The Ostomy Files: Summer Living with an Ostomy

    Summer is here. People flock to the beach, languish by the pool, or head out for vacation. However, summer with all its related activities, can be produce a great deal of anxiety for someone living with an ostomy.

One of the major concerns for a person with a stoma is body image and fear of public embarrassment (eg, noise from flatus, leakage, odor, or possible appearance of the pouch under clothing). Summer means wearing thinner clothing, bathing suits, and shorts, which can increase the level of unease surrounding these already angst-ridden circumstances. Selecting a bathing suit for a woman or man with an ostomy is somewhat easier than it was several years ago. Men’s swimming trunks tend to be patterned and knee-length. Flowered, patterned, or textured materials often serve as “camouflage” for a pouching system. Today, women have a variety of bathing suit styles from which to choose – many find a one-piece patterned suit appealing while others choose “boy short” bottom “tank-inis” or two-piece suits with a chemise-type top and/or a skirted bottom.

    As temperatures rise and exercise increases, so does perspiration. Individuals with an ileostomy must be instructed to carefully monitor fluid intake and stomal output, especially during periods of exercise or extreme heat. Many senior citizens live in homes without air-conditioning. Water alone is not sufficient – it does not replace the extra sodium and potassium lost in sweat as well as what is normally lost in ileostomy or high-output effluent. Sports drinks, tea, or colas should replace plain water because they contain valuable electrolytes. Patients should be taught the signs and symptoms of dehydration as well as preventive measures. Should dehydration develop, patients need to contact their physician or report to an emergency room for re-hydration with IV fluids.

    Higher environmental temperatures and increased perspiration also may decrease the wear time of solid skin barriers or skin barriers with a flange. Patients should anticipate this phenomenon, perhaps reducing wear time during the summer or switching to extended-wear skin barriers that are more resistant to meltdown (ie, erosion) from increased body temperature, high-volume liquid output, and increased perspiration. The need to change pouching systems before entering into physical activities should also be stressed, particularly if the individual is near the end of the usual wear-time.

    Summer also produces a bounty of fresh fruits and vegetables, such as corn on the cob, watermelon, peaches, green beans, cherries, okra, plums, tomatoes, strawberries, blueberries, raspberries, and peppers — foods that potentially create more gas and/or difficulty with digestion, especially those foods with an abundance of seeds and skins. This is usually more of a problem for people with an ileostomy but an increased amount of fresh fruits and vegetables also can cause problems (eg, diarrhea, excess gas) for people with a colostomy. If gas and odor become a problem, patients should be familiarized regarding closed-end and drainable pouching systems with effective gas relief and odor-reducing filter systems.

    Activities in the summer (or any other season, for that matter) may drive the individual’s pouching system choice. Some people with an ileostomy may chose to use a closed-end pouch under a bathing suit or switch from a drainable pouch to a closed-end pouch while on vacation (for convenient disposal “on the road”). One-piece pouching systems also may be appropriate during these times. Visiting friends and family can become problematic for people with an ostomy, especially with regards to emptying and/or disposing of soiled pouches. Sadly, many people choose to avoid situations (eg, visiting, sharing bathrooms, and the like) because of these issues. Clinicians should teach their clients to put the soiled pouch in a zip-lock bag or aluminum foil for sanitary and odor-proof disposal to avoid embarrassment. A sense of freedom can easily be restored if people with an ostomy are educated about various pouching options.

    Some individuals choose to alternate pouch types depending on their activity, output, and the setting in which they find themselves. These are personal lifestyle decisions that can only be made if people with a stoma are shown a variety of pouching options. Something as simple as a different type of pouch can make a huge difference in someone’s life — and what better time to feel better about oneself than during the summer.

    The Ostomy Files is made possible through the support of ConvaTec, a Bristol-Myers Squibb Company, Princeton, NJ. This article was not subject to the Ostomy Wound Management peer-review process.