Accessory

When referring to ostomy products, accessories are extra/optional products that are used to amplify an ostomate’s quality of life. Some examples include support wraps, cloth/decorative pouch covers, stoma guards, support belts, and ostomy garments/underwear. You may see certain supplies such as stoma paste, powder, or barrier rings as accessories, but those are often necessary for a good seal and everyday use.

Appliance

This refers to the entire ostomy bag system, the barrier, and the bag, which sticks to the body and collects output.

Barrier

Barriers are also known as wafers, baseplates or flanges, and are the part of the system that has adhesive and sticks to the skin around the stoma. Ostomy barriers come in many varieties, and finding the right one is essential to get a secure seal.

Ballooning

This describes what an ostomy bag completely filled with gas looks like. It can happen if you use a bag with a filter and it gets clogged, or if you use a bag with no filter and allow gas to build up. Many ostomates experience ballooning, especially during the night, and learn to burp their appliances to alleviate the problem. To burp your appliance is to purposely remove built-up gas from your bag. If you wear a 1-piece system this can be done by unrolling the bottom closure, while making sure to hold the bottom of the bag up so no output can fall out, and pressing the gas out. If you wear a 2-piece system this can be done by slightly disconnecting the bag from the barrier and pressing out the gas. 

Barrier Ring

A waxy moldable donut-shaped ring that is placed around the stoma between your abdomen and the barrier. It can act as a seal —similar to the caulking in your bathroom —  to help prevent any leaks and protect the skin around the stoma. Rings come in many varieties, so finding a shape that is right for your stoma is important. They can be torn and pressed back together to make a better fit. There are also convex options to help build convexity for flush stomas.

Blowout

A leak large enough that the output makes its way out from under the barrier. It is generally considered a blowout if the output is outside of the appliance and gets on the ostomate’s clothing. This is different from a common leak, during which output does not breach the edges of the barrier.

Convex barrier/Convexity

A barrier that is specially designed to help push out stomas that do not protrude from the abdomen far enough. The curved cup-like shape is designed to press more deeply around the stoma by pressing inwards towards the abdomen. This shape can help to always keep the barrier in contact with the skin, even on uneven or soft abdomens. This product can help to make sure that output is not emptying at skin level, which can cause leaks and skin irritation. You can find varying levels of convexity in soft and firm options, depending on the manufacturer. It is important to know if convexity is necessary for you as it should only be used in certain cases. A stoma care nurse (WOCN) can properly assess if this option is right for you.

Crusting Method

A method used to heal damaged skin, using stoma powder and barrier spray/wipes. To begin, sprinkle some barrier powder on the irritated skin. Brush/blow off any excess powder. Then spray the skin with barrier spray, or dab with a barrier wipe, preferably a skin barrier that is no-sting. Let it dry completely; it will turn back to the color of the powder when it is dry. Then repeat these steps one more time. This method should allow your barrier to still stick well while allowing the skin below to heal.

Dehydration

When the body does not contain enough water and other fluids to perform normal functions. This happens when you use up or lose more fluids than you take in. Ostomates are at a particularly high risk of dehydration due to the removal of small or large sections of the bowel. Signs of dehydration include: feeling thirsty, feeling dizzy, tired or lightheaded, dry lips, eyes, and mouths, infrequent urination, or urine that is dark in color and strong-smelling. To rehydrate you must consume an electrolyte drink, as simply drinking water will not be sufficient. If you feel that you have become severely dehydrated, seek medical attention immediately. 

Digestion

The process of breaking down food to be used by the body. The gastrointestinal system breaks down food into small enough particles that the nutrients can be absorbed into the bloodstream.

Distention

When the bowel becomes over-extended with gas, fluid, or stool. This can occur if there is an obstruction, frequent constipation, or significant inflammation.

Drainable Pouch

A type of ostomy pouching system that has an opening at the bottom to allow the ostomate to drain their bag, and then re-close the pouch. This allows the bag to be emptied when needed, but the whole system should be able to be worn for multiple days. Generally, this system works best for ostomates with more liquid output, and allows for the bag to be emptied multiple times a day. The opposite of a drainable pouching system is often referred to as a closed pouching system. This is a pouching system without an opening at the bottom. Ostomates with less frequent and thicker output may opt to use a closed pouch for convenience. These pouches are not reusable, and are thrown away when they reach a desired fullness (typically when they’re about half full). They come in one-piece and two-piece systems, but many people find the two-piece set up the most desirable because they can keep the barrier on for a few days. Generally, these pouches are worn by colostomates.

