A colostomy is a surgical procedure that creates an opening, known as a stoma, from the large intestine (colon) through the abdominal wall. This new pathway allows digestive waste, specifically stool, to exit the body into an external collection pouch, often called a colostomy bag. This procedure may be temporary, allowing a section of the bowel to heal, or permanent, depending on the medical condition. Many people with a colostomy frequently inquire about gas, wondering how it is managed with the bag.
Understanding Gas Production and Elimination with a Colostomy
Gas, or flatus, is a natural byproduct of the digestive process, occurring in everyone. It originates from two primary sources: swallowed air and the breakdown of undigested foods by bacteria within the large intestine. The human body typically produces about 1 to 4 pints of gas daily, which is passed an average of 14 times a day.
For individuals with a colostomy, the process of gas production within the digestive tract remains unchanged. The same bacteria in the colon continue to ferment carbohydrates and other food residues, generating gases like hydrogen, carbon dioxide, and methane. Instead of exiting through the rectum and anus, this gas is now rerouted through the stoma into the attached colostomy bag.
The type of colostomy can influence the consistency of stool and how gas might be managed. For instance, a transverse colostomy, located in the middle section of the colon, often produces softer stool and more gas because it bypasses less of the large intestine where water is absorbed. Conversely, a sigmoid colostomy, which is lower in the colon, typically results in firmer stool with less gas. Regardless of the colostomy type, gas accumulation in the pouch is a normal physiological occurrence.
Practical Strategies for Managing Gas and Odor
Managing gas and odor in a colostomy bag involves several approaches:
- Modern colostomy pouches often include integrated charcoal filters. These neutralize odors and allow gas to escape silently, preventing excessive “ballooning.” Filter efficiency varies and they may become less effective if wet or clogged.
- External venting devices can be attached to pouches without integrated filters or for additional venting. Devices like the Osto-EZ-Vent allow manual gas release without breaking the pouch seal, preventing pressure buildup.
- “Burping” the bag, by gently lifting a corner or opening a drainable end, is another method to release gas, especially with two-piece systems.
- Dietary adjustments manage gas and odor. Limit or avoid gas-producing foods (e.g., beans, cabbage, onions, carbonated beverages) and odor-contributing foods (e.g., fish, eggs, garlic). Reduce swallowed air by eating slowly, chewing thoroughly, and avoiding gum or straws.
- Internal deodorizers (drops, gels, or chewable tablets) can neutralize odors inside the pouch or reduce body odor.
- Maintaining a proper fit of the skin barrier around the stoma is crucial, as a poor seal can lead to leaks and odor.
- Regularly emptying the pouch when one-third to half full prevents excessive gas buildup and odor concentration.