Regular versus Extended Wear Barriers

There are various types of barriers readily available for people with ostomies. In addition, provision for ostomy products occurs in a range of wafers or barriers. Coming up with an idea of choosing the ideal barriers for a given type of stoma relies upon the required or desired appliance frequency changes, cost, and stoma drainage characteristic (liquid versus formed; volume fecal versus urine).

Perfect barriers should.

• Have a provision for secure/safe seal

• Protect peristomal skin against urine or feces

• Cost-effective with proper stoma management

• Should be gentle to the skin, especially in the process of flange removal

The composition of skin barriers includes various materials, including pectin, gelatin, karaya, and other synthetic materials. Several adhesive formulations are also added to the barriers to provide enduring adhesion and for initial tack. The precise formulation of the barriers will vary based on the manufacturer. However, regardless of the differences in the supplies, the set barrier principles apply in the selection. 

Typically, there is less resistance to liquid urine or stool for regular wear barriers. The wear-times for regular wear barrier for urostomies or ileostomies should be between 3-4 days). The type, as mentioned earlier, of barriers tends to melt, especially when exposed to stool or liquid (and mainly the high frequency/volumes of stool or urine movement), calling upon for unwanted peristomal skin exposure and the possibility of skin irritation, especially if left for quite some time. 

Regular wear barriers are ideal for well-formed stool, such as the one found with colostomies. Because the stool has less liquid content and less functioning of the stoma, a regular wear barrier will have achieved longevity of up to 5-7 days. Tack and adhesion tend to be slightly less with regular wear barriers since it provides a secure seal that allows frequent changes if needed without any damage caused to the skin. 

On the other hand, extended barriers developed to offer higher resistance to liquid urine and stool. Therefore, longer wear times with extended wear barriers are more realistic. Some of these products contain different substances known to be hygroscopic since they can absorb moisture originating from urine or stool, making the barrier swell around the stoma. This swelling action creates a provision for an ideal seal and resists stool weakening or urine under flange. 

The barrier movement will lead to normal peristalsis and stoma; it will not block or occlude the stoma opening. There is a tendency for more outstanding adhesion and track with extended wearable products. The advantage of these adhesions is that they assist with extended longer wear times. Great care is to prevent peristomal skin damage during flange removal. Extended wear barriers are ideal for people with urostomies or ileostomies. Simply because they will have them for longer times for about seven days, for people known to have liquid stool associated with colostomies, they should consider extended wear barriers.

The cost aspect should be put into consideration when factoring in the ideal barrier type. The extended wear barrier type tends to be quite expensive. However, the choice should be associated with the frequency of the flange changes, which tends to be somewhat less with extended wear barriers. 

On the other hand, if there is proper protection to peristomal skin with extended wear products, skin irritation is avoided, which helps eliminate additional products and accessories like powder. In addition, some of the products may be readily available as extended wear barriers.

The decision upon the melt-out degree determines the appropriate barrier and the time barrier is worn; it should factor the peristomal skin condition with the given appliance change.

How to Treat Peristomal Skin Irritation

Keeping your skin nice and healthy is essential for lots of people to do when they have an ostomy, since it can make it uncomfortable and itchy, along with red as well. If you do have skin that’s irritated, you do need to let it rest, cover it up with a dressing to let it heal, and then wait a bit. But with an ostomy, that’s really not possible.  It can hurt your skin if damaged, and it won’t seal very well, and it will get worse over time, and won’t be able to get the appliance on. What do you do then? 

What to Do? 

The biggest thing to understand is that skin irritation that’s not mild and is clearly getting worse is to first be analyzed by a nurse as quickly as you can. You may need to also add a new product during the pouches whenever the skin heals, or also to use a medication or topical to help with treating the irritations. 

There is also “crusting” which happens, which protects the skin from the wafer, and this of course can help some people. Some people use this when they’re new, since it helps with that skin which is adapting. 

All About Crusting 

Crusting is where you spread powder around the peristomal skin, right by the side where it’s irritated, and then adding a skin barrier layer.  You can use a wipe or spray, but you also should make sure it’s a formulation that won’t sting you. You can do this a couple of times to offer a barrier to protect this. 

The process involves three steps. First, you should sprinkle the powder that’s there around the skin and get rid of whenever there’s too much excess. You can tap the belly or slap it lightly on the side next to where the stoma is to get rid of the extra powder, and only the stuff that’s sticking is there. 

