**4. Ostomy problems and complications**

The construction of an intestinal stoma should not be considered a trivial undertaking. Serious complications requiring immediate reoperations can occur, as can minor problems that will subject the patient to daily and nightly distress. Intestinal stomas undoubtedly will dramatically change lifestyles. Patients will experience physiologic and psychologic detriment with stoma-related problems [8].

• Activities

A common concern for many patients is the impact of the stoma on activities of daily living. The patient can be reassured that most activities can be safely resumed with minimal, if any, modifications. As an example, bathing and showering can be performed with the pouch on or off, and clothing modifications are generally not required. Most sports activities can be resumed as well, with the exception of extreme contact sports, which could potentially damage the stoma. The addition of a belt or binder is helpful in maintaining a pouch seal during vigorous activity and with perspiration.

• Sex

Sexual activity is a particular concern for many patients with an ostomy. Patient counseling should address questions regarding sexual activity and partner

**39**

*Intestinal Ostomy Complications and Care DOI: http://dx.doi.org/10.5772/intechopen.85633*

**4.1 Risk factors for stomal complications**

4.Precocious physical effort.

colostomy or gastrostomy.

9.Quality of stomal bag devices.

**4.2 Functional complications**

6.Stoma protrusion.

complication.

placement.

• Output

occur [10].

sexual activity [9].

• Travel

1.Age.

3.Obesity.

safe.

response. The ostomy by itself does not affect organic sexual function; however it is advised to empty the pouch and assure an intact pouch seal before engaging in

Patients who are traveling should be advised to take extra ostomy supplies, to avoid exposing ostomy pouches and adhesives to extreme temperatures, which may alter the adhesive quality, and drink only bottled water if tap water is not known to be

The main risk factors for the occurrence of stoma complications are:

7.Type of surgery—emergency surgery is more likely to evolute with

8.Stoma site—lack of preoperative demarcation leading to inadequate stoma

10. Inadequate stoma care—the ideal care is provided by specialized nurse.

Patients with colostomy or ileostomy experiment physiologic changes related to the loss of continence and reduced ileal and colonic absorptive surface area with consequent fluid and electrolyte balance disturbances and lifestyle adaptation but generally with little effect on nutrition. It should be emphasized that if more than 50 cm terminal ileum is resected, nutritional consequences are likely to

Ostomy output is related to the location of the opening in the bowel, as the more

proximal the ostomy, the less surface area is available for water and electrolyte absorption and so the more liquid the stools. Right-sided colostomies, for example, not only produce a high volume but also have the additional disadvantage of a

malodorous output because of the effects of colonic bacteria.

5.Stoma type—ileostomies are more prone for the complication occurrence than

2.Comorbidity—inflammatory bowel diseases, diverticulitis.

## *Intestinal Ostomy Complications and Care DOI: http://dx.doi.org/10.5772/intechopen.85633*

response. The ostomy by itself does not affect organic sexual function; however it is advised to empty the pouch and assure an intact pouch seal before engaging in sexual activity [9].

• Travel

*Gastrointestinal Stomas*

**3.7 Shaving hair under the pouch**

dried before applying a pouch.

**3.8 What to wear when having a colostomy**

harm the stoma or prevent bowel function.

**4. Ostomy problems and complications**

he was used to more than the pouching system itself.

not flow into the stoma. Soap will not irritate it, but soap may interfere with the skin barrier sticking to the skin. Taking a bath without the pouching system is however highly impractical for the most obvious of reasons, primarily the risk of fecal output while bathing, which cannot be controlled. It's best to only use water while cleaning the skin around your stoma. If soap is used, one must be sure to rinse the skin well.

Having a lot of hair around the stoma can make it hard to get the skin barrier to stick well and may cause pain when the pouch is removed. It is advisable whenever possible to trim instead of shaving with a blade the skin hairs around the stoma to prevent skin scarification and inflammatory reaction. However if the hair density is high and shaving is indicated, it is recommended a dry shave of the skin around the stoma with stoma powder, since soap and shaving creams have lotions and oils that may impair the skin barrier sticking. After shaving, the skin must be rinsed well and

No special clothes for everyday wear are needed. Ostomy pouches are fairly flat and hard to see under most clothing. The pressure of elastic undergarments will not

If the ostomate gains weight after the ostomy surgery, this can affect the clothes

Snug undergarments such as cotton stretch underpants, T-shirts, or camisoles may give an extra support, security, and help conceal pouches. A simple pouch cover adds comfort by absorbing body sweat and keeps the plastic pouch from rest-

The construction of an intestinal stoma should not be considered a trivial undertaking. Serious complications requiring immediate reoperations can occur, as can minor problems that will subject the patient to daily and nightly distress. Intestinal stomas undoubtedly will dramatically change lifestyles. Patients will experience

A common concern for many patients is the impact of the stoma on activities of daily living. The patient can be reassured that most activities can be safely resumed with minimal, if any, modifications. As an example, bathing and showering can be performed with the pouch on or off, and clothing modifications are generally not required. Most sports activities can be resumed as well, with the exception of extreme contact sports, which could potentially damage the stoma. The addition of a belt or binder is helpful in maintaining a pouch seal during vigorous activity and

Sexual activity is a particular concern for many patients with an ostomy. Patient counseling should address questions regarding sexual activity and partner

ing against your skin. Men can wear either boxer or jockey-type shorts.

physiologic and psychologic detriment with stoma-related problems [8].

**38**

• Activities

with perspiration.

• Sex

Patients who are traveling should be advised to take extra ostomy supplies, to avoid exposing ostomy pouches and adhesives to extreme temperatures, which may alter the adhesive quality, and drink only bottled water if tap water is not known to be safe.
