Exercise and Ostomy
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O stomy patients are often told not to lift "anything heavier than a plate" during the first few postoperative weeks - not only to protect the abdominal and/or perineal incisions, but also to reduce the potential for developing a peristomal hernia. These patients frequently continue to embrace the idea that they are restricted from many forms of exercise, especially those that stress the abdominal muscles.
Exercise, however, plays an enormous role in health, especially in light of the high rate of obesity in our country and our rapidly aging population. Exercise is just as important to a person with a stoma as it is for any other person, young or old. Excessive postoperative weight gain or obesity interferes with pouch adherence, causing leakage; peristomal skin problems; repeated changes in ostomy management systems; frequent office, clinic, or emergency room visits; and overall increased costs of care associated with increased resource utilization.
Inflammatory bowel disease. Patients with inflammatory bowel disease (IBD) can develop arthritis as a complication of their disease. The progression of the two conditions may not be parallel because spondylitis often precedes the symptoms of IBD by months or years. Spondylitis may result in fusion of the vertebrae leading to a permanent decrease in range of motion, particularly in the sacroiliac joints. The goal of therapy for spondylitis is to ensure maximum functional range of motion of the spine. This is accomplished by physical therapy using postural and stretching exercises in conjunction with the application of moist heat and often non-steroidal anti-inflammatory drugs (NSAIDs). With proper treatment, however, most patients with arthritic symptoms from IBD can be effectively treated to control their symptoms and retain functional mobility.
Constipation. Constipation and falls are common problems among the elderly. An elderly person with a descending colostomy is also at higher risk for constipation. Because osteoarthritis is the leading cause of disability in people over the age of 65 years1 and most Americans with a colostomy fall into that age group, it is reasonable to assume that many seniors with a colostomy may suffer from constipation or arthritis or a combination of the two.
Many age-associated declines occur not because of the aging process itself but as a result of being inactive. Seniors and frail elderly adults can increase their quality of life with simple strength-training exercises and stretches. Although often overlooked, physical exercise clearly plays an important role in ostomy rehabilitation and improved quality of life. The question remains as to what exercises and activities are appropriate for a person with a stoma. No exercise regimen should be undertaken or recommended for a patient without a physician's approval, as other non-ostomy-related conditions might contraindicate particular types of activities.
1. Agency for Health Care Policy and Research. Managing Osteoarthritis: Helping the Elderly Maintain Function and Mobility. Research in Action, Issue 4. AHRQ Publication No. 02-0023, May 2002. Rockville, MD. Available at: http://www.ahrq.gov/research/osteoria/osteoria.htm. Accessed January 27, 2004.
2. Brach JS, Fitzgerald S, Newman AB, et al. Physical activity and functional status in community-dwelling older women. Arch Intern Med. 2003;163:2565-2571.