COLOSTOMY

An ostomy is a surgically created opening (stoma) in the abdominal wall through which
dietary wastes can be eliminated. To create a stoma, the cut end of the remaining segment
of the functional intestine is routed through an opening in the abdominal wall and stitched
in place so that it empties to the exterior. A stoma formed from a section of the colon is called
colostomy. To collect wastes, a disposable bag is affixed to the skin around the stoma and
emptied during the day as needed. Stool consistency varies according to the length of colon
that is functional. Even though parenteral or specialized enteral formulas may be used after
surgery, it is very important to try to get the patient to eat food as soon as possible. Nutrients
from food are the most potent stimuli to foster bowel adaptation. The ability of the
gastrointestinal tract to adapt, as well as dietary and medication needs depend on the
remaining small bowel or colon. Stool consistency varies according to the length of colon that
is functional. If the small portion of the colon is absent or bypassed, the stools may continue
to be semisolid. If the entire colon has been removed or bypassed, absorption of fluid and
electrolytes into the body is reduced substantially and the output is liquid ().
Causes:
 INFLAMMATORY BOWEL DISEASE
An umbrella term used to describe disorders that involve chronic inflammation of the
digestive tract. Types of IBD include: Ulcerative colitis. This condition causes long-
lasting inflammation and sores (ulcers) in the innermost lining of the large intestine
(colon) and rectum.
 DIVERTICULITIS
It's a serious medical condition that causes inflamed pouches in the lining of your
intestine. These pouches are called diverticula. They develop when weak spots in your
intestinal wall give way under pressure, causing sections to bulge out.
 COLORECTAL CANCERS OR MALIGNANCY
Colorectal cancer (CRC), also known as bowel cancer, colon cancer, or rectal cancer, is
the development of cancer from the colon or rectum (parts of the large intestine). A
cancer is the abnormal growth of cells that have the ability to invade or spread to other
parts of the body
 OBSTRUCTION
Intestinal obstruction is a blockage that keeps food or liquid from passing through your
small intestine or large intestine (colon).
 PERFORATION
Colon perforation is a hole in the wall of the colon. The colon is the end of the intestines
also known as the large intestine. A perforation may be a puncture, cut, or tear. The
opening allows air and intestinal material to leak into the abdominal cavity.

Risk Factors:
 A personal or family history of colorectal cancer od polyps
 Age
 A genetic syndrome such as Familial Adenomatous Polyposis(FAP) or Hereditary Non-
polyposis Colorectal Cancer (Lynch Syndrome
 Lack of regular physical activity
  A diet low in fruits and vegetables
 A low-fiber and high-fat diet or a diet high in processed meats
 Overweight and obesity
 Alcohol consumption
 Tobacco Use
Management:

DIETARY MANAGEMENT
Goals:
 To avoid major problems of blockage increased flatulence and problems with certain
foods
 Speed wound healing and recovery. In children, early feeding after surgery. In
children , early feeding after surgery is generally safe and results in shorter hospital
stay and fewer complications
 Correct weight loss or malnutrition from GI blood loss, anemia, protein
malabsorption, steatorrhea
 Prevent watery or unscheduled bowel movements. Correct or prevent dehydration
 Individualize the diet: Eat regularly, avoid odor-causing foods and monitor food
preferences. Normalize nutritional quality of life as much as possible
Guidelines:
 Progress from clear liquids that are low in sugars to low-residue diet to regular meal
plan. To speed healing, the formula or diet should be high in protein, energy,
vitamins and minerals
 Diet should provide normal or increased salt intake. One to two quarts of fluid taken
between meals, should be ingested daily
 Gradually introduce new foods; if done slowly, offending foods can be identified and
obstruction can be controlled or prevented
 Dietary adjustments are individualized according to the surgical procedure and
symptoms that develop afterward
FOODS ALLOWED FOODS AVOIDED RATIONALE
Clear Liquid
Full Liquid
Soft Diet
Diet as Tolerated