The Basics of an Ostomy

A lot of people have confused about different types of ostomies and aftercare. This article is written to help them understand ostomy in the best possible way.

Different terms are associated with the Ostomy such as stoma, colostomy, urostomy, ileal conduit, and ileostomy. So mean of you don’t know the difference between these terms and you want to know what happens if you undergo this condition.  Here are some examples with a complete explanation of all these processes.

How to take care of a colostomy patient?

Ms. Lora is a 69-year-old woman. She is a black –American and a retired educational officer. Her family members i.e. father and elder brother died because of breast and bowel cancer. All of them used to eat pork and foods high in fats. They also used to smoke a lot.

Even though Ms. Lora never had any difficulty or discomfort in her bowel movements, but she noticed less stool output with constipation and diarrhea for the last seven months.

The diseases that can reason for colostomy are:

  • Crohn’s disease
  • Constipation
  • Fistula in between rectum and vagina
  • Hirschprung disease
  • Birth defects
  • Imperforate anus
  • Perofrated diverticula
  • Rectal injury
  • Necrotizing enterocolitis

Ms. Lora needs to undergo a colostomy. A piece of the colon will be used to make a stoma and divert the passage of the bowel contents toward it.

She had a sigmoid colostomy that’s why it is made on the left side of the abdomen.

On the 3rd to 5th day, gas functioning will start.  At the start, the feces will be dark red or brown along with the mucus. Gradually it will come to normal color and consistency.

Ms. Lora’s healthcare expert may recommend she adapt an irrigation method that will help her regulating her smooth bowel and movements. It also helps in predicting bowel movements. So a patient does not need to wear a pouching system.

It is introduced in the body through a colostomy irrigation kit.

Ms. Lora’s nurse helped her to choose the best pouching system for her. Also, she helped her to learn about how to take care of her stoma. She can use these appliances or accessories for the first few weeks or days after the surgery. A skin barrier or wafer might be needed.

Her nurse will also educate her about how to clean the stoma and change the pouch. Simple water is the best of cleaning the stoma. Avoid any kind of soap or oil. Dry the skin completely and then attach the new pouching system.

Ms. Lora’s nurse will encourage her to look at her stoma. She needs to know the difference between a diseased or healthy stoma. The stoma should look as red as her mouth’s tissues. There is no nerve ending present in the stoma, it must be always wet or soggy. There can be stomal bleeding sometimes; there is nothing to be worried about. It can be risky if the bleeding does not stop for hours.

Ms. Lora wants to know how to empty the pouch. The nurse informs her that she needs to empty her pouch once it is one-third filled. She can use a tail closure and directly empty it into the toilet.

In case of some complications such as intestinal blockage, rectal injury, or parastomal hernias a second surgery is needed.

How to take care of an ileostomy?

Mr. Ben is a 29 years old white-American with a background of ulcerative colitis when he was eighteen years old. Her two sisters died because of toxic megacolon at twenty-five. When he was 7 years old his father died of gastrointestinal hemorrhage and his mother died two years after due to diabetes. He has many friends who can take care of him. He has been admitted for surgery for the restorative proctectomy also referred to as, ileal pouch-anal anastomosis.

Before her surgery and while he was admitted, the nurse inquired about the early bowel prep and antibiotic uptake. Mr. Ben tells him that he drank polyethylene glycol to cleanse his bowel completely. And he also consumed antibiotics.

Then his surgeon told him that his colon and rectum needed to be removed while his anus and sphincter will remain intact. The surgeon told him that he will use a part of his ileum to make a reservoir (internal). This will be a temporary ileostomy till the pouch heals completely. This ileostomy is required for almost eight to twelve weeks.

Mr. Ben has discovered different types of pouching systems on the internet. His nurse introduced him to a two-piece pouching system.  The pouching system should be sterile until it Is opened.

After the stoma surgery, he was under observation in the ICU for forty-eight hours. The nurse checked his abdomen if it was soft or tender. This ileostomy was made on the lower right side.

Mr. Ben used a nasogastric tube and a urine bag. He had a little pain compared with the pain at the time of ulcerative colitis.

The day when his bowel movements can be heard, the nasogastric tube and catheter were removed. His recovery was on the way and he started to empty the Ostomy pouch with the help of a nurse on his side. The nurse told him to prevent leakage and change his pouch after every four to six hours.

His doctor asked him to drink plenty of water and drinks to prevent dehydration.  And chew his food properly. He should take foods that can thicken his stool.

On the 8th day following the surgery, he will be discharged from the hospital with an Ostomy nurse.

How to take care of a patient with a urostomy?

Mr. J is a fifty-six years old Hispanic lady. He has three adults.  Four years ago he undergo an ileal conduit for the treatment of bladder cancer. It is the most used procedure for patients with invasive bladder cancer.

During the first few days, the nurse noticed yellowish urine with mucus m in the urostomy pouch, placed at the right side of the umbilicus. She also ensures the presence of the stents near the stoma.

Mr. S abdomen is soft and he has active bowel movements. His nurse told him how to change or drain the pouch. He used a stoma cap for preventing leakage. He sits on the toilet seat and drains the pouch between his legs into the seat.

His doctor told him that he must drink 8 Oz water daily. He should avoid garlic, asparagus, and onion because it may lead to an offensive odor in his pouch.

He knew the limitations of his physical activities. He can participate in sports but should avoid games that require a lot of pressure on the abdomen.

What is the role of a nurse?

All the test and procedure before Ostomy makes a patient very nervous. He is already worried about his Ostomy and is almost blank that how he or she would handle this situation. An Ostomy nurse helps the patient to learn their basic care routine. He or she encourages them towards improvement. If you get an expert and kind Ostomy nurse you can recover in time.