Stoma

Question 1

What should all patients with stomas receive?

Answer 1

regular follow up appointments with the stoma nurse

Question 2

Who gets Permanent (end) Ileostomy and where are they?

Answer 2

• After total colectomy for Inflammatory Bowel Disease (UC/Crohns) or Familial Adenomatous Polyposis (FAP)
• Most often in lower right abdomen

Question 3

Who gets covering loop ileostomys?

Answer 3

• To protect distal anastomosis when removing colorectal cancers
• Can be reversed at later date

Question 4

What is a colostomy, who gets them and what does it produce?

Answer 4

• After abdomino-perineal resections (APR) for low rectal cancers
• Permanent
• Most often in lower left abdomen
• Produces stools just like an anus

Question 5

What is a urostomy?

Answer 5

•To allow draining of urine from kidney, bypassing the ureter, bladder and urethra (e.g cystectomy)
•Ileal conduit urinary diversion ◦Section of ileum (15-20cm) is removed and end to end anastomosis is created
◦Ends of the ureters are anastomosed to this section of ileum
◦The end of the section is brought out onto the skin as a stoma
◦This stoma then works to drain urine directly from the ureters into a bag

Question 6

What are complications of stomas?

Answer 6

• Psycho-social impact
• Local skin irritation around stoma
• Parastomal hernia
• Loss of bowel length leading to high output, dehydration and malnutrition
• Constipation (colostomies)
• Obstruction
• Retraction
• Bleeding
• Granulomas
• Prolapse (telescoping of bowel through hernia site)
• Stenosis