Adjusting to life after stoma surgery can feel overwhelming, and many people quickly discover that there’s a learning curve to proper ostomy care. Understanding the common mistakes new ostomates make can help you avoid preventable complications like leaks, skin irritation, and discomfort. From choosing the right appliance to protecting peristomal skin, small habits can make a big difference in comfort and confidence. Plus, ,ost early challenges are manageable with the right education, support, and supplies. Here, we'll go over a few mistakes to avoid when living with an ostomy.
Quick Overview: Common Mistakes New Ostomates Make
- Measure your stoma regularly, especially during the first six to eight weeks after surgery, to ensure a proper barrier fit and reduce leaks, odor, and skin irritation.
- Protect peristomal skin by addressing redness or irritation early, using proper cleaning techniques, and ensuring your appliance fits correctly.
- Empty and change your pouch appropriately based on your ostomy type (ileostomy, colostomy, or urostomy) to prevent leaks, barrier breakdown, and discomfort.
- Use the right ostomy appliance and keep routines simple, choosing products that fit your body type and avoiding harsh cleansers that can interfere with adhesion.
- Stay hydrated and seek support when needed, especially if you have an ileostomy, and don’t hesitate to contact a healthcare professional or ostomy support group for guidance.
7 Common Ostomy Mistakes and How to Avoid Them
Before leaving the hospital, your surgical team will give you discharge instructions that include how to care for the skin around the stoma, potential signs of infection, and what to do if you experience any issues with your bowel movements. Your ostomy nurse can also help you with tips for adjusting your daily routine to maximize your quality of life. Still, even with all the tips, self-care is the most important thing you can do and improper ostomy care can make a big difference. To help you reduce pitfalls, here are the most frequently made mistakes and how you can avoid them.
1. Not Measuring the Stoma Regularly
One of the most common mistakes new ostomates make is assuming their stoma size will stay the same after surgery. In reality, stomas often shrink during the first six to eight weeks postoperatively as swelling decreases. If your skin barrier opening is too large, stool or urine can come into contact with the surrounding skin. If it’s too tight, it can cause pressure and irritation.
Luckily, you can avoid such issues as leakage, unpleasant odor, poor adherance of your ostomy pouch, peristomal skin breakdown, pain, and more by measuring your stoma regularly, especially during the first few months following surgery. Your ostomy products will likely come with a measuring guide, but you can also ask your ostomy nurse for tools and general instructions on how to ensure the right fit.
2. Ignoring Early Signs of Skin Irritation
Healthy peristomal skin should look similar to the rest of your abdomen; smooth and intact. Redness, itching, burning, or weepy skin are not “normal” and should not be ignored. Many new ostomates assume mild irritation will resolve on its own. Unfortunately, untreated moisture-associated skin damage (MASD) can worsen quickly and interfere with barrier adhesion. There are several things that can cause issues such as irritation or skin breakdown, and it's important to speak with a healthcare professional if issues continue. However, some ways you can prevent common skin issues include:
- Ensure proper appliance fit
- Clean gently with warm water (avoid residue-heavy soaps)
- Pat skin completely dry before applying a new barrier
- Use ostomy powder for moist skin
- Apply skin barrier wipes for added protection
If broken skin doens't get better, it's importan to seek help from a medical professional.
3. Waiting Too Long to Empty or Change the Pouch
Allowing the pouch to overfill places unnecessary strain on the adhesive barrier. As the pouch becomes heavier, it pulls away from the skin, increasing the likelihood of leakage and reducing overall wear time. However, the time between changing your pouch often depends on the type of ostomy you have and what your output is like.
Ileostomy output is typically more liquid and more frequent because it bypasses the colon. As a result:
- The pouch may fill more quickly
- Increased output volume can place greater stress on the barrier
- Dehydration risk is higher
If you have an ileostomy, you'll likely need to empty their pouch several times per day, when it's about one-third full, especially if you're experiencing diarrhea or a more liquid output.
Colostomy output is usually more formed and may occur less frequently, depending on the location of the stoma within the colon.
- Descending or sigmoid colostomies may have more predictable output, allowing for colostomy irrigation instead of a pouch
- Some patients may even use closed-end pouches
Even with thicker output, waiting too long to empty can still cause excess weight and barrier strain. Therefore, it's recommended to empty the pouch when it's one-third to one-half full.
Urostomy output is continuous, as urine flows steadily from the kidneys.
- The pouch fills gradually throughout the day
- Overnight drainage systems are often recommended
- Emptying should occur regularly to prevent backflow or seal compromise
To avoid overflow, it's best to empty a urostomy pouch when it's about one-third full.
4. Using the Wrong Type of Ostomy Appliance
Not all ostomy systems are designed the same, and using the wrong type of appliance can lead to repeated leaks and ongoing skin irritation, amongst other things.
For example, some stomas protrude outward, while others may sit flush with the skin or retract slightly. A flat barrier may work well for a protruding stoma, but a convex barrier may provide a better seal for a flush or retracted stoma. Body contours, scarring, and abdominal folds can also impact how well a barrier adheres.
Additionally, choosing between a one-piece and two-piece system often comes down to personal preference and lifestyle needs. One-piece systems are flexible and discreet, while two-piece systems allow you to change the pouch without removing the skin barrier.
5. Overcomplicating Cleaning Routines
Many new ostomates believe they need special cleansers, antibacterial soaps, or alcohol-based wipes to keep the stoma area clean. In most cases, simple is better.
The stoma itself does not require special cleaning solutions. Warm water is typically sufficient for cleansing the surrounding skin. Products containing oils, lotions, or heavy fragrances can leave residue behind, which may interfere with barrier adhesion and increase the risk of leaks.
A simple cleaning routine should include:
- Gently cleansing the skin with warm water
- Avoiding oily or moisturizing soaps
- Patting the skin completely dry before applying a new barrier
Keeping the routine straightforward helps protect the skin and improves the performance of your ostomy appliance.
6. Not Protecting Against Dehydration
After undergoing an ostomy surgery, your body handles fluids differently. Therefore, hydration is an extremely important part of ostomy care, esepcially for individuals with an ileostomy. To avoid dehydration, it's imortant that you hydrate mindfully, especially if you engage in physical activity. To help, drink plenty of fluids throughout the day and keep an eye on your ostomy output's consistency and volume. If your output increases suddenly or significantly, or you notice any signs of dehydration such as prolonged constipation, it's important to contact your healthcare provider.
7. Avoiding Emotional Support and Education
Adjusting to life with an ostomy involves more than physical healing. Many new ostomates experience concerns about body image, odor, leakage in public, or returning to normal activities. Some individuals avoid asking questions because they feel embarrassed or assume discomfort is normal. Others delay follow-up appointments if problems arise.
At the end of the day, it's important to remember that ostomies are typically life-saving surgeries and, although you may feel like you have no one to talk to, there are support groups available. Ostomy support groups are a great resource to help you find other ostoamtes and normalize the expeirence while building confidence and even making some new friends. Just remember, seeking support is not a sign of failure, it's a proactive step towards improving your comfort and maintaining a strong quality of life during this transition.
The Right Ostomy Care Supplies Make a Difference
One of the most common mistakes new ostomates make is assuming all ostomy supplies work the same. In reality, the right products can mean the difference between frequent leaks and long-lasting comfort. Instead of trial and error, it helps to speak with a specialist who understands ostomy care and product options. Working with a knowledgeable supplier like Byram Healthcare can also make ordering online stress-free and straightforward, especially when navigating insurance-covered ostomy products and reliable delivery. To learn more or to find a pouching system and ostomy products that work for your lifestyle, contact Byram Healthcare today.
