People with colostomy bags do experience gas. A colostomy is a surgical procedure that creates an opening, called a stoma, on the abdomen, redirecting a part of the large intestine (colon) to this opening. This allows stool and gas to exit the body through the stoma into an external pouch.
Understanding Gas Production with a Colostomy
Gas in the digestive tract originates from two primary sources: swallowed air and the breakdown of certain foods by bacteria. Everyone swallows small amounts of air while eating and drinking. This swallowed air, known as aerophagia, contributes to gas in the stomach and upper intestines. While most swallowed air is expelled through burping, some travels through the digestive tract and is eventually released as flatus.
The majority of intestinal gas is produced in the large intestine (colon) due to the fermentation of undigested food residues by bacteria. Carbohydrates, specifically sugars, starches, and fiber that are not fully digested in the small intestine, pass into the colon. There, harmless bacteria break them down, producing gases such as hydrogen, carbon dioxide, and sometimes methane. The colostomy simply reroutes the exit point for this gas, causing it to collect in the ostomy pouch rather than being passed through the rectum.
The amount of gas produced can vary significantly among individuals, depending on their diet and the specific composition of their gut bacteria. Conditions like irritable bowel syndrome or food intolerances can also influence gas production.
Practical Management of Gas and Odor
Managing gas and associated odor with a colostomy involves several practical strategies, starting with dietary adjustments. Certain foods are known to increase gas production, including beans, cabbage, broccoli, Brussels sprouts, onions, and some whole grains due to their complex carbohydrates. Carbonated beverages and beer also contribute to increased gas in the pouch. Identifying and limiting these foods can help reduce the volume of gas.
Eating habits also play a role in gas control. Eating slowly, chewing food thoroughly, and avoiding talking while eating can minimize swallowed air. Similarly, refraining from drinking through straws, chewing gum, or sucking on hard candies can reduce aerophagia. Some individuals find that consuming peppermint tea or activated charcoal tablets may help reduce gas and odor.
Ostomy appliance management is also important. Many ostomy pouches are equipped with charcoal filters designed to absorb odors and allow gas to escape silently, preventing the pouch from “ballooning.” If a pouch does not have a filter or if the filter becomes ineffective, gas can be manually released, a process often called “burping” the pouch. This involves carefully opening a small part of the pouch or its outlet to vent the gas, ideally in a private setting.
Addressing Common Concerns
Concerns about sound and odor are common among those with ostomies. Modern ostomy products, often with integrated filters, enhance discretion by neutralizing odors and allowing gas to vent quietly.
Pouch deodorizers, available as drops or sprays, can also be placed inside the pouch to further minimize odor. Regularly emptying the pouch when it is one-third to half full also helps prevent excessive gas buildup and potential ballooning.
While gas is expected, persistent excessive gas accompanied by symptoms like pain, changes in stool consistency, or unusual odor changes should prompt consultation with a healthcare professional. These symptoms could indicate underlying issues such as dietary intolerances or other digestive concerns that may require medical evaluation. A healthcare provider can offer personalized advice and assess if any adjustments to diet, medication, or ostomy care are necessary.