ELIMINATION is the complete removal or destruction of

something. OR
The expulsion of waste from body is known as elimination

DEFINITION
BOWEL ELIMINATION  It is also known as defecation.
Bowel elimination is a natural process critical to human
functioning in which body excretes waste products of digestion.
OR
Defecation (bowel elimination) is the act of expelling feces (stool)
from the body.
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 Age
• Must be of a certain age or physical maturity to be able
to control your bowels
• Humans also can lose control of their bowels after a
certain age
Diet
• There many different ways that diet can affect bowel
elimination
• ex: high fiber diets & fruits promote regularity, while
cheese cause constipation
Fluid intake
• The more fluid you take in the less likely you are to
become constipated
• The less fluid you take in the more likely you are to
become constipated.
 Physical activity
• Higher activity rate lessens the chances of constipation
Psychological factor
• Usually the source of ulcerative colitis or crohn's disease
• Depression causes peristalsis to decrease
Personal habits
• A person not wanting to go for an extended period of time can
cause harm to their body and can make it harder to go later
• They may not want to use those facilities
 Positions
• Normal positioning for Bowel elimination is sitting or squatting

Pain
• Person may be hesitant about going if they think it will cause
them pain
• usually due to haemorrhoids, rectal surgery, or Abdominal
surgery

Pregnancy
• The way the baby is lying on the mothers GI tract affects
peristalsis by slowing it
• Force the mother to go in between 
 Surgery & anaesthesia
• Affects defecation by the slowing of peristalsis or complete
stoppage of it

Medications
• Different medications affect Bowel elimination differently
• some medications increase the process others may inhibit it or
stop it completely

Diagnostic tests
• These affect the patient because they usually require them to be
NPO prior to it which in turn will limit their food intake which
limits Bowel elimination or stops them completely
6. HEMORRHOIDS
Complaints of rectal fullness or pressure 
Pain on defecation 
Decreased frequency of bowel movements 
Inability to pass stool 
 Changes in stool characteristics such as hard small stool
Constipation is classified into one of four distinct types

Primary

Secondary

Iatrogenic

Pseudoconstipation
  PRIMARY OR SIMPLE CONSTIPATION
Primary or simple constipation is well within the
treatment domain of nurses. It results from lifestyle
factors such as inactivity, inadequate intake of fiber,
insufficient fluid intake, or ignoring the urge to
defecate
 SECONDARY CONSTIPATION
Secondary constipation is a consequence of a pathologic
disorder such as a partial bowel obstruction. It usually
resolves when the primary cause is treated.
 IATROGENIC CONSTIPATION
Iatrogenic constipation occurs as a consequence of other
medical treatment.
For example, prolonged use of narcotic analgesia tends to
cause constipation. These and other drugs slow peristalsis,
delaying transit time.
The longer the stool remains in the colon, the drier it
becomes, making it more difficult to pass.
 PSEUDOCONSTIPATION
Pseudoconstipation, also referred to as perceived
constipation, is a term used when clients believe
themselves to be constipated even though they are not.
 Medical management
Treat the under lying cause
Increase fiber and fluid intake
Routine exercises
Biofeedback
Use of laxatives
Nursing management
Maintain a regular pattern of elimination
Dietary pattern
Exercises
Privacy
Psychological support
Posture
Laxative administration
Administration of suppositories or enema
 FETAL IMPACTION
It is the accumulation of hardened feces in the rectum, as
a result of which the person is unable to voluntarily
evacuate the stool.
Mass or collection of hardened feces in folds of rectum
Passage of liquid fecal seepage and no normal stool

Usual causes
◦ Poor defecation habits
◦ Untreated or unrelieved Constipation
 Signs and symptoms
Feeling of fullness in rectum and abdomen
An urge for defecation and inability to pass stool
Generalized malaise
Loss of appetite
Nausea/vomiting
Abdominal distension

