Choosing a colostomy bag - CANCER

Choosing a colostomy bag

December 31, 2010, 3:21 pm

Of course I was shocked when my surgeons told me that they would have to perform a colostomy operation to remove my cancerous tumour. I was only 37. I wanted to have children. Swimming and water sports were among my favourite hobbies. The idea of living (and even dating) with a poo-bag was terrifying. But there was no way around it and I had to accept the situation.

Before the surgery I asked nurses to show me some examples of colostomy bags and I started to try them out.  I tested them in the swimming pool, saunas, playing golf, tennis, and while exercising. I learnt that the designs and fitting differed depending on the manufacturer. Some of them performed better in water while other were better when travelling. It was just a question of choosing the right one for my needs. I found one that was perfect for my needs. Convatec Esteem – discreet and practical (picture above). I have been using the same colostomy bag ever since. Size small when irrigating, size medium when not, size large if I have diarrhea. Please, read below about the pros and cons of this specific bag and about irrigation.

Six years later I don’t even think about the poo-bag. I choose one and put it on like a pair of jeans. And I did date. I am happily married and swim a lot.

Basic Facts about Colostomy

Colostomy is a surgical procedure in which the large intestine is connected to an opening in the abdominal wall. This is an alternative way for poo to leave the body. The poo is collected in a colostomy bag, or poo-bag. My colostomy (I had my colostomy surgery in 2005) is irreversible because the surgeons amputated part of my buttocks and part of my large intestine. Reversible colostomy is a temporary solution for those with treatable diseases of colon. Ureostomy is a similar solution for the urinary tract and ileostomy for those with a small intestine connected to the abdominal wall.

Manufacturers of colostomy products

I have tested colostomy appliances from following world-wide colostomy manufacturers: Convatec, Coloplast and Holister. They all have extensive Internet Sites with information about the range of products on offer and they also offer advice and help in regards to colostomy.

Types of colostomy bags

I use the term poo-bag for a colostomy bag, however the correct term is colostomy bag. The poo-bag is a pouch that is attached to the abdominal wall and the opening in the abdominal wall, just like a patch, in order to collect poo. The bags are generally divided into 1-piece and 2-piece bags.

In the 1-piece bag the pouch and the skin barrier adhesive are all one system. You remove and change the whole bag every time the bag is filled with poo.

In the 2-piece bag the pouch and the skin barrier are two separate pieces that can be joined together with a plastic coupling ring. When the bag is filled with poo, you remove only the bag while the skin-barrier stays attached to the body for a longer time.

Both, 1-piece and 2-piece bags, are either closed or drainable. Drainable means that you empty the poo-bag trough a closable flap without removing the bag. I tested the drainable bag twice. The smell while you push the poo trough the opening in the bag is almost unbearable. The colostomy nurses advise drainable bags for diarrhea. However, in spite of the risk of faeces- accidents when changing the bag during diarrhea, I use 1-peace closed bags and deal with the spillage afterwards.

I strongly recommend 1-peace closed bags.

At the time of my colostomy surgery I was very active, I liked water-sports, I played golf, tennis, hiked. I also was a swimmer, and still am. I needed a bag that would be good in water, a bag that would follow all my moves, and a bag that would be as discrete as possible. After testing different bags I ended up using 1-piece bags from Convatec, called Convatec Esteem. These bags are available in large, medium, and small sizes. I have been using these bags (medium and small) for 6 years and during the years I have encountered only few problems. (I have heard of accidents from other colostomy users and for 5 years I did not understand what they were talking about until one day, when I tested a colostomy bag from another manufacturer.)

Pros and cons of the Convatec Esteem bags. They are attached to the skin by a skin-like skin-barrier, just like a second skin. The Convatec bag is also “elegant” and I do not mind if it shows, for example if my t-shirt is too short. The only draw bag is that the bags need to be changed more frequently in the moist environment because the skin-barrier has a tendency to melt. The “melting” can make the removal of the bag difficult, the bag can fall apart, which is not very nice. But if you know about it, you can be prepared. So, if you were sweating, swimming and bathing, change the bag as often and as soon as you can.

My advice is to really try different suppliers and different models of bags in order to find the right one for you. If you live an active life, my recommendation is Convatec Esteem. Don’t just pick the model that is suggested to you by your colostomy nurse. You can always ask the manufacturers directly to send you samples of a certain model that you would like to test.

Irrigation

Irrigation is similar to colonics. The purpose is to avoid faeces and poo altogether, i.e. you empty the colon once in two days to the extent that the poo-bag is empty between the irrigations. The process involves infusing water, using a 1-2 litre water container similar to a drip bag, into the colon (using the stoma cone) through the stoma opening. This stimulates the colon to empty. By repeating this process regularly – once a day or once every second day – the colon can be trained to empty with no poo in-between the irrigations.

This procedure is difficult in the beginning. You also need a professional colostomy nurse to show you and to assist you the first time. I fainted the first time. Luckily there were two nurses assisting me and everything went fine. The first time I irrigated at home, I asked a friend to assist me and to be there if I would faint again. She assisted me until I was sure that I can manage on my own. Once I have learnt how to do it, it was just a question of making the time, because it requires an extra hour in the mornings. The procedure takes about a half an hour, but I needed another half an hour to rest afterwards. Stress makes the process and the procedure more difficult, therefore do not stress.

What do you need? For irrigation you need a drip-like bag and a special plastic drainable bag.  I use the drip bag from Hollister and the plastic drainable bag from Convatech. In between irrigations I still needed to cover my colostomy with either a colostomy bag or a tampon-like product. The tampon-like product (Coloplast) is nice, but I have always used my Convatech Esteem bag anyway (size small). The bag gave me a sense of security in case there would be a poo on its way. I also compared the sizes of the size small bag from Convatec and the “tampon” like product from Coloplast and the difference was minimal. And as long as the poo bag was empty, it did not show anyway.

I used irrigation for about 3 years. Why did I stop? Once I started with chemotherapies I felt tired and my digestion was out of balance. Irrigation requires discipline and healthy digestion. Diet is important. If the poo is too dry, the irrigation procedure can be extremely painful.

Diet and poo-bag

Dry poo combined with colostomy is problematic even without irrigation. Therefore it is important to think about what you are eating. It is important to include fibres and liquid in the diet. I eat about two tablespoons of crushed flax seeds soaked in water or milk every morning. If the diet does not help, I use Importal ex-lax, a powder based on Lactitol, which softens the poo without being a laxative.

My recommendation for athletes with new colostomy

Discuss with your doctor when and how to start to exercise your stomach muscles. I was recommended to put quite strong bandage around my hips with focus on the colostomy area, by reinforcing the bandage around the colostomy area. I did use the bandage during the first year after my surgery, especially when playing golf. This to prevent hernia, i.e. tearing the muscles around the opening. I have heard of hernias acquired by chopping wood, which was not my case, but the effect it has on the muscles is similar to a golf-stroke.

Dating with Colostomy

I told my husband about my cancer on our first date. On our second date I asked him to join me for a swim. And I wore bikini. In my opinion it is good to find a good way to tell about the handicap as soon as possible. Some people have difficulties accepting a partner with a handicap. It is simply a fact. But, at the same time, it is a good indicator of what kind of person you are dealing with.

Do nor hesitate to ask even if you are not a cancer patient.