http://www.gicare.com/pated/edtgs13.htm

 Colostomy, Ileostomy, Rectal Pouch Diets and sample meals.

http://www.ostomy.evansville.net/hints.htm

HINTS AND TIPS FROM EVERYWHERE

and
http://www.ostomy.evansville.net/october98.htm
Volume 26, Number 1  October, 1998

COLOSTOMY HINTS
Metro Maryland & The Osto-mee News, Hamilton, Ohio
Save money by making your own elastic belts for holding your irrigation sleeve or
appliance. Save the end attachment from the old worn-out belt and transfer to the
new elastic. A cup of buttermilk in irrigation water can help control odor. If you
irrigate, try adding about 1/4 cup of Vaseline Intensive Care Bath Beads into the
irrigation sleeve when you are cleaning it. Rinse with clear water. Odors will be
gone and fecal matter will slip out easily. Water cans with long, curved spouts
are excellent for rinsing reusable appliances. If you notice a persistent odor
after changing your appliance, check to see if you have cleaned the tail piece
properly. It isn't necessary to clean the inside of an appliance (as it is acting
like the inside of your colon ), but the end of the tail flap is exposed to the
outside and will cause odor if fecal material is not removed. A careful swipe with
a piece of tissue will do the trick. Always carry an extra appliance and an extra
closure clip for emergencies. Check it periodically to make sure that it is not
showing wear and tear. When traveling, carry a collapsible plastic cup for water,
a packet of tissues, and a small plastic bag for any other unforeseen need. Check
your stoma whenever you change your appliance. You want to make sure that you
catch any possible problems early. Look for changes in color, shape, or function.
Also, look around the stoma for changes in the skin. If you spring a leak while
wearing your best "dry clean only" winter whites, get them to the cleaners
quickly. Explain the nature of the stain. You can help educate the public and you
have the best chance of getting the stain out if you "come clean" as to what
caused it. If you can't eliminate odor from your faceplate, try taking an old
toothbrush and scrubbing the faceplate with toothpaste. If you find the scissors
sticky when you cut Stomahesive wafers, lubricate the scissors with KY Jelly or
clean the blades with rubbing alcohol. Try using one of those small seam rippers
(available in any fabric store) for cutting the size you need from Stomahesive. It
is quick and gives a nice smooth edge .... but be careful. Be careful with
zippers. The pouch can get caught in the zipper when zipped in a hurry. Be careful
with what you place in your pockets. Ballpoint pens, keys, nail files, tooth
picks, and other sharp objects could puncture the pouch. Before you leave for
travel abroad, call Intermedic, Inc. in New York City at: (212) 486-8974. They can
provide you with names of English-speaking doctors abroad.

   * Return to Contents

COPING WITH MY UROSTOMY APPLIANCE
By. John Baird, Via: 0stoline, Sherman Area Ostomy Association
Let me share with you some of the tricks I've found useful, over the past seven
years since my ileal conduit was installed, to keep on good terms with my
appliance. I keep attached with a three-piece appliance, (a base which is fastened
to my abdomen by cement, a vinyl pouch attached to the base by an elastic
"O-ring," and a belt). For ostomates, as much as for Scouts, our watchword is "Be
Prepared." I keep a fairly complete supply of extra pouches, etc. in my office, as
well as at home, including extra underwear for the rare, but potentially
devastating occasions when my appliance comes loose while I am at work. I always
take my extra kit with me when I travel. Another device which helps me keep
prepared is the hole, specially cut in my cotton under shorts, to fit around my
appliance. This serves not only to place cloth between my pouch and my skin to
absorb and prevent sweating, but also to serve as an early warning signal when the
base begins to separate. An ear syringe comes in handy every morning, for
squirting diluted white vinegar into my pouch, through the lower tip, for rinsing
urea crystals from my stoma, as well as cleansing my pouch. I fill the pouch to
soak my stoma while I'm shaving, then empty it, leaving the pouch refreshed. This
routine also confirms whether I ought to change pouch at that time, since the
pressure from the filled pouch (with the tip drawn up and tucked under my belt)
will stimulate beginning leaks. When dampness appears, I look carefully to see
whether it comes from a seam in the pouch which would then need to be thrown away
and replaced.