Management
Laxatives , enema or manual removal of the stool (digital
evacuation)
 Causes
Action of bacteria on the Chyme in L. intestine
Swallowed air
Gas that diffuses between the blood stream and the
intestine
Foods (cabbage, onions)
Signs
Gastric distension
Management
Insertion of rectal tube
 Manifested by frequent evacuation of watery stool
Besides the intense urge to defecate, there may be
abdominal cramps, nausea & painful burning
sensations at the anus
 Causes
 Intestinal infections (enteritis)
 Nervous tension - emotional or psychogenic diarrhea
-excessive stimulation of parasympathetic nervous
system
 Medications - antibiotics &iron supplements
 Mechanical causes : incomplete obstruction -stenosis,
adhesions and tumors
 Other causes :- Malabsorption syndrome, irritable
colon, narcotic withdrawal.
 Management
◦ Replace the fluid and electrolytes
◦ Treat the cause
◦ Drug therapy
-Antibiotics/antimicrobials
-Antimotility agents (loperamide)
Nursing care
Replacements of fluid and electrolytes ( potassium)
Small frequent diet
Avoid spicy foods
Use of bedpan and commodes
Skin care
Adequate rest
Psychological support
Medications
Healthy eating habits
 Types
 Partial : Inability to control flatus or to prevent minor
soiling
 Major : Inability to control feces of normal consistency
Causes
Neuromuscular disease
Spinal cord trauma
Tumors 
- Treated with surgery
- Repair of sphincter
- Fecal incontinence pouch
- Bowel diversion or colostomy
 Types of stool tests
A stool analysis is a series of tests done on a stool (feces) sample to
help diagnose certain conditions affecting the digestive tract.
 A gFOBT (guaiac-based fecal occult blood test) uses a chemical
reaction on a paper card to find traces of blood in the stool that
you can’t see.
 A FIT (fecal immunochemical test) uses specific antibodies for
human blood to find traces of blood in the stool that you can’t
see.
 A stool culture looks for bacteria that are not normally found
in the GI tract.
 Stool fat testing looks for extra fat in the stool to see if the body
is having trouble absorbing fat from food.
 COLLECTION of fecal specimen
• Universal Precautions
• Stool should be collected in a dry, sterilized, wide mouthed
container.
• It should be uncontaminated with Urine or any other body
secretions.
• Properly named and always a fresh sample should be tested.
 PHYSICAL EXAMINATION
 Mental status examination:- It can be evaluated by
listening to the client’s responses to questions and by
observing interaction with others
  Mobility & Dexterity:- Mobility may be evaluated
by observing the client undress or move onto a table,
chair or bed. Dexterity assessed by observing the
client remove clothing; particular attention paid to
the manipulation of zippers, buttons, shoestrings and
snaps.
 Inspection:-
Rectal examination are particularly important for
both men and women. The cheeks of the buttocks
should be pulled apart and the anus & surrounding
area visually inspected.
 The client may asked to bear down and anus
inspected for prolapse gapping, indicating significant
weakness of anal sphincters.
   3. DIAGNOSTIC TEST
  Defecography:- X-rays images of rectum and anal
sphincter obtained during defecation .
 Anorectal ultrasonography:- It is vital accepted
popular imaging motility for evacuating lower
rectum, inner sphincter and pelvic floor in patient
with various anorectal disease
 Colonoscopy:- It is used to visualization of the colon
  Avoid alcohol and smoking because alcohol irritates
the intestine and bowel, causing inflammation. This
effect causes increased elimination of fluid into the
stool, resulting diarrhea. 
 Smoking stimulates the bowel through the action of
nicotine caused increased bowel tone and motility result
is diarrhea.
 Flatus: 
Gas in the intestinal tract or gas passed through the anus. 
Intestinal gas contains numerous gases including oxygen, nitrogen,
hydrogen, carbon dioxide, hydrogen sulfide, ammonia, and
methane.
The foul smell usually is caused by small traces of gases such as
hydrogen sulfide, ammonia, and methane.

