"People who eat a lot of protein, such as big meat eaters, ingest a high level of amino acids . . . which is a major source of odor."
A discussion between Eugene Galindo, Nu-Hope Laboratories, Inc. and Karl W. Schiller, Chief Microbiologist, Truesdale Laboratories, Inc.
Mr. Galindo asks the first question.
GALINDO: Basically, what causes odor in our body wastes?
SCHILLER: Let's start with fecal wastes. These are primarily made up of bacteria and indigestible material. There are millions and millions of bacteria per gram in fecal material. It also contains fats, some protein residue and indigestibles such as cellulose materials. What causes the odor is the conversion of materials in the diet to compounds which have a strong odor. The chief offender, the one with a very strong odor, is caused by the decomposition of amino acid materials in food during the digestive process. Everyone who has changed a babies diaper is aware of this odor. It is the traditional odor of fecal matter.
GALINDO: Is this a natural part of the digestive process?
SCHILLER: Yes, the bacteria in your digestive tract do this as a natural function of converting food to body fuels. This process cannot be eliminated but there are some ways that it can be controlled.
GALINDO: How about oxygen? What role does it play?
SCHILLER: If oxygen was present in the digestive tract then you would have less conversion of food to waste compounds which have strong odors. Unfortunately oxygen is not available in the intestines. Moreover, when fecal matter is discharged to the pouch you are not going to have much oxygen present. There is such a large percentage of organic material involved and the bacteria that exist will consume the available oxygen in the pouch. The absence of free oxygen accelerates production of other odoriferous compounds such as organic acids.
GALINDO: In other words, pouches should be changed and cleaned within a reasonable times during usage, otherwise odors from contents will accentuate?
Dr. Schiller asks a question.
SCHILLER: How long is a pouch usually worn before it is emptied and cleaned?
GALINDO: A pouch may be worn as long as a week at a time but the user is advised to flush and clean it daily. And whether it contains fecal matter or urine the pouch user generally empties it as soon as it is convenient simply because waste content adds to the pouch weight.
SCHILLER: How is pouch cleaning accomplished?
GALINDO: With urinary ostomies the pouch is flushed and usually irrigated with a vinegar and water solution. The acetic acid of the vinegar stops bacteria growth and freshens the pouch. With ileostomies and fecal diversions, the pouch is flushed and washed with soap and water.
SCHILLER: That's fine. Emptying pouches with reasonable frequency and observing daily pouch cleansing is fundamental to pouch odor control. But let's talk about other ways that you can control odor and minimize pouch odor problems. First, diet. Do you have any suggestions here?
GALINDO: Well there should be an awareness of foods that are odor forming. Obviously, it pays to avoid or at least limit these foods. It's generally agreed that onions, garlic and too much spice are no-no's. Cabbage, broccoli, turnips, beans and peas are strong odor contributors. Fish and eggs can create odor problems. And asparagus certainly affects urine odor. Of course these all vary according to the individual and are best define by each person. There are also gas-forming foods that each of us will know from experience - beer, carbonated beverages, radishes, rich dishes. All of us, ileostomates in particular, should chew food thoroughly to get the most nutrient value and assure proper digestion.
SCHILLER: People who eat a lot of protein, such as big meat eaters, ingest a high level of amino acids. As we've discussed, the digestive conversion of these acids is a major source of odor. Here again, reasonable moderation on protein input is advised.
GALINDO: Another in-body helper would be bismuth subgallate tablets taken orally which tend to deodorize fecal matter before it leaves the body and enters the pouch. If subgallate bismuth creates any gastric problems the user may switch to bismuth subcarbonate as a substitute.
SCHILLER: Let's not forget urine odors. Not only odors from your diet but urine odors caused by waste removal of protein from digestion. Bacteria in the pouch breaks urine down to ammonia and carbon dioxide. Ammonia of course has a pretty pungent smell. Adequate water intake will help maintain good kidney function and help control urine odor.
GALINDO: For the lay person to understand, are we saying that ammonia is an alkaline condition in the urine?
SCHILLER: Right. For good health, urine should be maintained within a proper balance between alkaline and acid. And this will avoid urine odors (except of course odors from certain foods such as asparagus).
GALINDO: Ostomates can readily take a reading on urine balance using a simple nitrazine paper kit available from their pharmacist. Dipped the nitrazine paper test strip in a urine sample will react in shades of color ranging from yellow to purple. Properly balanced urine will read in the 5.5 to 6.5 pH scale.
SCHILLER: To sum up, body waste and pouch odor problems can be reasonably controlled through sensible diet selection and sufficient water intake plus thorough pouch hygiene.
GALINDO: What about the use of specially-formulated deodorants inside the pouch?
SCHILLER: Fine. However, keep in mind that like body deodorants we put on our skin, the pouch deodorant is an extra aid to refreshing pouch scent. Good body health and diet and disciplined pouch cleaning are fundamental. The use of a pouch deodorant is the finishing touch for worry free odor control.