Stomas

Question 1

what is a stoma

Answer 1

artificial openings of a hollow organ created surgically to allow bodily waste to exit the body
- bowel or urinary system is artifically opened onto the surface of the abdomen
- bypasses distal portion of tracts
- stoma bag then fitted to collect waste products

Question 2

what is a colostomy

Answer 2

large intestine brought onto the skin
- they drain more solid stools as much of the water is reabsorbed in the remaining intestine
- they are flatter to the skin as the solid contents are less irritating to the skin
- typically located in the LIF

Question 3

what is an ileostomy

Answer 3

ileum is brought onto the skin
- drain more liquid stools as the fluid content is normally reabsorbed later
- they have a spout which allows them to drain directly into stoma without the content coming into contact with skin
- typically located in RIF

Question 4

what is a gastrostomy and when is it used

Answer 4

involves creating an artificial connection between the stomach and the abdo wall
- used for providing feeds directly into patients stomach
- PEG: endoscopically

Question 5

what is a loop colostomy/ileostomy

Answer 5

temporary stoma used to allow a distal portion of the bowel and anastomosis to heal after surgery
- allow faeces to bypass the distal, healing portion of bowel until healed and ready to restart normal function
- 2 ends of small bowel brought onto skin
- proximal end turned inside out to form spout to protect skin
- distal end is flatter

Question 6

what are some complications of stomas

Answer 6

• local skin irritation
• parastomal hernia
• constipation
• stenosis
• obstruction
• prolapse
• bleeding

Question 7

what is a urostomy used for

Answer 7

to drain urine from the kidney, bypassing the ureters, bladder and urethra
- may be used after a cystectomy

Question 8

what does forming a urostomy entail

Answer 8

creating an ileal conduit
- section of the ileum is removed and an end-to-end anastomosis is created so that the bowel is continuous
- ends of the ureters are anastomosed to the separated section of the ileum
- end of the section brought out onto skin as a stoma and drain urine directly from the ureters into a urostomy bag

Question 8

why do urostomy bags need to fit tightly around the urostomy

Answer 8

to avoid urine coming into contact w skin –> irritation and skin damage

Question 9

what are the different types of stoma

Answer 9

Question 10

what are indications for stomas

Answer 10

• GI disorders e.g. colorectal, IBD
• trauma or surgical complications
• congenital abnormalities
• bladder cancer or neurogenic bladder

Question 11

what is involved in the care and management of stomas

Answer 11

• cleaning
• skin care
• monitor for complications
• patient education: daily maintenance, lifestyle and dietary advice + mental health