You then add barrier spray to offer a seal layer of protection. You can put this right over the powder itself if it’s a spray seal. For wipes, you simply place this gently over the surface of where the skin is so that it won’t wipe off, but instead seals. Once applied, you fan it with a card to let it dry. Repeat this multiple times to offer more protection, especially layers of protection. However be mindful of this, as too many layers does affect the seal itself, so only use what you need to. 

You can try this type of crusting with the area that’s sealed. You can use a wafer that has a taped border, offering crusting within the original area of this wafer, where you have the adhesive the most there.  That way, you avoid extending directly towards the area that’s taped. When crusting happens past this, it can actually cause this to actually leak too, which again, is a bit of a problem. 

This is a technique that can be used to help with skin irritation to protect it from worsening, and it can also protect your skin so it’s able to heal. The best thing to understand is that it is a prevention technique in most cases, so only do this if the skin is raw, and if it’s not raw, don’t bother to use this. You also should make sure to get medical help if you notice that there is an irritation of all kinds, since this can offer a better, more rewarding experience, and also prevent problems with the stoma down the line as well. 

Can you Hike and Run with a Stoma?

I love Spring and Fall.  This time of year allows me to really enjoy my passion when I have the time and that is because the weather is really nice. One area that really pumps me up for life is heading to my favorite local parks and enjoy the trails.  At one point I thought I would never do this again.  This is one area that worried me when I got out of my ostomy surgery because I was afraid that I would not be able to hike or jog my favorite trails again.  Luckily, I was all afraid for no reason and that is something that I strive to share with all new estimates.  The fact that you have a stoma now means that you have a few extra routine changes through the day, but that your life can still be as active or enjoyable as you wish it to be.  My search for amazing gear helps me enjoy what I love doing and I hope this helps you too!

Where do you go to get gear that allows you to hike and run with an ostomy?  You may even find that there is a whole new ostomy setup that may work better for your body and the task that you are planning on doing.  I like to personally keep my eyes and ears open to all different aspects of this industry to see what is available and if I am missing something.  One location that usually seems to keep me up to date is the social media world.  This is a vast and crazy fast-changing industry. No joke, new things are coming out all the time and you need to keep up or you may miss it. 

Now I like to stay up to date on social media for all the new things.  This means following tons of people who have an ostomy.  Now I think that it is key to find outdoor people who enjoy hiking, bushcraft, and backpacking.  I have learned more from these people than probably anyone else and that is because they are doing what they enjoy and showing how they are doing it.  The truth is my body is different from many of them and how my stoma is on my abdomen is different.  That means a lot of the tips and tricks that they do are not applicable to me but a lot of their successes and failures are truly applicable and I am so happy to share in their journey and to be able to chime in as well.  I have learned a lot from others talking about my own questions and listening to their solutions and failures. 

People who like to be outside and keep things lightweight have been key to me.  This scene has actually influenced people with stomas greatly because we can use backpacks with no hip belts and keep things ultra-lightweight in order to carry our extra ostomy gear.   Adding all of their tips and tricks into my life has allowed me to see more and enjoy lots more time in the great outdoors.  It has also built my confidence up because I have seen people fail and know that I can succeed because they are willing to teach.  May my journey and tips help you in yours. 

Tips To Manage Your Loop Ileostomy

The process of digestion starts when you chew your foods and swallow them. That food passes through your esophagus and enters your stomach, where acids and other digestive enzymes break it down even further to form a liquid mixture. This mixture then passes to the small intestine.

The six meters long small intestine is where a significant part of the digestion process takes place. This part of the bowel absorbs everything from proteins, vitamins, minerals, and fats into the body. The leftover digestive material is passed to the large bowel, also known as the large intestine.

When digestive wastes enter into the large bowel, they are generally in the form of liquids due to an excess amount of moisture. The large intestine absorbs moisture and stores digestive wastes until you feel the urge to move your bowels.

What is a loop ileostomy?

A surgically created opening into your bowel is known as an ostomy. If it is created on the small intestine, it is an ileostomy. And if it is on the large intestine, it is a colostomy. A loop ileostomy is when the surgeon doesn’t disconnect the ileum from the colon or large bowel completely.

The surgeon, during surgery, brings a loop of the small intestine out through a cut in the belly. He then makes a small incision on the top of that loop to create a stoma. A supporting rod or bridge is placed under that loop to prevent it from sinking into the abdomen. This rod is usually removed 5-7 days after surgery.

