How to Size Your Stoma for the Best Pouch Fit

 If you’re getting an ostomy, you probably know you’re going to have to care for it. 

One part of this, is getting the right type of equipment so your seal is tight. And unfortunately, there isn’t one specific way to do this. 

We’ll go over here how you can properly fit your equipment on your stoma, and also what type of pouch system is best for you. 

As you know, the stoma is the opening in an abdomen which is connected either to the urinary or digestive tract to expel waste from your intestines, or your bladder. This can be a temporary or permanent action, so you need to take care of it regardless, and make sure you get the best fit on your pouching system too. 

The First Few Weeks 

In the first few weeks, your stoma will not be the same shape as it will ultimately be.

It also will look swollen, where the swelling is larger, but it will subside as you go along. 

It’s important to measure the stoma on the regular and adjust the barrier as well. Eventually, it will finally level out and you won’t have to measure it all the time. 

However, this does still change, so remember that if it doesn’t fit one time, that doesn’t mean it may not fit down the road. 

Usually, within the first 8 weeks after the surgery, the stoma does the most shape. 

This is usually because of weight loss or gain, hernias or prolapse, aging, or other significant physical appearance changes. If you see the stoma changing, make sure you measure it so you use the right barrier and wafer for your skin. 

How to Measure 

You will probably do this with the ostomy nurse or your doctor a few times, and you will learn this initially, and what problems might arise., 

However, naturally you will have to do this on your own, so it’s good to have a series of steps. 

First, you need to get your supplies, including the barriers, scissors, a marker or pen, some gauze, the adhesive or a mirror in order to assist with this. 

Next, you want to prepare the stoma by taking off and emptying the bag, then washing the area, removing hair and any adhesives that are on before. however, so make sure the stoma is fully dry before you continue. 

Next, you want to measure the stoma, and see how far it protrudes out of the hole without a ton of skin.  You typically will have a gap between 1-3 mm between the stoma and the guide.

Next, you take that measurement and then put that on the skin barrier and adjust it before you apply it.  Sometimes, it takes a minute to adhere to the area, and make sure you use the scissors for the wafer since you don’t want to damage cutting it. 

Finally, it’s time for a test run. Put it right over the stoma, and then test the way that this fits. You might need to adjust before you take the backing off of it and put the ostomy appliance back on. 

Remember, you also can choose different types of barriers too, since some people might prefer the convex, the pre-cut, or even the cut-to-fit types.  You can talk to your doctor about the options that you have, and of course what’s best for you. 

This can be a challenge to do initially, especially if you’ve got a loop ostomy or other types, but hopefully, now that you know a little bit about it, you can from here, get the best results possible from your ostomy too. 

Bowel Obstruction and Blockages

Sometimes, you may get an ileostomy, and there’s a bowel obstruction. You may wonder what to do with this. We’ll go over this problem here. 

What is a bowel obstruction 

This is when the normal food and gas isn’t able to leave. This is either partial, where some of this can go through, but not all of this, or there is complete blockages, meaning that nothing can get out. About 20% of those who get to the hospital with painful abdominal problems have a bowel obstruction. Of these, most of them will have a small bowel obstruction. Sometimes this is a complication from surgery, scar tissue, or there is food obstruction. 

Adhesions 

Adhesions are tissue bands such as tissue that’s scarred that connect together or bind the bowel to different orgasms or may tack this to the wall of the abdomen. Wen this forms, it does prevent the food, fluid, and the gas to move through. Most of this does result from events that do disrupt it, and as the body starts to repair this, it further creates scar tissue. Sometimes, infection, trauma, or radiation cause this. 

They’re the most common complications of stoma surgeries, and usually, this is a few days after. In a lot of cases, most of the time they don’t’ cause problems, but later on down the line, it may cause bowel obstructions over time. 

Food Getting Stuck 

This is usually common in those who have an ileostomy, and usually there is more concern during the first 8 weeks of your surgery due to how swollen the bowels are. While usually the swelling is a temporary measure, it does cause a narrowing of the inner bowel openings, especially when the bowel goes through the abdominal wall layers that are there. This narrow opening may cause some foods to not be able to pass through quite readily. Anything that’s high in cellulose, or tough meat cuts usually cause this. Small amounts won’t do it, but anything that’s big and not chewed enough, it ma cause this. Usually, this is mostly a concern right after surgery due to the swelling. 

Symptoms of Blockages 

Usually the biggest symptoms are that they feel nauseous or have cramps. They also may vomit and lose their appetite as well. The output may be affected as well. With a partial obstruction, the output may look more liquid and usually may be a lot more noisy and forceful. With complete, there’s nothing coming out. 

If there is a suspension of possible bowel obstruction, you should talk to the doctor and never try to figure this one out yourself. You can start to enlarge your stoma opening to help with this, and drink water. If you are in major pain, or are vomiting, or if there is no output within 12 hours, you need to go see a doctor to help you with this. They’ll ask for a medical history, and get an exam, and also scan the area, and also may look to see if there is anything that you can get, such as a nasogastric tube that’s there to drain the stomach fluid. It may take a few days for this to resolve, and you might need to get surgery, but usually, once the threat is gone, you can slowly reintroduce some of the foods that you liked before, e while also monitoring for different symptoms. 

You also may need to talk to your doctor to see if there’s any surgery that may happen as well, so that if there are problems, it can be handled. Usually, there is not on specific reason, but if you do feel anything bad happening, and you feel like there may be an obstruction, you should talk to your doctor.