Ostomy Lifestyle Question (Oct 16, 2014)

Question:

I have had an ileostomy for 9 years. For the past 3 months I have had a strong unpleasant odour coming through the exterior of my pouch on day 3 or 4 of wear. It smells like rotting vegetables, or cabbage. The odour is transferred to my clothes. I am very conscious of the smell and afraid that nearby people can smell it. I have not changed my diet recently, so that does not explain it. Should I worry about disease? I do not want to change my appliance too frequently in case I irritate my skin. Please help.

Answer:

Ostomy pouches are odour-free, and they do not allow gas or stool to leak out when they are worn correctly. Odour should only be noticed when emptying your bag or doing an appliance change; a sealed pouch should not smell. If you notice odours at any other time, it could indicate a leak, defective ostomy appliance, improperly cleaned pouch outlet, or non-functioning filter (if it’s clogged, it may leak out odour).

You should talk to your ostomy Enterostomal Nurse, when you are having any problems like that.

Although, the ostomy equipment from all of the manufacturers is of the highest quality, as with any product, possibly you have somehow received a defective equipment shipment. Also, you could call your ostomy equipment supplier to discuss the odour issue and their product.

Possibly your stoma has changed in size or shape, with a new shape or size, there could be a possibility that the opening on the flange around the stoma itself, no longer fits well, and a small amount of leakage is occurring and being absorbed in the underside material of the flange opening, (a wicking effect might be happening). You’ve had your ileostomy for 9 years, if you have put on weight, lost weight, have developed a parastomal hernia, or your abdominal skin changed, there is a possibility that your stoma has changed shape and/or size. You may want to measure your stoma again, and determine if your current flange size is still appropriate for you. Again, it is recommended you discuss this with an Enterostomal Nurse, who is experienced in measuring and recommending flange opening size.

Having said this, you’re having odour issues. There are a number of additional areas you’ll want to explore, although you mentioned you have not changed your diet recently there are some foods that  you may want to watch out for and eliminate the items that might cause odour. Each food affects us differently, and you’ll have to experiment for yourself to determine what ones are offending foods for you. A short list of typical odour-causing foods are:

Asparagus                             Baked Beans
Broccoli                                  Cabbage
Cod liver oil                           Eggs
Fish                                         Garlic
Onions                                   Peanut butter
Some vitamins                      Strong cheese

Through discussions with fellow ostomates many state fish and eggs are real offenders. Eating garlic, onions, broccoli and beans are very nutritious foods, and you may not want to eliminate them from your diet. Following is a list of foods that might help reduce odours naturally. You may want to try them to see if they work for you:

Cranberry juice                     Orange juice
Parsley                                    Tomato juice

Do keep in mind that some medications and supplements (like probiotics) we take, can adversely affect how our output smells. Dietary changes may not reduce odour if this is the case for you.

A popular way of controlling pouch odour is with pouch deodorants that are either liquids or gels that are poured into your ostomy pouch with each bag change and/or every time you empty your pouch. Most are designed to kill odour-causing bacteria. You’ll want to discuss this with your Enterostomal Nurse and/or ostomy equipment supplier.

Call your Ostomy Nurse or Doctor if:

  • Your stoma smells bad, or there is pus draining from it, or it is bleeding a lot.
  • Your stoma is changing in some way. It is a different colour.
  • There is blood in your stool.
  • Your stools are looser than normal.
  • You have a big increase in the amount of stool collecting in your pouch.

Conclusion:

Talk to your ostomy (Enterostomal) Nurse, and you can call your ostomy equipment manufacturer/supplier to discuss the odour issue.

Odour could indicate a leak, defective ostomy appliance, improperly cleaned pouch outlet or non-functioning filter (if it’s clogged, it may leak our odour).

Has your stoma changed in size or shape, this could affect a proper fitting flange opening?

Watch and eliminate things that might cause odour. Each food affects us differently, and you’ll have to experiment for yourself to determine what ones are offending foods  for you.  Do keep in mind that some medications and supplements (like probiotics), we take can adversely affect how our output smells.

A popular way of controlling pouch odour is with pouch deodorants

Call your Enterostomal Nurse or Doctor to discuss any stoma or digestive changes, including odour.