Anthony Salafia from Turlock, CA (Emanuel Medical : What about ileostomy or colostomy?
Kara Stoning: What about PEG tubes?
The general rule for stomas, is to pad around them using a washcloth or piece of foam, to create a relief around the wafer/stoma site. This will prevent asymmetrical pulling which may cause leakage and soil the harness, taking it out of commission (only new stoma sites tend to be tender or sensitive).
Gastrostomy (PEG) tubes are often higher than the top of the harness, in which case no special treatment is necessary. If it lies under the top edge of the harness, you can “leave room” in the top strap by closing it more loosely, or pad as you would an ostomy bag. To avoid pulling out a long PEG tube (if there is no “button”), tape the tube down to the skin so you don’t accidentally tug on it during harness application.
Empty all ostomy bags prior to applying the harness to prevent leakage. Once the harness is on, the pressure applied may slow bag output.
To avoid “rapid filling” of the ostomy bag during training, have the patient avoid eating for an hour prior to therapy: eating stimulates peristalsis, which causes bag output. This is particularly true for ileostomies, whose output tends to be “wetter” than colostomies, whose output is pastier. Work with the medical and nutritional team as needed to slow output using anti-diarrheal medications (e.g. immodium), avoiding fiber, and eating “clogging” foods (e.g. white rice), avoiding “rapid fill” foods (e.g. soup). Most people with long-standing ostomy bags know which foods run through them quickly, and can manage bag output for the therapy hour.