INSERTION OF FLATUS TUBE

1. Flatus tube or rectal tube inserted into the rectum to relive
flatulence and gaseous distension of the abdomen.
2. Passing of flatus tube is defined as an introduction of a tube into
the rectum for expulsion of gas
 PURPOSE
1. To remove flatulence from the lower bowel.
2. To relieve abdominal distension.
3. Used before giving a retention enema.

GENERAL INSTRUCTIONS
 Introduce the rectal tube into 4-5 inches.
 Rectal tube should not leave more than 30 min. 
 Longer periods of insertion can lead to permanent sphincter damage.
 The tube can be reinserted every 3-4 hours if necessary.
 Preliminary assessment
Check
The doctors order for any specific precautions.
Patients general condition
Diagnosis of the patient.
Self care ability of the patient.
Mental status to follow the instructions.
Articles available in the unit.

Preparation of the patient and environment

Explain the sequence of the procedure.
Provide privacy.
Provide left lateral position.
Arrange the articles at the bedside.
Place the Macintosh under the buttocks of the patient.
 Use of bedpan
Bedpan is made up of steel or plastic device to meet elimination
need of patient confined to bed.
It is used by person who is unable to get out of the bed.

Purposes
To provide comfort
To facilitate bowel and bladder elimination
To collect specimen for diagnostic purposes
To give perineal wash.

Indications
Patient with spinal injury.
Postoperative patients
Patients with fracture and traction
Chronic bedridden patients
Patients those who are at strict bedrest.
HOW TO PLACE BEDPAN
TYPES OF BEDPAN
BOWEL WASH/ ENTEROCLYSIS
 PURPOSE
To clean the colon of faeces, gas, excess mucus, barium etc.
To dilute and remove any of the toxic agents that may be present
in the large intestine.
To keep the individual clean in faecal incontinence and to check
diarrhoea.
To supply heat to the colon or to the pelvic  and abdominal
organs surrounding the large intestine (to relieve pain and bring
about circulatory changes in these organs).
To reduce temperature in hyperpyrexia and heat stroke.
To apply medications locally.
To supply the body with fluid and electrolytes that are absorbed
from the intestine.
As a preparation for diagnostic examinations and certain
surgeries to cleanse the bowel.
 Contraindications
Bleeding hemorrhoids
Chronic diarrhoea
Rectal surgeries, infection
Intestinal obstruction
Rectal polyps
Massive colon carcinoma
Loose anal sphincter
Debilitation
Anal fistula
Intestinal diverticulum
Painful skin lesions around anus
 Solutions used
 Plain water
 Cold water
 NS,NaCo3 solution 1-2%
 Antiseptic solution, silver nitrate 1:5000
 KMNO4 1:5000
 Thymol 1:100
 Alum 1:100
 Boric solution 1-2%
 Tannic acid 1:100
 Amount of solution used 2-3 liters or till the return flow is clear

