Most people who have urinary diversion surgery generally do not need to make special adjustments to their diets. However, if these people also have conditions, such as diabetes or heart disease, a change in diet would be prudent. The emotional trial of going through this type of major surgery should motivate everyone to maintain a healthy diet.
Urostomates must take special care not to gain too much weight because weight gain may precipitate some special problems. The stoma may retract as the flesh grows around it. This may happen due to the unique procedure used by the surgeon because of your particular anatomy. Some people gain weight and the relative position of the stoma never changes. But, with some, a retracted stoma will result. In addition, there is an increased chance of developing a peristomal hernia if there is too much pressure inside the abdomen due to being overweight.
Most people should perform regular exercise, like walking, soon after surgery to eliminate a laundry list of complications. Benefits include: reduced probability of blood clots and hernias, better healing, improved skin condition. Your physician will offer advice as to the extent that you must exercise.
Normally urine is acid, and it is good to keep it acidic. This natural defense mechanism prevents growth of bacteria and the resultant infection. If the urine becomes alkaline, then the peristomal skin may develop granular, raised or warty areas, which may be painful or reduce prosthetic adhesion. Alkaline urine may even cause crystal like encrustations or gray, plaque like lesions on the stoma. If such problems occur, the pH level of the urine should be checked to see whether it is acid or alkaline. Your ET nurse can do this for you.
To help make the urine more acidic there are some easy steps you may take. Drink 10 ounces of cranberry juice daily. (Cranberry juice is usually sold diluted. A concentration of over 30% cranberry juice is usually advised.) Also, vitamin C may be taken. Vitamin C as well as cranberry juice increase the acidity of urine. This will also reduce the probability of kidney stones in most people. Always check with your doctor to make sure there are no reasons to avoid these items.
Vinegar soaks around the stoma may also be used for plaque encrustations or for raised tissue on or around the stoma.
Blue discoloration: Urostomates occasionally notice blue discoloration in the pouch or overnight drainage system. Be assured that there is nothing wrong with the appliance. In laboratory test conducted by ConvaTec, the blue color was found to be the result of normal bacterial decomposition of an essential amino acid called tryptophan.
There is no clinical evidence, according to an article in the American Journal of Nursing, to indicate that the production of indigo blue is harmful or that dietary tryptophan should be limited. If you are concerned, please talk with your doctor. Tryptophan is part of the regular intake of dietary protein. As it passes through your system it undergoes a series of chemical changes that ultimately result in a blue color when it finally oxidizes in the pouch.
One last issue, most urostomates require a convex faceplate. This will increase wear time and virtually eliminate leakage problems. Make sure there is some air in the pouch so the urine may easily run away from the stoma. A karaya barrier will melt when exposed to urine. Paste is also not advised because it may reflux into the conduit and cause infection. A belt will improve security when using a convex barrier.
Ostomy News. Okanagan Mainline Ostomy Association, BC Oct 2002 |
