Having an ostomy should not limit most of your teen's activities. They can still take part in activities—such as sports and exercise, going to school, swimming and travelling—with proper planning and ostomy care. As they become responsible for their care, teens will also need to think about what supplies to take to school and who to tell about their ostomy.
School
Having an ostomy should not limit your teen's ability to go to school but there will be things they will have to think about that they might not have thought about before:
- Where the washrooms are and emptying their pouch as needed to prevent leakage.
- Bringing extra supplies with them, such as extra pouches, cleansing wipes and a small pair of scissors and keeping them in different places, such as their locker or backpack.
- They can also bring extra clothes with them
- Choosing to tell their friends, teachers and school nurses about their ostomy.
Sports and exercise
Playing sports and exercising are things your teen can do with an ostomy, but they should start slowly to see how they feel during the activity. It will take time to increase their stamina and endurance.
- It will be important that they hydrate with water or a low-calorie sport drink before, during and after their activity. If they ever feel lightheaded or dizzy during the activity, they should stop immediately, rest, drink fluids and join back in the exercise or game when they feel ready.
- All exercises and sports are generally allowed, including contact sports, but you should ask your teen's surgeon first if they are allowed to participate in the activity they want to be in.
- Your teen might want to get a wrap, stoma guard or a support belt to help keep their pouch in place and protect their stoma. If they are worried about the spout opening and leaking, they might want to switch to a closed-pouch system.
Hygiene and bathing
- Bathing can be done either with or without the pouch system in place. It is recommended that your teen wears a pouch when taking a bath or shower.
- Water, soap or shampoo cannot harm the stoma. Your teen should just make sure the skin is well rinsed.
- Use unscented soaps.
- After bathing, your teen should thoroughly dry the wet pouch and skin barrier with a towel or with a hair dryer set on a cool setting to prevent moisture from being trapped against the skin.
- If bathing without a pouch, they can time their bath with planned or unplanned pouch changes. When the whole system is off, they can cleanse the peri-stomal skin gently using water, soap and a soft cloth.
Swimming
- The pouch should always be worn while swimming. Your teen can consider using a closed pouch to reduce the chances of the pouch opening during swimming. They may want to tape the edges of the flange with barrier strips or waterproof tape while swimming to provide extra security. You may also wish to purchase a waterproof seal ring they can use to protect the flange.
- Any waterproof tape should be removed after swimming as it can irritate the sensitive skin. Immediately after swimming, also dry the flange and pouch.
- Printed bathing suits as opposed to solid colours can help to camouflage the outline of the appliance. Tight briefs/underwear under boxer swimsuits can also help to secure the pouch.
- They also want to empty the bag before swimming. Another option is to change to a closed-pouch system if they are concerned that the spout will open and leak.
Travelling
- Do not put supplies in the trunk of a car in the summer or when visiting warm travel destinations. Heat can interfere with the adhesive.
- When travelling on a plane, be sure to pack supplies in your carry-on luggage. Check with the airline company if scissors are allowed to be brought on the plane. Otherwise, you might want to pre-cut the pouch that you are packing in your carry-on.
- Always carry an emergency kit. The kit should contain a zip lock bag, pouching system and individually packaged pre-moistened paper towel, or a reusable soft cloth to serve as a washcloth. In an emergency, the contents of the pouch can be emptied into a zip lock bag.
- Do not use baby wipes or towelettes that contain lanolin or other oils as these interfere with the adhesive and may irritate the skin. Avoid using alcohol to clean the peri-stomal skin as well as this will dry and irritate the stoma and/or skin.
- Take more ostomy supplies than what you normally require.
- Check to see if there is an ostomy supply store that you can access at your travel destination.
Relationships and dating
It is up to your teen whether they tell friends or someone they are dating about their ostomy. They should decide who to tell, when to tell them and how much information they want them to know. Talk with your teen about how you can respect their personal boundaries when sharing information about their ostomy.
Fasting
You may want your teen to, or your teen may want to, participate in fasting during the season of Lent, the holy month of Ramadan or as part of your religious practice. People with ostomies can fast if there is no medical reason preventing them from doing so, but fasting can lead to dehydration, nausea and constipation. This means that it is very important to hydrate during this time. If you are worried about fasting, speak with your health-care provider.
When fasting during the summer months, there is a higher risk of getting dehydrated. You may want to shorten the amount of time your teen is fasting during the long summer days, and they can make up the time during shorter days in winter months. When they break their fast, start off with small bites of food. Overeating may cause diarrhea that can last for 24 to 48 hours.
If you or your teen feel(s) that they cannot fast due to personal choices or medical advice, it is OK! There are other ways that they could participate in worship, such as almsgiving to charitable donations or volunteering their time to an organization or cause that they want to support instead of the religious practices that they were not able to join.
Praying
For some people who identify as Muslim and practise Islamic faith, the thought of having an ostomy can prevent them from participating in acts of prayer and worship. Muslims with stomas often avoid or reduce participation in prayers due to perceived inferior hygiene, not being in a state of ritual purity through physical ablution and fear of leakage.
The consensus of Islamic scholars is that a person with an ostomy can pray normally, attend mosque and perform the Hajj pilgrimage. It is not prohibited for a person with an ostomy to enter a mosque or participate in prayer. Your teen is encouraged to perform Wudhu (ablution before prayer) before each prayer. This can mean emptying their ostomy bag or stool or gas before engaging in prayer and taking steps to ensure that their ostomy bag does not leak, dirty the mosque or have any excess odours that might disrupt fellow worshippers. If your teen's stoma has output during prayer, they can continue praying as they have no control over when output is released from their stoma. At the onset of a new prayer, they can perform ablution again. This Fatwa was released by The International Ostomy Association alongside its regional associations.