The importance of accessories in stomach care: what they are and how to use them correctly

Annarita Lenza, nurse at the Umberto I Hospital in Nocera Inferiore (Salerno) illustrates how to take care of the peristomal skin thanks to the use of accessories

When did it all start?

It all started precisely on the day when a distant colleague of mine, Elise Sorensen, launched a challenge to herself, which had a single goal: how to help my "ostomized" sister! How to help her dear sister to alleviate and reduce the many skin lesions caused by the sacs, then known as "skin-tearers"! We are in the immediate post-war period, and thanks to her commitment and tenacity, nurse Elise is the forerunner who has opened the doors to numerous companies that currently deal with ostomy devices.

The continuous research and clinical practice of professionals, who walk hand in hand, such as "stoma nurses", have created and made available a range of accessories for ostomy management, which help ostomy patients to adapt to the "new lifestyle" in the most natural and comfortable way possible. The stomach (the set of procedures to carry out the hygiene of the peristomal skin) becomes essential for those who, from one day to the next, face a radical change in their body pattern!

Adhesion to the body is one of the key features of the ostomy device, as it allows users to feel more secure. We are all different from each other, the challenge is to ensure a safe adaptability to the different shapes and natural movements of the body. Recently, some studies have prepared a major market survey (interviewing 1,800 users and 500 nurses) which confirmed that more than 80% of people with an ostomy have "bodily problems" (e.g. skin folds, scars and hernias).

Infiltrations below the plate of the presidium must be categorically avoided because they can lead to skin alterations that in the long run could affect the adhesion of the plaque itself. Infiltrations can cause frequent detachment of the device, generating a lot of discomfort for the wearer and, above all, peristomal damage, such as dermatitis of various degrees that are then difficult, but not impossible to resolve.

The sudden change in one's body pattern, the constant fear of the unknown, gives rise to a series of questions from patients. The most frequent ones focus on particular habits that concern certain periods of the year such as, for example, how to face the summer with an ostomy, when you are more inclined to devote yourself to outdoor activities, or you want to go to the beach and the pool. With a few simple precautions, even in summer, the collection systems can offer you maximum peace of mind.

Especially for ileostomized patients , the intake of sodium and potassium is important, if necessary, mineral salt supplements can be added to the water. Especially in summer, it becomes essential for each of us to drink a lot. Water helps maintain body temperature and regulate osmotic pressure despite the heat outside. Therefore, in the presence of high temperatures, sweating increases, as a natural consequence of body thermoregulation, and with it the risk of dehydration increases. This need to drink becomes all the more true for people with stomas, because there is also a lack (especially for ileostomized people) of part of the intestine that also has the task of reabsorbing water. Drinking plenty of water also helps prevent constipation problems. Especially in summer, it can become important to use accessories that help the plate to stay in place, without the risk of detachment or infiltration. Here, then, in cases of increased sweating, some accessories help us. Changing the bag is a very delicate moment. 

The products and devices you choose can help prevent or reduce irritation. It is a good idea not to use products that scratch (such as gauze) or that could leave threads such as cotton wool. The best thing would be to use compressed cotton wool pads (facial cleansing pads) which I recommend to all my patients. For proper cleaning of the stoma and peristomal skin, simply use a mild soap with a pH of 5.5 and running water. Never use products containing alcohol, ether, gasoline or sodium hypochlorite solutions (such as Amuchina) as they irritate the stoma, especially the peristomal area, and weaken the skin's natural defenses.

But will I be able to do sports? Of course you can!

But will I be able to shower? Will I be able to swim in the pool or/and in the sea? Of course you can! All ostomy aids are waterproof.

And above all, will I be able to travel? For those who have never done it, I recommend doing it right away and for those who love to travel they can continue to do so!

Life is beautiful and must be lived every minute at 360° and an ostomy device will not be able to stop any type of experience, because today, thanks to the wide range of accessories and our moral and professional support, we have all the weapons to do it. Another recurring problem is the presence of the "ballooning" effect, which refers to the swelling that the bag can have as a result of the production of gas. Their formation also depends on the type of diet; This happens more frequently in the case of a colostomy. 

It is important to avoid or try to reduce as much as possible the swelling of the bag due to this effect, not only for the purpose of greater discretion, but also because excessive pressure exerted by the air inside the device could compromise its tightness, and that is why each patient is advised to follow a diet that can avoid such discomfort. The fact that our body produces gas is normal and physiological, but this can be annoying in the case of people with an ostomy. 

Complete control of the gases produced is difficult, if not impossible; however, they can be limited by proper power supply. The swelling of the bag can be reduced and controlled also thanks to the good functioning of the filter positioned in some devices. The use of a filter cover before taking a bath or shower prevents it from being damaged. If you have any doubts, do not hesitate to contact your stoma nurse.

And here come the small accessories, but with a great potential solution, such as:

•   The inevitable protective film in spray or wipes, which helps to protect the skin, to improve the daily management of the skin. The product should be used on well-cleansed and dry peristomal skin; Thanks to its immediate absorption, it is possible to immediately place the stomal device.
•   The adhesive remover in spray or wipes makes the change of the device quick and less traumatic as possible, eliminating any adhesive residue, leaving the peristomal area intact and soft.
•   The protective paste or the moldable ring, to be used as a protective barrier and filler for irregular surfaces of the skin, improving the adhesiveness of the device; a real seal, which protects the integrity of the peristomal skin.
•   The protective powder helps to create a protective barrier in case of irritated or exuding peristomal skin.
•   The lap belt offers safety and tightness of the device, especially in patients with ileostomy, as the weight of the effluents tends to pull the device with consequent detachment of the latter.
•   The anti-odour gelling sachets help to gel liquid effluents, avoiding annoying lapping in the bag and the activated charcoal neutralises odours.

We stoma therapists have been entrusted with the delicate task of being the "guardian angels" of every single patient who finds himself catapulted into this new "lifestyle"; it is up to us to teach and guide all of you in this new path that may be tortuous at the beginning, but which will then turn out to be a new life, A second chance that has been given to you.

The accessories that I have listed above represent nothing more than a sort of small cuddles, caresses, which make you more confident with their function, which make your daily life more pleasant.