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Life with a stoma

Follow-up

Upon discharge from the hospital, the patient obtains stoma supplies for about 4 weeks. The patient should be checked regularly at a stoma clinic or by nurse or doctor in their home town.  Stoma patients need follow-up to assist with practical and emotional challenges.

Stoma supplies can be obtained from a surgical store or pharmacy as a "blue prescription" § 3.1 in one year intervals. The equipment is specified on a stoma bandage card which is attached to the prescription. It is common to obtain equipment for a 3 month period. The patient should pay a copayment until they have a "free-card."

Daily life

A stoma itself is not a hindrance in the workplace or in daily life. For air travel, stoma equipment should be stored in hand luggage. Stoma equipment cannot be purchased on a "blue prescription" outside Norway. A shower can be taken with or without the bag. Bathing can done with the bag if the filter is covered. Tight clothing and waistbands which might squeeze the bag such that it does not fill properly should be avoided.

Sexuality

A stoma itself is not a hindrance for a normal sexual relations. Lack of energy and changes in body image after surgery may require time before sexual desire resumes. This will happen more quickly if partners are open about their relationship where both are able to express feelings and needs and have consideration for each other. If sexual relations become more difficult to master, it might be beneficial to seek professional help.

Special conditions for females

For stoma operated females who have removed the colon or rectum, the uterus can lean to the back in the empty space. The vagina can also be bent where a pocket can form in which discharge collects. The pocket is emptied by changing body position. It is helpful to rinse the vagina regularly with water containing a small amount of yogurt or a tablespoon of vinegar to one liter of water. This can be added to a an ear rinsing balloon which is obtained at a pharmacy.

A bentover uterus may cause pain and during intercourse but can be avoided by choosing positions in which the female is not on her back. If the operation after cancer treatment has lead to nerve damage, reduced feeling and discomfort from vaginal dryness may occur. Lubrication jelly will help this.

A stoma is not a hindrance for pregnancy and birth. Before the stoma is installed, the woman should discuss prevention and sterilization with her doctor and whether she plans on having children. The doctor can then take the necessary precautions.

Special conditions for males

The nerves in the groin area may be damaged during cancer treatment and surgery. This can lead to impotence and ineffective ejaculation. There are measures for impotence which may also be psychological and resume after time. It is important the patient is informed about this before the operation.

Nutrition

It is usually not necessary to change eating habits. It may be appropriate to resume the eating habits the patient had prior to surgery. Food that is tolerated is very individual and it is also necessary to try different foods. It is recommended to eat 4 medium-size meals a day. If one does not prefer to eat enough at each mealtime then snacks are recommended. Irregular mealtimes can cause irregular bowel motions and gas.  General advice is to chew food well, take time for meals, and drink at least two liters of water per day.  Food should have a low fat content and moderate amounts of fiber. Regular exercise with relaxation after mealtimes is recommended.

Food which can cause constipation/ileus

Nuts, fibrous foods such as asparagus, oranges, celery, seeded grapes, prunes, mushrooms, popcorn and corn shells, and fruit skin can cause constipation.

Food which can cause gas

Carbonated beverages, cabbage, onions, beans, sorbitol (artificial sweetener), chewing gum, and spicy foods can cause gas. Tea, caraway, fennel seed, and blanching of cabbage vegetables before boiling as well as physical exercise at a moderate tempo can be preventative. The pharmacy has over-the-counter products to prevent gas from accumulating.

Foods which can cause thin stool

Dried fruit, orange juice, pears, cherries, plumbs, hermetic fruit, alcohol, sorbitol, aspartame, sugar in large quantities, and fatty foods can cause diarrhea. Ripe bananas, blueberries, boiled potatoes, carrot puree, apple sauce, apple juice, pasta, rice, boiled milk, and peanut butter have the opposite effect. The pharmacy has over-the-counter products which improve the absorbance function of the bowel and can be taken in prevention and regularly.

General advice for ileostomy operated patients

Food can be salted extra due to loss of electrolytes through bowel movements. Food with a high fiber content should be chewed well to ease digestion and hinder enteralgia. It is recommended to take vitamin B12 due a lack of nutrient absorption in the lower part of the small intestine. Electrolyte mixtures are available at the pharmacy. Sport drinks can be taken used an alternative.

 

 

 

 

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