General Nursing Discussion

Nurses General Nursing

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I'm a nursing student and I have a patient with a colostomy. He has a very weak stomach and cannot handle the odor when the colostomy bag is being changed. Does anyone know anything that can help this. He is only eating about 20% of his meals because of the fear of throwing up when the bag gets changed. I really want to be able to give him some suggestions.

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Debbie,

There are several different things you can do to prevent really noxious odors from a colostomy bag. There is even something one of the ostomy companies makes - it's like a powder to go in the bag? which absorbs some of the odor. I don't see a lot of colostomies- so I don't know exactly what the product is. In addition, there are foods to avoid- the ones that produce a lot of gas- broccoli seems to be a big culprit. I would suggest you call the ostomy nurse- or skin specialist for the hospital- He/she will probably be delighted to help you- and it will certainly make you look good in clinical (using all the resources around you!). I think it is great that you are so concerned about this patient. Good Luck in school.

I think the suggestion about the ostomy nurse is a good one, too. However, I think that you need to explore with the man his revulsion at his body changes, which could be at least part of his problem.

In the very old days, I worked with post op patients whose surgeon didn't believe in putting a colostomy bag on patients post op. He wanted a dressing. So these people would stool all over their abdomens. I had a client who had actually a fairly distal colostomy and, over time, it could be expected that her colostomy would produce pretty formed stool, but now she had liquid stool regularly spilling onto her abdomen. I gave her that simple information [that her stools would eventually be more formed] and that, with a bag, her situation would become more controllable. Months later, I met that woman casually and she told me that that information had given her hope and helped her to believe that her situation was going to be, somehow, manageable.

The odors of that colostomy, odor stoppers aside, are going to be a fact of that man's life. He needs room to express his fears that, when he walks into a room, everyone will smell him. He needs time to talk about how out of control he feels about his stools and the odors. Maybe he needs to meet someone with a colostomy who is coping. Maybe he needs to hear from you how you cope with being around obnoxious odors. I always plug my nose by pressing my tongue against my palate. Maybe he needs to be taught to care for his colostomy in the bathroom so that bathroom odors stay where they belong and he doesn't have to contend with them in his living space, his hospital room. I don't know this man, you do. But he needs time to tell you these things and maybe you can help him find what it will take to help him cope with this momentous life change.

Good luck to you and your client.

[Debbie......... Natural Yoghurt, thats what our stoma nurse recommends and it seems to work :-) would suggest as the last reply states, look into the psycology of altered body image, coming to terms with a stoma is half the battle.. good luck.

Now, I don't want to suggest you ignore all the other factors for his nausea (like stres, altered body image, etc.), but one thing that helps me get over smells that make me sick is mints or gum. I know it sounds dumb, but it works if the smell is only really bothersome for a few minutes then subsides. Try excel gum, I swear you can't smell anything when you're chewing it. A teacher gave me that tip when I had a fecally incontinent client and it really worked.

Thank you all so much for your help! I will pass this info on to my patient. I know he will really appreciate it.

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