urine is rerouted) you will use a pouch to collect the urine coming from your stoma. The pouching system needs to have a barrier that protects the skin around it from getting irritated and infected. The skin barrier is meant to protect your skin from urine or fecal matter and is usually a stiff sticky material. It truly varies with different systems but in general you will need to cut a hole with scissors before placing it on your abdomen so that the stoma remains uncovered by the barrier. Some systems are pre-cut or pre-sized eliminating this extra step.

Pouching system with stoma

For anyone coming out of surgery they will be going through emotional and physical changes. Not only do they have whatever condition or injury that caused the need for the stoma, they have to figure out how to take care of it. This can be distressing to them, their family or caregivers too. The first few weeks of healing, the stoma will be swollen, red, and possibly causing pain or discomfort. Learning how to change the pouch before it leaks or becomes loose and emptying waste is very important. There are different reasons it may leak or detach. It could be caused by sweating, oily skin, weight change, and physical activity. Digesting food will be a bit different and you would be given a list of foods that may cause diarrhea or gas or mess up the system. There are many accessories available such as an ostomy belt to keep it in place against your skin. Some find certain elastic waisted pants are better than traditional zippers and buttons of jeans and trousers.

These are common goals to keep up with for new stoma patients:

• Maintain a good leak-proof seal that lasts for 3-7 days

• Manage odor

• Protect the skin around the stoma

• Be nearly invisible under clothing

• Be easy to put on and take off

• Learn how to shower or bathe with the pouch on and dress and undress

• Maintain clean environment when using the pouch system

You'll need time to heal but will be able to return to your normal routine most likely. If you are used to heavy manual labor you will have to learn how to protect your stoma while working. If you are having difficulty taking care of your stoma and changing the pouch it’s a good idea to talk to your doctor or nurse before resuming regular day to day activities like working. There are wonderful resources online for those adapting to this new way of life and I recommend finding peer support from the online community or groups meeting face to face. Here’s one person’s massage experience with their ostomy that paints a clearer picture of what to expect.

BENEFITS OF MASSAGE FOR THOSE WITH A STOMA

⦁ helps reinforce body positivity and self-confidence
⦁ reduces the amount of scar tissue and adhesions forming
⦁ may prevent post-surgical bowel blockages
⦁ helps prevent constipation and releasing gas
⦁ helps with circulation of blood to muscles and lymphatic system

A common misconception or worry stoma patients may have with massage is having to lie face down on a table. Since there are plenty of positions and cushions and bolsters used for those with disabilities and pregnant clients, it is not a barrier to getting a massage. I look forward to meeting any new stoma patients so I can have their valuable feedback for what works or didn’t work for them while getting a massage.