Temperature of the solution

For cleansing purpose 104 F
For reducing temperature 80-90 F
For thermal effect (43.3 to 46 degree C)
 General Instructions
 A cleansing enema should be given 1 hour before the colon
irrigation is started, so that the rectum will be free of faecal
matter.
 The bladder should be emptied before a colonic irrigation to
reduce the intra-abdominal pressure.
 The temperature of the solution be kept constant throughout the
procedure.
 Do not allow air to enter into the intestines by:
Expelling the air from the tube.
Not letting the fluid to run in completely from the tube.
 Make sure that the return flow is not blocked.
 Stop the procedure temporarily if the client complaints of pain.
 Use a smooth and flexible rectal tube and lubricate it well to
prevent damage to the rectal mucosa.
Listen to the complaints of the client and should not ignore any
discomfort however small they may be. Stop the treatment if the
client shows the signs of fatigue and collapse.
Allow only 200 to 300 ml of fluid to run into the rectum at a
time. Then it should be drained out completely before
introducing the fluid second time.
Regulate the flow the fluid. Do not have the in-going tube higher
than 45 to 60 cm above the bed level and do not have the
outgoing tube more than 30 cm below the bed.
 Nurse’s Responsibility in Giving Colonic Irrigations
Preliminary Assessment
 Check the diagnose and general condition of the client.
 Check the abilities and limitations concerning movement.
 Check the consciousness and the ability to follow instructions.
 Check the doctor’s orders and the specific precautions, if any
to be followed.
 Check for any lesions on the rectal or perineal area.
 Assess the need for extra help.
 Articles available in the unit.
 Sitz Bath
A sitz bath is a warm, shallow bath that cleanses the perineum,
which is the space between the rectum and the vulva or scrotum.
A sitz bath can also provide relief from pain or itching in the
genital area.
Sitz is from the German word sitzen, which means to sit.
A sitz bath can be done in 2 ways: in a bathtub or using a sitz bath
bowl.
 PURPOSE
A sitz bath helps clean and treat certain problems in the anal
area, genital area, and the perineum. The perineum is the area
between the anus and the vulva in women. In men, it is between
the anus and the scrotum.
A sitz bath helps increase blood flow to these areas and relax the
muscles.
A sitz bath may be done to:
Help ease pain and itching from hemorrhoids
Help ease pain from an anal fissure
Bathe and soothe the perineum after childbirth
Clean and soothe the anal area or perineum after surgery
Ease prostate pain during prostatitis or after a procedure
Help ease period cramps
Clean the anal and genital areas if can’t take a bath or shower
 For any type of sitz bath:
Fill a clean bathtub with 3 to 4 inches of warm water.
Sit in the water for 10 to 20 minutes.
Add more warm water as needed to keep the water
comfortable.
Get up slowly from the tub or toilet. You may feel lightheaded
or dizzy. Hold on to a railing. Or ask for help from a family
member, friend, or caregiver if needed.
Gently pat your anal area, perineum, and genitals dry with a
clean towel. Don’t rub the area.
Wash your hands. Put any ointment or cream on the area, if
advised.
Wash the bathtub or sitz bath bowl with soap and water after
each use.
Use a sitz bath 2 to 3 times a day, or as often as your healthcare
provider advises.
 Enema Procedure
Definition
An enema is an introduction of fluid into the lower bowel through
the rectum for the purpose of cleansing or to introduce medication
or nourishment.
Purpose
To stimulate defecation & to treat constipation ex: simple
evacuant enema
To soften hard faecal matter ex: oil enema
To administer medication ex: sedative enema
To protect and soothe the mucus membrane of intestine & to
check diarrhoea ex : emollient enema
To destroy intestinal parasites ex : anthelminitic enema
To relieve the gaseous distention ex : carminitive enema
 To administer the fluid and nutrients ex: nutritive enema
 To relieve inflammation ex : astringent enema
 To induce peristalsis ex : purgative enema
 To stimulate a person in shock and collapse ex: stimulant enema
 To reduce the temperature ex : cold enema or ice enema
 To clean the bowels prior to x-ray studies , visualization of the
bowel , surgery on the bowel or delivery of a baby ex : saline
enema
 To make diagnosis ex: barium enema
 To establish regular bowel functions during a bowel training
programme
 To induce anesthesia ex : anesthetic enema
 Classification of enema

