The big challenge of managing an ostomy in warmer weather is an increase of sweat on the skin under the pouch, flange or barrier. This undoubtedly becomes uncomfortable and may even decrease wear-time as the absorbent material in the pouch’s adhesive absorbs more fluid and causes it to breakdown. The skin under the barrier can become irritated. This can affect every type of ostomy.
Here are several solutions to prevent skin irritation and aid in pouch management.
1. If you use a regular-wear flange or barrier consider using an extended-wear version. This may increase wear time when more sweat is present.
2. Likewise, consider using a barrier or ring around the stoma (if you are not using one already) to create a stronger seal. Tackifiers may also help when used in conjunction with other products.
3. Shorten your wear time. This will depend on your usual wear time. Shortening it by a day or two may be enough, but inspect the adhesive after removing it and note any areas that may be more worn than others. The barrier material is typically lighter in color and may be spongier to touch.
4. Pouch covers made with soft, moisture-wicking material may also help to remove sweat and moisture from the surrounding skin. Covers can help reduce friction against the skin from the pouch material.
5. Trimming the material along the edge of the flange may prevent sweat from accumulating in certain areas but should be done cautiously, as removing too much may compromise the seal.
6. Avoid Karaya-based ostomy products, such as barriers and seals. Most people with ostomies use synthetic materials but if you’re using Karaya, it may be more susceptible to breaking down in warm conditions.
7. A belt may help your pouching system to better adhere itself.
8. Be cautious when using tape or other adhesives to reinforce the edge of the flange or barrier border. If there is sweat beneath the barrier and the seal breaks down stool or urine could collect and cause skin irritation. Taping is a good option if you are engaging in activities where there is more movement of the abdomen.
It’s not always necessary to wear a special band or device to keep your pouch dry while swimming. Pouching systems are designed to get wet, so long as the pouch is dried off afterwards. You should rinse off your pouch if you’re in a chlorinated pool or in salt water (otherwise your skin may become irritated).
Using an antiperspirant has been suggested to prevent sweating under a pouch. Approach with caution. Antiperspirants contain aluminum chloride. This substance interacts with sweat and forms a pore-blocking gel which temporarily prevents perspiration (this is different from deodorant, which interacts with the sweat bacteria to reduce the smell rather than block the sweat). For a person with an ostomy the aluminum may irritate the skin around the stoma. Moisturizers in the antiperspirant may prevent a proper seal. If the skin is already irritated, the antiperspirant can irritate it further.
9. Change up your wardrobe. Summer is the time to keep cool and comfortable. You may be self-conscious of others seeing your pouch and this is completely understandable. Patterned designs, on clothes and bathing suits, can break up the outline of your pouch. Take some time to hunt for clothing that has a higher waistband to cover the top of the pouch completely. There are specialized belts and binders designed to be worn over the pouch but under clothing to help provided concealment. Sometimes spending a few extra dollars at a tailors on those new shorts will go a long way and keep you happy for many seasons.
10. Hydration (this is especially important for a person with an ileostomy). Salt is an important element in staying hydrated and is lost with perspiration. An ileostomy will pass salt, so it’s important to add more salt to your diet when hydrating. Sports drinks with low sugar content, soups, broths, coconut water and even homemade electrolyte drinks are all great ways to stay hydrated.
If you have any questions about the tips and guidelines in this article, please speak with your ET nurse for more information. ■
By Neal Dunwoody RN, ET
Neal Dunwoody is a Registered Nurse and with over ten years of experience in wound, ostomy and continence care. He completed his WOCN training through Emory University in Atlanta, Georgia. Neal currently works part time as a nurse clinician at Lion’s Gate Hospital. Outside of Lion’s Gate, Neal works as a nursing consultant including scheduling regular ET appointments through Nightingale Medical’s West Broadway location.