Living with a new stoma after a crash: skills and warning signs
Everyday skills and red flags from a wound ostomy continence nurse and a trauma surgeon
An injury to the belly may mean surgery to route part of the bowel out to an opening on the abdomen. This opening is called a stoma. Waste passes out through it into a pouch. You might need it for a short while or for the long haul. A trauma surgeon explains why you needed it and what may come next. A wound ostomy continence nurse helps you learn the everyday skills that make life at home manageable. [1, 2]
Practice the routine before you leave
Have the nurse walk you through emptying and changing the pouch. Learn how to measure the stoma, clean the skin around it and spot a poor seal. Next, try the steps on your own or with a helper. Find out which supplies to order and how many to keep at home. Learn who to call when a pouch won’t stay on. [1, 2]
Leaks that keep coming back are a problem to solve. They are no sign of personal failure. [1, 2]
Keep an eye on the skin and the output
Check the stoma and nearby skin every time you change the pouch. As the early swelling eases, the stoma may get smaller. The opening in the skin barrier may then need to be rechecked. Report skin that turns raw, wet or painful, or keeps getting irritated. Ask how much output to expect for your type of ostomy and how thick it should be. If you have an ileostomy, you may need a special plan for staying hydrated. [2, 3]
Changes that need a fast call
If the stoma turns purple, black or white, call the surgical team promptly. Call too if bleeding is heavier than expected or output drops for no clear reason. Fever, belly pain or signs of dehydration also need a prompt call. If you have severe pain or vomiting and nothing is coming out, get an urgent exam. Without medical advice, don’t put anything into the stoma or make big diet changes to clear a blockage. [2, 3]
Ask when the surgeon plans to discuss whether the ostomy will likely be reversed. The answer may hinge on healing and any later surgeries. Until then, make sure your home care routine works for your hands, eyesight, bathroom and support network. [1, 2]
Questions for your ostomy nurse
- Which kind of ostomy is this, and what output is normal for it?
- Will you watch while I empty and change the pouch?
- Who can help with leaks, sore skin or supply problems?
Keep contacts with your supplies
Sources and further reading
- 1American College of Surgeons ostomy home skills
- 2MedlinePlus caring for an ileostomy stoma
- 3MedlinePlus changing an ostomy pouch
This article shares general knowledge from ostomy nurses and trauma surgeons. Your routine depends on your type of ostomy and your surgeon’s instructions. Get checked promptly for a dark stoma, severe pain or no output when you expect it.
Keep learning
Safe Driving Resource Center
Guides, self-checks and articles for drivers, parents of new drivers, and families recovering after a crash.