   * Return to Contents

PUSH THE SKIN, DON'T PULL THE TAPE
By: Milly Johns, North Wind News, Anchorage, AK
Damaging the skin around a stoma (or anywhere else), is asking for infection.
Don't peel your pouch away from your body. Take hold of an edge of the adhesive
sections or tape, and push the skin away from the tape. In older people and babies
with thin skins, you can peel their skin off by pulling on tape. Take a good look
at what is happening when you pull tape. The tape is pulled upwards, dragging the
skin with it until it is pulling hard enough to break loose. It even looks
painful! Owie! Now look at what happens when you push the skin away from the tape.
It doesn't hurt and the outer layer of skin is not torn off, which sometimes
happens with pulling. These people who think yanking it fast is best, ought to
take a good look at the skin afterwards. If you have a leak, digestive enzymes in
the discharge will excoriate your damaged skin quicker, and deeper than if your
skin is okay, or protected with some sort of skin preparation. Be careful in
removing the appliance around excoriated skin, as pulling may further damage and
irritate the skin. Learn to treat skin quickly.

   * Return to Contents

NUTRITIONAL MATTERS FOR THE PELVIC POUCH PATIENT
By: Barbara E Wendland, RD
Pouchitis, or inflammation of the pelvic pouch, is a well recognized complication
of pelvic pouch surgery. Approximately 10 to 25 percent of patients experience an
episode of pouchitis at some time. Our experience has not indicated that food
intake causes pouchitis. Patients with pouchitis have been found to respond well
to antibiotics, which suggests that bacteria are major participants in the
inflammatory reaction. Nothing has been published in the research literature to
indicate that specific food or food preparation methods contribute to the
inflammatory reaction of pouchitis. After pelvic pouch surgery, follow a meal
pattern that consists of three main meals or four to six smaller meals, taken
throughout the day, depending on your tolerance. It's important to take meals at
regular times, to give your bowel a consistent message. Choose nutritious foods
from each of the four food groups (breads and cereals, meats and meat substitutes,
fruits and vegetables, and dairy products) as tolerated. Increasing the intake of
dietary starch products that are easily digested such as potatoes, pasta, and
soluble fiber sources (oat bran, oatmeal bread, and barley) is important. easily
digested starches should act to assist the pelvic pouch adapt to its new role.

http://www.nmh.org/nmh/patientinformation/ostomyddietguidelines.htm
Ostomy Diet Guidelines

Whether you have a colostomy or an ileostomy, you will probably find you can
return to your usual way of eating within six to eight weeks following surgery.
After surgery your diet will progress from clear liquids to bland, low fiber
diet.

Please follow your doctor_s recommendations on specific food restrictions:

   * Eat regular, balanced meals (three to six per day). Your dietitian can
provide you with added information on a balanced meal. Skipping meals increases
gas and watery stools.
   * Add small amounts of new foods, one at a time every two days.
   * If a food is not initially tolerated, try again in a few weeks.
   * Each person has different tolerances, so do not exclude a food unless it
causes a problem for you. Your food intolerances before surgery will probably
continue after surgery.
   * Always drink 8 to 12 glasses of fluid per day.
   * Chew your food well and always take plenty of fluids to prevent
obstruction.This is important when eating fibrous foods, such as celery, cabbage,
bamboo shoots, nuts, and corn or other kernels.
   * Try to prevent large weight gains. If you need to lose weight, consult your
doctor.

If you have excessive gas or odor

   * Eat slowly, in a relaxed setting to prevent swallowing air.
   * Trial and error may reveal foods that cause gas or odor.
   * High fiber or very spicy foods may be offenders. Try the following one at a
time to isolate problem foods: coconut, green peppers, legumes (dried beans and
peas), onions, cabbage, broccoli, cauliflower, raw fruits and vegetables, sugar
port, oat bran, pumpernickel bread, carbonated beverages, alcohol, and fried
foods.

If you have diarrhea

   * Do not control diarrhea by restricting fluids.
   * Remember to drink fluids (8 to 12 glasses) during the day to replace the
fluids lost.
   * After surgery or after taking antibiotics, the normal bacteria in your
intestines may need to be replaced. Eating a cultured milk product daily (i.e.
yogurt) may help the normal bacteria.
   * You may need to avoid high fiber foods, such as fruits, vegetables, whole
grains, legumes, and bran for a few days.

If you have constipation

   * Drink plenty of fluids.
   * Increase high fiber foods, such as whole grains, bran cereals, fruits, and
vegetables.
   * Moderate exercise may also be helpful.

Dietitian:__________________________________________

Phone Number:_____________________________________

Notes:____________________________________________________________________________