Evacuant enema

Simpl Medic
Anthe
e ated Purga Astrin Carmi
Oil lminth Cold
Evacu Evacu tive gent native
enema ic enema
ant ant enema enema enema
enema
enema enema
 Simple evacuant enema
Purpose
 To stimulate defecation & to treat constipation
 To relieve the gaseous distention by stimulating the peristalsis
 To relieve the retention of urine by reflex stimulation of the
bladder
 To stimulate uterine contraction & to hasten the child birth
 To cleanse the bowel prior to x-ray studies , visualization of the
bowels (ex: sigmoidoscopy) , surgery & retention enemas
 Solutions used :
 soap & water : soap jelly 50ml to 1 liter of water
 Normal saline : sodium chloride 1 teaspoon of half litre of water
 Tap water
Amount of solutions to be used :
 Adults : 500 to 1000 ml ( 1 to 2 pint )
 Children's : 250 to 500 ml ( 0.5 to 1 pint )
 Infants : 250 ml or less
Temp of solution :
 Adults : 105 to 110 degree Fahrenheit
 Children : 100 degree Fahrenheit
 Oil enema
These are given to soften faecal matter in case of severe
constipation
Before the 1st bowel movement after operation on the rectum or
perineum.
To avoid straining & injury to the sutures & wounds
It should be retained for half an hour to 1 hour to soften the
faeces
It should then be followed by a soap & water enema to open the
bowels
Solutions used :
Olive oil
Gingerly oil or sweet oil
Castor oil & olive oil (1:2)
Amount of solution to be used : 115 to 175 ml
Temperature of the solutions : 100 degree Fahrenheit
 Purgative Enema
These are given to cause the bowel to contrast actively & to
evacuate its contents
Its acts by their irritating effect on the mucus lining, stimulate
peristalsis & cause the evacuation of bowel
 The stretching of the intestine due to this inflow of fluid causes
the intestine to contract & leads to the evacuation of bowels
Solutions used :
Pure glycerin – 15 to 30 ml
Glycerin & water – 1:2
Glycerin & caster oil – 1:1
Magnesium sulphate : 60 to 120 ml with sufficient amount of
water to dissolve it
1-2-3 enema : magnesium sulphate 30 ml, glycerin 60 ml, &
water 90 ml
Amount & temp of solution is that of oil enema
 Anthelmintic enema
This is given to destroy & expel the worms from the intestines
Before the treatment is given the bowel should be cleansed by a
soap water enema so that the drug may come in direct contact
with the worms & the lining of the intestine
The treatment is given until the worms are destroyed
Solution :
Infusion of quassia : 15gms of chips to 600 ml of water
Hypertonic saline solution : sodium chloride 60 ml with 600 ml of
water

Amount of the solution : 250 ml

 Carminative enema (antispasmodic)
 These are given to relieve gaseous distention of the abdomen by
causing peristalsis & expulsion of flatus &faeces
 It is given as simple evacuant enema
Solution :
Turpentine : 8 to 16 ml of turpentine mixed thoroughly with 600 to
1200 ml of soap solution
Milk and molasses(granular sugar ) : 90 to 230 ml of molasses well
mixed with equal quantity of warm milk

Cold enema (ice enema)

This is given to decrease the body temperature in hyperpyrexia
and heat stroke
It is given in the form of colonic irrigation
Complications :
Hypothermia
Abdominal cramps
 Astringent enema
It contracts the tissues & the blood vessels , checks bleeding &
inflammation , lessens the amount of mucus discharge & gives a
temporary relief in the inflamed area
It is usually given in colitis & dysentery
They are usually given in the form of rectal or colonic irrigations
The solution is allowed to run in slowly & return quickly to avoid
distension , pain & irritation of the inflamed wall
Solutions :
Tannic acid : 2 gms to 600ml of water
Alum : 30 gms to 600ml of water
Silver nitrate 2% : (silver nitrate is dissolved in distilled water )
Temperature of the solution : It is given as hot as the client can
stand
 Stimulant enema
A stimulant enema is given in the treatment of shock and collapse
It is also sometimes given in case of poisoning ex: coffee enema is
given in case of opium poisoning
Solutions :
Black coffee : 1 table spoon coffee powder to 300 ml of water
Brandy : 15 ml of brandy added to 120 to 180 ml of glucose saline
Amount of solution : 180 to 240 ml
Temp of solution : 108 to 110 degree Fahrenheit
 Sedative enema
It is retention enema containing a sedative drug given to induce
sleep
Drugs used :  Paraldehyde  Chloral hydrate  Potassium
bromide
Dose : As ordered by the doctor
Anaesthetic enema
It is a retention enema containing an anesthetic drug to produce
anesthesia in client