Electrolytes

Essential minerals that play a key role in major body functions. Sodium, calcium, and potassium are vital and need to be replenished when you sweat or have output. There are many drinks specially formulated to replenish these vital minerals including Gatorade, Pedialyte, and various hydration powders that can be mixed with water. It is especially important for ostomates with liquid output to maintain electrolyte levels, as they are losing significant amounts in their daily output.

Fiber

The substance in some foods that is indigestible. It is used to bulk up stool which helps in normal elimination, and is considered to be a healthy and important part of anyone’s diet. Because this substance causes the bowel to work harder to pass it, it may be necessary to avoid fiber when you’re recovering from ostomy surgery or trying to heal intestinal inflammation. High amounts of fiber can be problematic for ileostomates, so slowly learning how your body handles it is important. 

Fiber (insoluble)

Does not dissolve in water, and helps to speed the passage of foods as well as to bulk up stool. It is thought to help soften stool and make it easier to pass. Some examples of foods high in insoluble fiber are whole grains, wheat bran, quinoa, and vegetables with the skin on.

Fiber (low Residue)

A diet that focuses on limiting your fiber intake for a period of time. It is most often used after abdominal surgery to allow the bowel to rest and heal. Foods to avoid while on a low residue diet include whole grains, fruits, and vegetables with skin, dried fruits, nuts and seeds. Foods to include on a low residue diet would be refined bread and crackers, cream of wheat, white rice, refined noodles, skin-free apple sauce, skin free potatoes, bananas, chicken, or eggs. This diet is meant to be temporary, as it can lead to malnutrition if followed for a long period of time. It’s best to have a doctor oversee this type of restricted eating. 

Fiber (soluble)

Dissolves in water, and is used to slow digestion by attracting water and turning into a gel-like substance. This slowing down of digestion is used by the body to have adequate time to digest nutrients and is thought to improve digestion overall. Some examples of foods high in soluble fiber are seeds, nuts, beans, some fruits and veggies, sweet potato, oat bran, barley, lentils and peas. 

Irritation

In this case irritation refers to soreness, redness, or inflammation of the skin. This is not the same as an allergic reaction and is often caused by moisture that’s trapped under the barrier. 

Leak

A leak is when any output gets under the barrier instead of falling into the bag. This does not necessarily mean that the output makes it all the way out, simply that it is on the skin and the appliance should be changed. In rare cases, output can leak from the coupling, filter, or outlet.

Ostomate

A term used to describe a person who has any variety of a stoma.

Ostomy

A surgically created opening, called a stoma, that allows for stool, mucus, or urine to pass to a bag attached to the abdomen. The common varieties are colostomy, ileostomy and urostomy. Ostomy and stoma are used interchangeably by many people. 

Pancaking

This describes when output gets stuck at the top of the ostomy bag right around the stoma and does not fall down to the bottom of the bag as it should. This tends to happen when the output is thicker and the pouch has a filter. Some ways to help with panicking include: using a filter sticker for a few hours a day to allow for some gas build-up, using lubrication to help the output fall, and/or increasing water intake to help thin out the stool.

Peristomal Skin

The skin directly surrounding a stoma and radiating out about two inches from it. It is the area covered by the barrier.

Prebiotics

These specialized plant fibers help to feed good bacteria in your lower bowel and can help to stimulate growth of this bacteria. 

Probiotics

These are living microorganisms that can help to alter the micro-flora of the gut. This good bacteria is important in the process of digestion.

Quality of Life

Any individual’s ability to pursue and enjoy life. The pursuit of personal goals, standards, and concerns all tie into quality of life. Aside from some adjustments, having a stoma should not be detrimental to your quality of life.

Stoma

A surgically created opening in the abdomen that has a portion of bowel brought though. This allows for the passage of stool or urine out of the body. The stoma itself should be pink and moist and will have no feeling, as it has no nerve endings.

Stoma measuring guide

A paper or plastic guide that has a variety of holes cut out in different sizes. It is used by ostomates to help them determine what size barrier opening they need. A stoma can change after any amount of time, particularly in the weeks immediately following ostomy surgery, so checking the size of your stoma occasionally is recommended. This is especially  important if you are noticing more leaks, as it may mean that your stoma size changed and that you will need different products or to cut your opening to the new size.

Wear Time

The length of time that an appliance can be worn before it fails. That failure includes any output getting under the barrier, the filter clogging, or the edges coming up significantly. Each person will experience a different wear time, and this will vary greatly due to activity level.

WOCN

An acronym for a wound, ostomy and continence nurse. This nurse is specifically trained to specialize in the care of wounds, ostomy, and continence. Consulting a WOCN before and after an ostomy surgery can be very beneficial. They can help to find the best stoma placement before surgery, and can help find the best products for you after surgery and as you continue to learn to function with your ostomy.

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