Stoma care refers to the management and maintenance of a stoma, which is a surgically created opening on the body’s surface. Stomas are typically created as a means for the diversion of bodily waste or fluids when normal bodily functions are disrupted or impaired.
There are three main types of ostomies, each corresponding to a different part of the digestive or urinary system. The types of ostomies are named based on the specific organ involved and the location of the stoma. Here are the three primary types:
- Colostomy: A colostomy involves the creation of a stoma in the colon (large intestine). It is typically performed when a portion of the colon needs to be bypassed or removed due to disease, injury, or other medical conditions. The stoma is usually located on the abdominal wall, and its placement can be in various regions of the colon, including the ascending colon, transverse colon, or sigmoid colon. The output from a colostomy is stool.
- Ileostomy: An ileostomy is created by bringing a portion of the ileum (small intestine) to the surface of the abdomen to form a stoma. This procedure is performed when the colon and rectum are either removed or bypassed. The stoma is typically located in the lower right quadrant of the abdomen. As the ileum is closer to the beginning of the digestive system, the output from an ileostomy is liquid or semi-formed stool.
- Urostomy: A urostomy is created to redirect urine from the urinary system to a stoma on the abdominal wall. It is usually performed when the bladder is removed or when it is necessary to bypass or redirect urine flow due to certain medical conditions, such as bladder dysfunction or urinary tract abnormalities. There are two main types of urostomies: the ileal conduit and the continent urinary reservoir. In an ileal conduit, a small section of the ileum is used to create a conduit for urine to exit the body. In a continent urinary reservoir (e.g., Indiana pouch or Kock pouch), a portion of the intestine is used to create a reservoir where urine is collected and emptied periodically through a catheter.
Proper stoma care is essential to maintain its health, prevent complications, and ensure the individual’s comfort and well-being. Here are some important aspects of stoma care:
- Cleansing the Stoma: Regular cleaning of the stoma and the surrounding skin is crucial to maintain hygiene and prevent infection. Use warm water and a mild, non-perfumed soap or a specific stoma cleanser recommended by a healthcare professional. Gently clean the stoma and the skin around it, being careful not to scrub or irritate the area. Avoid using harsh or abrasive substances that can damage the stoma or irritate the skin.
- Stoma Protection: The skin around the stoma needs to be protected to prevent irritation and breakdown. After cleaning the stoma, ensure the area is completely dry before applying a protective barrier, such as a skin barrier or stoma paste, as recommended by a healthcare professional. These barriers create a protective layer between the stoma and the skin, preventing contact with waste or bodily fluids and reducing the risk of skin irritation or infection.
- Choosing the Right Ostomy Appliance: An ostomy appliance, such as a pouching system, is used to collect waste or fluids from the stoma. There are various types of pouching systems available, including one-piece and two-piece systems. It’s important to work with a healthcare professional or a stoma care nurse to select the most suitable appliance for your needs, considering factors such as the stoma’s size, shape, location, and individual preferences.
- Emptying and Changing the Pouch: Depending on the type of stoma and the output, the pouching system may need to be emptied multiple times a day. Follow the instructions provided by the manufacturer and healthcare professional for proper pouch emptying and disposal. The pouch should be changed as needed, typically every few days or when it becomes full, leaky, or damaged. Regularly assess the skin around the stoma for any signs of irritation, redness, or breakdown during pouch changes.
- Monitoring Stoma Appearance and Output: It’s important to monitor the stoma’s appearance and the characteristics of the output. A healthy stoma should be moist, pink or red, and protrude slightly from the skin. Changes in the stoma’s color, size, shape, or discharge should be reported to a healthcare professional. Monitoring the consistency, color, and odor of the output can help identify any changes in bowel or urinary function and may indicate the need for further evaluation.
- Diet and Hydration: A well-balanced diet and proper hydration are important aspects of stoma care. Maintaining a healthy diet that is suitable for your specific stoma type and consulting a healthcare professional or a dietitian can help manage any dietary restrictions, promote regular bowel movements, and prevent issues like dehydration or constipation.
- Psychological and Emotional Support: Adjusting to life with a stoma can be challenging emotionally and psychologically. Seek support from stoma care nurses, support groups, or counseling services to address any concerns, cope with lifestyle changes, and improve your overall well-being.
Remember, stoma care should be tailored to the individual’s specific needs and may vary based on the type of stoma and personal circumstances. It’s essential to consult with a healthcare professional or a stoma care nurse for personalized guidance and to address any concerns or complications related to stoma care.
Contact us for consultation.