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WHAT IS AN OSTOMY By
Carol (Hepp) TenEyck, RN,BSN, CETN
- Several questions have been raised in our group regarding the differences between a Colostomy, Ileostomy, and Urostomy. Here are a few definitions to help clarify things. A COLOSTOMY is formed by bringing a healthy portion of the large bowel, or colon, through the abdominal wall, to the outside. Some colostomates wear a pouch over the stoma, while others may give themselves an irrigation, like a colostomy enema, on a regular basis, and wear only a gauze pad over the stoma. ( or a small appliance). The location of the ostomy in the colon dictates whether irrigation may be a chosen method of management. Irrigation is a convenience, not a necessity. A large percentage of colostomies are performed for cancer. Some colostomies, for treatment of other diseases, may be temporary. AN ILEOSTOMY, is formed by bringing a portion of the ileum, the end portion of the small intestine, through the abdominal wall to the outside. Usually the colon and rectum are removed. The person with an ileostomy, must wear a pouch at all time, because the discharge will be loose and cannot be regulated. A large percentage of Ileostomies are performed for inflammatory bowel diseases, otherwise known as ulcerative colitis and Crohn’s disease. Most ileostomies are permanent. The most common type UROSTOMY is called an ileal conduit. In this procedure, a small segment of the small intestine is fashioned into a passageway for urine from the kidneys to the outside of the body, the bladder is usually removed. A pouch must always be worn, as there is no way to regulate the flow of urine. Birth defects and cancer are common causes for this procedure. STOMA FACTS By Diana Krasner, RN, MS, ET via The Ostomist, WHAT IS INVOLVED IN INSPECTING A STOMA? At each pouch change, check your stoma for color, shape and function. Watch for any stomal problems such s swelling retraction stenosis or prolapse. Urostomates should be on the lookout for crystal formation or alkaline encrustation (gritty white deposits coating the stoma). Any stomal complications should be reported to your Doctor or your Enterostomal Nurse (ET). WHY DOES THE STOMA BLEED SOMETIMES? Some bleeding may occur with rubbing of the stoma because the mucous membrane out of which the stoma is formed is so highly vascular. This bleeding should stop quickly. Prolonged bleeding and increased amount of bleeding or very easy bleeding may be indicative of another problem and should be reported to your MD.
CAN A STOMA GET CUT? Cuts or lacerations of the stoma can occur and some can be quite serious. Since a stoma has no sensory nerves, and therefore, no feeling, it can be cut without you feeling it. Causes of stomal laceration include shifting of the faceplate or skin barrier, too small an opening (of the pouch), incorrect pouch application, etc. Your Doctor or ET should be consulted for diagnosis and treatment in any case of stomal laceration. SHOULD THE STOMA BE DILATED? Very controversial issue. ...Daily or weekly stomal dilation is very controversial. Some authorities claim that dilation PREVENTS stomal stenosis; others claim dilation CAUSES stomal stenosis. Check with your Doctor or ET for advice on this widely debated issue. HOW SHOULD A STOMA BE PROTECTED? Stomas are fairly hardy, but some common-sense rules apply. Stomas should be protected from direct physical blows, from too tight clothing, and from rigid objects (e.g. belt buckles) over them. Ostomates engaged in contact sports should protect their stomas by wearing an abdominal binder for support. Kathrine Jeter writing of children with stomas in “These Special Children” states, “ Generally speaking, stomas may be slept on, rolled on, and even sat upon by another child for a few minutes without undue concern”. 57 |