Colostomy & Bowel Resection

• Bowel Resection and Colostomy are medical procedures
• Colostomy care is essential for managing a colostomy

Colostomy

• Colostomy is a surgical operation performed to create an opening from the colon (large intestine) through the abdomen.
• Colostomies can be either temporary or permanent.

Ileostomy

• Ileostomy involves creating an opening in the ileum to treat ulcerative colitis and divert intestinal contents in colon cancer.

Reasons for Colostomy

• Reasons include diverting fecal flow away from an area of inflammation or an operative site.
• It can also be neccessary for birth defects like an imperforate anus.
• It is also a solution for serious infections like diverticulitis.
• Further reasons include inflammatory bowel disease, injury to the colon or rectum, partial or complete intestinal or bowel blockage, and rectal or colon cancer.

Types of Colostomies

• Ascending colostomy involves a stoma located on the right side of the abdomen and drains liquid stool.
• Transverse colostomy has a stoma in the upper abdomen toward the middle or right side which drains loose or soft output.
• Descending or sigmoid colostomy has a stoma on the lower left side of the abdomen and drains firm output.

Purpose of Colostomy Care

• To prevent leakage.
• To allow examination of skin around the stomach.
• To assist in controlling odor.

Assessment Considerations

• Determine type of ostomy.
• Detemine type and size of appliance and the skin barrier substances used.
• Assess stoma size and shape.
• Assess the stoma for bleeding.
• Assess patient for complaints of burning sensations.
• Assess amount, color, and consistency of effluent.
• Assess the client’s and family’s learning needs.
• Evaluate the client's emotional status.

Equipments

• Essential equipment include a colostomy/ileostomy bag or pouch, soap, warm water, a wash cloth, gauze dressings, tissue paper, a wafer, a dry sheet, and gloves.

Colostomy Pouch

• Colostomy pouches can be either open-ended (reusable) or closed-ended (disposable).

Wafer

• A wafer is an additional piece of equipment for a colostomy.

Stoma Size Guide

• The stoma size guide helps in accurately measuring the stoma for proper fitting of the ostomy appliance.

Changing an Ostomy

• Choose a time when the stoma is least active, such as in the morning, and wash your hands.
• After washing hands, empty ostomy pouch and wipe the tape surrounding the old wafer.
• Place the old pouch, wafer and other waste in a plastic bag for disposal.
• Clean the skin and stoma with a washcloth, pat dry, and measure the stoma, leaving 1/8" to 1/16" between measuring guide and the stoma.
• Afterwards, trace the correct size onto the back of the wafer, cut out the hole, and apply skin protector to the peristomal skin.
• Remove the paper backing from the tape and apply the appliance over the stoma, ensuring its is centered.
• Press firmly, smooth wrinkles, and snap the new pouch into place to guarantee a good seal.
• Seal the bottom of the bag with a clip.

Ostomy Homecare

• Ensure your pouch and skin barrier opening are the correct size.
• Change regularly to avoid leakage and irritation.
• Gently remove the pouching system by pushing your skin away instead of pulling.
• Barrier creams may be necessary it the skin becomes irritated.

When To Seek Medical Attention

• Notify your doctor immediately if you experience cramps for more than two hours, continuous nausea, or an unusual odor for more than a week.
• Other problems to follow up with a doctor are a change in stoma size or color, a blocked or bulging stoma, bleeding, a wound or cut in the stoma, skin irritation, or watery stool for more than five hours.

General Guidelines

• A good rule is to empty your pouch when it is one-third full and change the pouch before it leaks.
• Change is no more than once a day, but no less than every three or four days.