We have a resident with a new colostomy. Any suggestions for changing the colostomy so it doesn’t leak?

There are several things you can attempt. First of all, change it when the resident has not recently had anything to eat or drink. Eat foods that thicken the stool, such as rice, pasta, cheese, bananas, potatoes, applesauce, smooth peanut butter, pretzels, yogurt and marshmallows. 

If lots of fluids are filling the colostomy bag during the day, offer the resident two or three glasses of fluid like sports drinks, fruit or vegetable juice, and broth, that will replace electrolytes. But limit these, especially if the resident has a cardiac problem.

Drinks like soda, artificial chocolate drinks, Kool-Aid and fruit juices do contain lots of sugar and will cause an increase in output. Make a list that hangs in the room so that everyone, including the resident, family and all staff, know what you have tried and what may have been successful or not so successful with slowing the output!

Foods high in sugar content, such as carrots, grapes and oranges, will come through fast as well,  especially if the resident has an ileostomy or short bowel syndrome. Trial and error also will be the thing that works best as, like I mentioned, everyone is different. Make a list of the fast-traveling foods and give a copy to the family so they, too, know what they should not bring in as a snack, or limit the amount or number of times they offer it to their loved one!

Some colostomy wearers swear by eating marshmallows before changing the appliance, and/or sprinkling some sugar directly on the stoma to cause it to shrink a bit. It’s all about trial and error, and everyone is different! Try a few things to see  what works. Be sure it’s on the care plan so everyone can benefit from the trials and success.