Week 6- Stoma

Question 1

what is a stoma?

Answer 1

• opening in front of abdomen
• surgically created can be the bowel or bladder
• enables elimination of contents

Question 2

why may someone need a stoma?

Answer 2

• some diseases like IBD, DIVERICULAR DISEASE, CANCER OF THE LARGE INTESTINE
• volvulus (twisting of the inestine causing lack of blood into area
• perforation (hole in the wall) of colon
• Haemorrhage
• Toxic Megacolon
• Growth Retardation
• Colonic Polyps

Question 3

what are the different types of stoma?

Answer 3

• colostomy
• ileostomy
• urostomy

Question 4

what is a colostomy?

Answer 4

• the most common type
• large intestine used
• the stool is firm as it has already passed through most of intestine
• loop colostomy is when there is 2 openings and is temporary before the patient goes home, one hole drains faeces and the other drains mucus

Question 5

what is a ileostomy?

Answer 5

• when the end of the small intestine is used
• the large intestine is normally partially/full removed and sometimes the rectum too
• generally more fluid contents as it hasnt gone through much of the intestines

Question 6

what is a urostoym?

Answer 6

-output is urine
-formed after bladder removal
-not reversible
continuous flow

Question 7

what is a colostomy bag?

Answer 7

• where the stool is collected
• is a closed bag should be changed one or twice a day
• there is a one piece and two piece bag

Question 8

what is a ileostomy bag?

Answer 8

• generally drain-able bag and are reuseable

- change 3-5 times a day

Question 9

what is a urostomy bag?

Answer 9

• the bags have a tap at the bottom that needs changing 1-3 times a day
• night drainage bags can be used at home

Question 10

how do you use a stoma?

Answer 10

 Remove appliance gently
 Empty contents of pouch down toilet
 Push skin down and away from the appliance
 With other hand, pull pouch up and away from stoma
 Clean and prepare peristomal skin
 Soft tissue, warm tap water
 Gently remove any hair around the area
 Pat dry skin
 Cut the correct hole to the shape of the stoma
 Apply appliance
 Even pressure on baseplate
 If pouch is leaking, change immediately

Question 11

what are some changes a patient can do to their lifestyle once recovered from surgery?

Answer 11

• diet= high fluids fibre rich diet to avoid constipation
• should avoid contact sports or heavy weightlifting
• the filters should be covered during water sports
• for travelling have plenety of supplies or forward planning, travel certificates
• most resume normal sex life

Question 12

what are some food problems people might have?

Answer 12

• alcohol=gas producing
• some cheese= odour in stool
• nuts and celery= can cause blockage

Question 13

what are some medication problems people might have?

Answer 13

• antibiotics= diarrhoea
• laxative=diarrhoea
• asprin= GI side effects
• NSAIDs= GI side effects
• diuretics= constipation

Question 14

what are the recommendations for constipation treatment for patients with stoma?

Answer 14

• review diet and medication as first line
• increase fibre and water intake
• Consider use of Ispaghula Husk

Question 15

what are the recommendations for diarrhoea treatment for patients with stoma?

Answer 15

• review diet and medication as first line
• loperamide liquid and disp tabs
• caps pass too quickly to be absorbed

Question 16

what are other common problems for patients with a stoma?

Answer 16

• pancaking when the stool gets stuck at the top of the bag leading to leakage
• ballooning due to gas
• skin problems, skin irritation, preexisting skin disease or hair
• leakage
• retractionof the stoma where it sinks below skin surface
• stenosis which is narrowing of the bowel preventing stool passage
• parastomal hernia due to heavy coughing, weight gain
• urinary crystal, alkaline urine so drink fruit juice to keep it acidic as it can cause bleeding or irritation