* Saddle pain
With a stoma, you can just swim. You can also swim in the sea, natural pools etc without harming the stoma. Make sure the stoma is sealed with an Ostomy bag, so that no sand or water can get in (water in a whirlpool, for example, can cause infections). The sun (or sun bed), can dry the mucous of the stoma if there is no bag over it. The bag and adhesive are waterproof and you do not need to fear it will release. A few years ago a swimming instructor did a test on the instructions of some stoma consultants. He stood for 4 hours up to his chest in water to test various base-plates. It appeared that all the base-plates were water resistant. Some of them could not even be removed for the first hour after the swim.
When you go swimming you can use a smaller bag if you want to, the so-called mini activity bags. It is advisable to cover the filter with the corresponding stickers. If the filter becomes damp, it no longer works whereby the bathwater may cause the bag to bulge. The disadvantage of masking the filter is that the gases are no longer able to escape from the bag. Fortunately a solution for this problem has been found: the Gore-Tex membrane filter. If you place this round sticker on the filter, the filter remains dry even under water, whilst the gases can escape normally. Of course the bag can still be filled with faeces under water. It could be that you have to change the bag after swimming, so always take a spare.
Brand: Gore-tex membrane filter from
The edges of the base-plate can just curl up and become slimy. When you are out of the water it attaches to the skin again, providing no sand or sunburn is between them. For security you can tape around the rim with special tape, if only for a safer feeling. You can also use Circleplast from NuHope, these are waterproof, available in various diameters and equipped with a rubber surface. You can also use Circlemate from Eurotec, these are available in different diameters and with a soft top layer. Eurotec also has the Varimate thin strips, these strips are made of a thin and transparent hydrocolloid and are also a solution for people with a plaster allergy. Welland has semicircular hydrocolloid patches for extra fixation around the base-plate. However the old reliable Leukopor also works well.
Brand: Circleplast from
NuHope, Circlemate from Eurotec, Hydrofame strips from Welland
and Varimate thin strips from
With a continent stoma it is important to cover the opening with a waterproof plaster. If the micro-organisms in water come into contact with your stoma opening, you can become very ill.
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A stoma does not stop you diving; you just have to take account of certain things. Firstly you dehydrate in the water, especially if you dive on holiday in a hot country. People with a stoma (and certainly an ileostomy) should therefore ensure that they have enough fluids before and after a dive. Also do not dive if your bowels are not working correctly, with diarrhoea you lose more moisture than usual so you could become dehydrated. Secondly, it is recommended to put a new stoma bag on before the dive. But only if you have a two-piece system. When using a one-piece system it is not wise to replace the base plate just before a dive, because it is insufficiently adhered to the skin (or else replace the base plate a couple of hours in advance).
Many questions from ostomists are about the under-water pressure: does that give any problems for a stoma. The answer is no! An exception is the continent stoma. When you return to the surface after a dive, the air leaves your body, including your bowels. That gas must escape, which is why many people pass wind after a dive. Naturally for ostomists this goes into the bag. Therefore it is better for people with a stoma not to drink carbonated beverages before a dive, as well as other products that could cause gas. With a continent stoma there is a risk that it is not possible for the gasses to escape, because the reservoir is sealed by the pressure. This can place an enormous pressure on your intestines. Whilst these are very flexible, naturally you do not want to run any risk of tearing the intestinal tissues. This is only relevant for continent stomas.
Whether you wear a wet suit or a dry suit, is very personal. A suit keeps the stoma bag better in its place, but it must not be so tight that it stops the gasses from escaping into the bag when surfacing. It is better if the suit is stretchable. You can also use a stoma cap, together with a sports corset, in order to protect your stoma (see below under the headline sport) and to prevent a hernia for example when lifting your diving gear. If your lead belt presses on the stoma, you can place the lead in lead pockets in your diving vest or on your bottle for example. If you wet dive, you can cover the filter with a Gore-Tex filter membrane. If you place this circular sticker on the filter opening, the filter will remain dry under water as well, whilst the gasses can escape as per normal. Look for further tips on, for example, masking around the base plate, in the heading swimming above. Above all, your diving gear can be very heavy, so do not hesitate to ask for help to lift it into the water.
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If you wish, you can go to the sauna as usual. Because of the high temperature and the excessive sweating the base plate can loosen earlier. Therefore it’s better to be safe than sorry and to tape around the edges of the base plate with special tape (see above under swimming). Also take some spares and change the base plate after the visit to the sauna. Also make sure you drink enough! There are also special sauna belts. If you fold your stoma bag in half underneath, you can see nothing!
Picture source: above
Stoma na und and below
Design your stoma
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On the forum there have already a number of times been asked if you can still go under the sun lamp if you have a stoma, therefore I consider this issue is relevant. Of course you can still go under the sun lamp, no problem! It can be that your stoma base plate attaches itself even better due to the heat. I sun-bed also and because I wish to be as brown as possible, I try to peg back my stoma bag to itself so that the skin under the bag can get brown as well. It is probably easier to tan under the sun bed than in the real sun, because it is a different sort of heat.
You sweat in the sun much faster than in the solarium, which can be annoying for ileostomists especially due to the salt loss. Also, the edge of the base plate can crumble. You have no problem with this in a solarium. Do not sunbathe without an ostomy bag, because it can dry out the mucus of the stoma. I would say, go ahead and sun.
