 An ostomy is a surgically made opening

from the inside of an organ to the

outside. The stoma is the part of the
ostomy attached to the opening, in the
case of colostomies, ileostomies,
jejunostomy 7 gastrostomy
 Colostomy- opening from the large
intestine to the abdominal wall so faeces
bypass the anal canal
 Ileostomy- opening from the small
intestines to the abdominal wall so
faeces bypass the large intestine and
the anal canal
 Gastrostomy & jejunostomy- opening
between the stomach & jejunum
respectively and the abdominal wall,
used predominantly for enteral feeding
tubes
 When inspecting a stoma the presence
of the following indicates a healthy
stoma:
• Stoma should be above the skin level
• Red and moist stoma (pallor may suggest
anemia; dark hue may represent ischaemia)
• No separate between the mucocutaneous
edge and the skin
• No evidence of erythema, rash, ulceration or
inflammation in the surrounding skin
 Emotional states especially fear & anxiety
cause irregular bowel movements
 Wearing a colostomy bag over the
stoma, helps to collect the faeces which
can be cleaned at a convenient place
& time
 The patient should find out what is
agreeable & what is disagreeable to him
& thereafter regulate his diet
 Irrigation is done at same time to
establish a habit
 The patient with the colostomy are more
prone for diarrhoea therefore avoid
those factor that precipitate an attack of
diarrhoea
 Patient’s with wet colostomy are prone
to electrolyte imbalance so they should
be encouraged for adequate fluid intake
 Do not irrigate the colostomy when the
patient develops diarrhoea but patient
has ingested irritant food, colostomy
irrigation may help
 Faecal impaction may occur if the patient
is having a sigmoid colostomy & it becomes
difficult to evacuate the bowel. A dietary
regulation may prevent such complication
 Regulation of bowel with irrigations will
prevent such problem
 Oil instilled directly into the stoma at bed
time or several hours before irrigation will
usually help to evacuate the bowel
 Be careful to introduce only a small amount
(5 to 10ml) of oil into the stoma or oil will
leak after the irrigation
 Odour proof disposable bags with
charcoal filter disc are available for use
 The patient has to avoid the foods which
may produce the gas
 Swallowing of air cause flatulence,
patient should be instructed to eat foof
slowly
 Charcoal & antacid may help to relieve
the flatulence
 Digestive juice irritates the skin therefore
prevent the contact of stool with stoma
 The stool should be emptied at frequent
intervals through the opening at the bottom
of the bag
 A protective ointment such as zinc oxide or
petroleum jelly applied around the opening
 Application of Tr. Benzoin may help to keep
up integrity of skin
 The skin should be washed with soap & water
& the dressing should be changed as often as
necessary to prevent the skin irritation
 Patient instruction
 They may be given a chance with
another patient with a colostomy
 Constant encouragement & teaching