Geothermal Bathing for Patients with a Stoma

Precautions and Recommendations

The American Thoracic Society recommends that patients with tracheostomies avoid bathing in shallow water without a trained caretaker during the early postoperative period 1
The European Society for Clinical Nutrition and Metabolism suggests that patients with intestinal stomas can shower, bathe, and swim once the stoma site is properly healed, approximately one week or more after surgery 2, 3, 4
The European Society for Clinical Nutrition and Metabolism recommends using a waterproof dressing when the stoma will be exposed to water, particularly in public pools or shared bathing facilities 2, 3, 4
The American Gastroenterological Association advises ensuring the peristomal skin is completely dry before reapplying the ostomy appliance after bathing 5

The American Gastroenterological Association recommends cutting the appliance opening one-eighth inch larger than the stoma to prevent mucosal irritation while limiting skin exposure to effluent 5
The British Society of Gastroenterology suggests monitoring for signs of dehydration, including decreased urine output and low urine sodium, in patients with high-output stomas 6
The European Society for Clinical Nutrition and Metabolism advises ensuring adequate hydration before and after bathing, particularly with glucose-saline solutions, for patients with high-output ileostomies or jejunostomies 6

The American Gastroenterological Association recommends cleansing the stoma site with fresh tap water and soap after bathing 3, 4
The European Society for Clinical Nutrition and Metabolism suggests inspecting for signs of infection, including erythema, purulent discharge, or skin breakdown, after bathing 7
The British Society of Gastroenterology advises applying zinc oxide or stoma adhesive powder if any skin irritation is present after bathing 3, 7