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A stoma (or scar) is a weak spot in the abdominal wall. If you push too much, there is too much pressure on the abdominal wall and there may be a hernia. The abdominal wall is surrounded by a strong muscle layer and is covered with peritoneum to hold everything in place. The construction of a stoma creates a weak spot in the abdominal wall, and there is talk of an excessively large opening in the muscle layers of the stomach. Due to this too large opening, the abdominal contents next to the stoma can bulge out, forcing a part of the intestines to come forward of the abdominal muscles. The result is a large or small swelling or bulge of the abdominal wall. Almost a third of ostomists develop a hernia (for the vast majority this occurs during the first year after construction). Sometimes you only see the hernia during effort, others constantly have a huge bump on the stomach. In some cases the doctor decides to deal with the hernia surgically, for example through moving the stoma to the other side of the abdomen or to strengthen the abdominal wall with mats. In many cases this is not possible and only people with serious problems, such as severe leakage, are eligible for such surgery. A new operation will in fact further weaken the abdominal wall, so the risk of the return of the hernia is large. It is therefore better to prevent a hernia.
What is too heavy? Opinion is divided about this, but often you hear of a limit of 5 kilos. Be careful and make sure that you bend correctly, using your knees and as close as possible to the body. But do not lift too quickly. It is good to train your abdominal muscles, precisely to prevent a hernia. But don’t overdo it. If it really is essential and you must lift something heavy, for example during your work, then wear a truss for support.
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Movement is healthy for you and above all relaxing, both for healthy people and for people with a chronic disease. For the ostomists, there are some specific advantages: the abdominal muscles become stronger, thus lessening the risk of a fracture or protuberance (prolapse). In addition, sport is a way to learn to accept your stoma better. If you can exercise, you feel less handicapped. Some people find it difficult to start exercising. For example, from caution or uncertainty about the stoma. There are courses with the air of gaining back the confidence in your physical functioning. Also some hospitals have set up a “stoma gym”, where under the guidance of a physiotherapist you can develop your sporting activities after construction of the stoma.
You can practise virtually all sports with a stoma. There are some exceptions because too much pressure on the abdominal wall is not good for the stoma. Therefore intensive contact sports (boxing, judo, wrestling, rugby, karate etc) and weight lifting are discouraged. After the operation, it is wise not to exercise for the first 8 to 12 weeks, and then to slowly build up your condition under expert supervision. However you can go swimming earlier after the operation. But take care with your abdominal muscles.
During ball sports, for example, it is important to protect the stoma. There is a special stoma cap available for this. You use this protective cap under a support bandage. That is an elastic band which you close with Velcro around your waist. You can of course use just the support bandage during intensive support where you do not need protection, which helps to prevent a hernia. For sports there are special ventilating and narrow versions available.
Baas op eigen buik and
There is also an ostomy bag with an integrated cap, needing no support band:
Another idea for protection is to place a shoulder pad around the base plate. It’s also fine to wear an extra pair of underpants to aid support. There are also pants with
extra support in the abdomen. It can also be good to wear a cotton cover over your stoma bag, so that the sweat can be better absorbed. Below you see an example.
It is important to apply a new base plate well before you sport, as the material needs several hours to attach correctly to the skin. What is also important to know is that sport slows the working of your small intestine. Therefore people with an ileostomy can use a smaller bag. During sport the blood supply to the small intestine increases, which means less water is extracted from the faeces. This means people with a colostomy have more problems with a watery output. Also by a colostomy the output (how much faeces comes out of the stoma) can reduce, however during endurance and jerking movements (for example tennis) the colon relaxes and produces more output.
If you find it difficult with the thin faeces sloshing about, you can thicken the output with special products. For example with Braun ileo-gel tablets, Eurotec gellymate or Laprocare Super Absorbent Sachets from Lapronlan. The thin output or urine is turned herewith into a gel-like substance.
Brand from left to right: BBraun,
Through excessive sweating during exercise you lose more moisture and salts than normal, 1 to 2 litres of fluid per hour. A lot of drink before, during and after sport is very important.
Certainly for ileostomists it is also important that these salts are added back. This can be done before or during sports taking a salt tablet or capsule, which you can obtain without prescription at the pharmacy. Nowadays you also have sports drinks with mineral salts added. One example is “AA sports water”, which gives you exactly which minerals you have lost through sweating. Also to be recommended in very hot weather.
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People who have been operated on in the intestines or anus often suffer from saddle pain. A short ride is not usually a problem, but in longer bicycle tours saddle pain starts to become a problem. A good saddle is therefore of great importance. It is important to try out a saddle for a few days before you buy it. A saddle must support the body in the correct place (the sitting bones).In women the sitting bones are further apart than in men. Hence ladies saddles are wider and shorter than men’s saddles. Leather saddles have to be used for a while to adapt to the shape of the rider, whilst other saddles such as gel saddles are softer and more comfortable but do not adapt completely to your body. Many people benefit from a seat that has a bezel in the middle, because that removes the pressure from the rectum.
It is important to have a good adjustable seat, so that you can adjust the saddle. There is also a sprung seat. This absorbs shocks by cobbles for example. You get the feeling of constantly riding on a paved road. The sprung seat is also sold separately and is mountable on virtually every bicycle and has adjustable weight levels. Some bicycles have a sprung frame. You can smear your skin in with a layer of zinc ointment for example, to make the skin smoother and to create less friction. You can buy special cycling underwear in sports shops. Even cycle shorts with a synthetic chamois provide support and protection. As extra pressure you can place on the chamois leather in your cycle shorts a layer which is used in hospitals for pressure ulcers (decubitus). Moving often is also important, as it helps to keep the blood flowing.
Another solution to saddle pain is the recumbent cycle. Saddles of recumbent cycles are called seats and there are many types. The result is that the weight of the body is spread over a larger surface area, as in an ordinary chair, so you do not get saddle pain so quickly. You can get them with 3 wheels if you find 2 wheels too scary. Nowadays you can also rent a recumbent cycle.
Brand: Optima Cobra
Under the subject saddle pain information was used form the magazine