A loop ileostomy creates two openings in a stoma. One of these openings passes out stools, while the other one remains idle. This second opening is the pathway to the colon and rectum. Since the active part of the stoma doesn’t have any sphincter muscles, you will not be able to control when to move your bowels. That is why wearing an ostomy bag the entire time is an utmost necessity.

Ileostomy output

Your stoma will start producing output a few hours after surgery. This output will be more watery during the first few days. However, its consistency will thicken over time. The average amount of the stomal output passing out of an ileostomy is 500-800ml per 24 hours. If it is greater than 1000ml per day, you may need to consult with your physician.

Managing your loop stoma

A stoma doesn’t stop you from bathing and showering, eating your favorite foods, and going out for traveling.

If you have a stoma, you can bathe or shower just like you have been doing before surgery. Water and soap will not enter your stoma. However, the stomal output discharge can happen at any time, so it is best to wear an ostomy bag the entire time.

While you will be able to eat anything you want eventually, you will need to take a restricted diet for the first few weeks after surgery. That will allow your GI tract to recover from the impact of surgery and adapt to its new length. You may need to bring some changes to your dietary habits, though.

You will have to be particularly careful about the skin around your stoma. Make sure to wear an ostomy bag that makes a proper seal with your peristomal skin. You may also need to ensure extra protection with the help of some supplementary products. The best way is to discuss your condition with an ostomy care nurse and ask for suggestions.

Worst Ostomy Day Ever

Have you ever just had a bad day and you knew it was going to go that way? Sometimes when you have an ostomy you just know it will be that way. We had a fun time last week and that was because we decided to buy a home that needed lots of work.  We have toughed and fixed what feels like every single part of it and sometimes you just know the house is going to win.

One day I knew I was going to have to go under the house.  We were smelling lots of bad things and I knew it was a mold under there.  I was worried because of my ostomy and we have a crawl space. This means crawling and going down through a very small hole. It was before I was using quality supplies so I knew that my bad feeling was justified. Instead of having a great time I had a leak whilst under the house. Surrounded by spiders, in a small space and leaking from my old bag.  Yes this, this is what nightmares are made of. I had a bad seal it wasn't the first time with the old brand.  I wish I was never recommended by a friend to use them because I went all in on supply. This means I used them till they were all out.

After that mishap under the house I decided to go shopping.  I found a health store online and I gave them a call. After talking with them and going over my past issues they were nice and knowledge about what I may need. I do lots of hard work and push my body and they gave me great products to give a shot at helping with my daily lifestyle. I would say the best part is trying the products out for free. That helped me see what worked well and what didn't.

This helped me from having more days where I knew I was going to lose.  I was more confident on working on the house after work and not being afraid of winding up in my own filth.  That is a definite plus on a 15 hour work day. So I suggest finding a really good brand and maybe trying it hard first without going under the house. Because that is really no fun and rather scary. Stay safe and have a happy time with your gear!

Waking up in an Ostomy Nightmare

There are some things that you fear when you have an ostomy.  That is waking up with the bag off and torn and filth everywhere. The worst part is the fear that you didn't wake up but your spouse woke you up.  That is my biggest fear and what I worried about most after my ostomy surgery. Luckily it is a bad dream that has never come to life. I am happy to say that due to my luck or choice of good products that it has not even really been a possibility as far as I can see. What I am actually saying is that you don't have to worry about it that much.  If you are using the right gear then you will be more than prepared for any issues in the night. So how do you get prepared?

Well, I suggest first and foremost learning all you can from your healthcare provider and ostomy nurse.  That is a good start and they are loaded with information.  If you are beyond that point and simply need some good advice then go to the good old internet.  That is where I learned that ostomy store existed and a whole bunch of other companies too.  Their Supplies is a gear manufacturer and they also put out a lot of content for people with a stoma.  I have found their website a really good place to start. When you get brave enough you can call in and start asking questions and so far they have been a really good help. But my favorite place to go is the good old YouTube.

Yes, I picked up the premium account because I spend way too much time looking up ostomy gear and I have to admit, its been worth it.  I am a gear junky and lots of people on their are as well.  Find and follow a few people with the life habits and styles that you like that also have an ostomy and you can get some great tips.  And also learn from a lot of epic fails.  It all is knowledge and it can all be for free with commercials haha. But really it is a great place to get tips on the questions you don't want to ask people in person. I highly suggest spending some time there and finding out more about the things you like to do and how to do them well.