Ostomy care: Types, Indications, and Complications

• Ostomy care involves understanding ostomies, stomas, types of intestinal ostomies, indications, complications, prevention, and interventions.

Ostomy

• An ostomy is an opening created for gastrointestinal or respiratory tract access onto the skin.

Stoma

• A stoma is an opening in the abdominal wall created by an ostomy.

Types of Intestinal Ostomies

• Gastrostomy involves an opening through the abdominal wall into the stomach.
• Jejunostomy involves an opening through the abdominal wall into the jejunum.
• Ileostomy involves an opening into the ileum.
• Colostomy involves an opening into the colon.
• Urostomy involves an opening in the ureter.

Indications for Ostomies

• Infections such as H. pylori.
• Inflammation.
• Abscesses.
• Trauma.
• Intestinal blockage.
• Colon or rectal cancer.

Complications of Ostomies

• Peristomal skin irritation.
  • Fungal rash.
  • Irritant dermatitis.
  • Allergic dermatitis.
• Other complications include diarrhea.
• Stomal stenosis is caused by circular scar tissue that forms at the stoma site.
• Urinary calculi can occur in patients with ileostomies, often associated with dehydration.
• Cholelithiasis involves altered absorption of bile acids, with Crohn's disease being a risk factor.

Preventing Ostomy Complications

• Results from leakage of effluent can be prevented with a drainable pouching system that fits well.
  • These systems include a pouch, solid skin barrier, and adhesive.

Ostomy Interventions

• Utilize drainable pouching systems.
• Encourage clients to keep a food diary to track specific foods that cause gas.
  • Examples include beans, apples, pears, asparagus, broccoli, nuts, cauliflower, dairy, grains, and carbonated drinks.
• Eat slowly to swallow less air.
• Avoid gas formation habits.
• Wear comfortable clothes to hold the ostomy.
• Sexual intimacy and relationships can be resumed with an ostomy.
• Keep extra supplies on hand.
• Encourage independence with individual ostomy care.
• Encourage enrolling in support groups.
• Filters allow digestive gas to be released without odor.
• Prevent the filter from getting wet.
• Cover the filter with medical tape when showering.