Drugs used :  Avertin 150 to 300 mg per kg of body weight

 Emollient enema
This is an introduction of bland solution into the rectum for the
purpose of checking diarrhoea or soothing & relieving irritation
on an inflamed mucus membrane
Solution used :
o Starch & opium : opium 1 to 2ml is added to 120 to 180 ml of
starch mucilage or rice water
o Starch mucilage alone
Amount of solution : 120 to 180 ml
Temp of solution : 100 to 105 degree Fahrenheit (37.8 to 40.5
degree centigrade )
 Nutrient enema
 It is a retention enema to supply food & fluids to the body
 Selection of the fluids depend upon the ability of the colon to
absorb it
 Nutrient enema is particularly useful in conditions like
haemophilia which makes I.V. infusion difficult or undesirable
Solutions :
Normal saline
Glucose 2 to 5%
Peptonized milk 120 ml
Amount of solution :
1100 to 1700 ml in 24 hour or 180 to 270 ml at 4 hourly interval
Temperature of solution :
100 degree Fahrenheit (37.8 degree Fahrenheit )
 Methods used in giving enema
 Using enema can & tube :
When large amounts of fluids are to be given , this method is
used ex : soap & water enema
 Funnel & catheter method :
When a small quantity of fluids are to be given , this method is
used ex: oil enema
 Glycerin syringe & catheter method :
When a small quantity of fluid is to be given , this method is
used ex: purgative enema
 Drip method :
When the fluid is to be administered very slowly in order to aid
in its absorption ex : nutrient enema
 Size of catheter & rectal tube :
no. 22 F for adults
12 F for an infant
14 to 18 F for the school age child
Lubricated with water soluble jelly & Vaseline – to decrease the
irritation of mucosa lining
For retained enema quantity at a time should not be more than
100 ml to 150 ml
Distance of tube to which inserted is depend upon the age & the
size of the client
for adult it is inserted 7.5 to 10 cm (3 to 4 inches )
for children it is inserted only 2.5 to 3.75 cm ( 1 to 1.5 inches )
The height of the enema can should not be above 18 inches ( 45
cm ) from the anus & for the retention enemas.
“Suppositories are solid dosage forms intended for insertion in to
body cavities or orifices (Rectum, Vagina & Urethra) where they
melt or dissolved & exert localized or systemic effect.”

TYPES OF SUPPOSITORIES
(Acc. To routes of administration)
1. Rectal suppositories.
2. Vaginal suppositories.
3. Urethral suppositories.
 ADVANTAGES
 It avoid first pass effect.
 Melt at body temperature.
 It gives localized and systemic action.
 It can be given to unconscious patient.
 It is easy to use for pediatric and geriatric patients.
 Useful to produce local effect.
 Useful for rapid and direct effect in rectum.
 Useful to promote evacuation of bowel
 Convenient for those drug causes GIT irritation , vomiting etc.
 DISADVANTAGES
 Irritant drug cannot be administered
 Embarrassment to patients
 Need to store at low temp.
 Cant easily prepared
 Cost-expensive.
 Fluid content of the rectum is much less than that of the small
intestine; this may effect dissolution rate, etc.
 Some drug may be degraded by the microbial flora present in
the rectum
An operation (as a colostomy) to create an artificial passage for
bodily elimination.

DEFINITION
An ostomy is an operation that creates and opening from an area
inside the body to the outside.
For eg. A colostomy create an opening to the outside to abdomen
to allow stool to pass through.
OR
An ostomy is a surgical procedure creating an opening in the
body for the discharge of the body waste.
 PURPOSE
Certain diseases of the bowel or urinary tract involve
removing all or part of the intestine or bladder.

This creates a need for an alternate way for feces or

urine to leave the body.

An opening is surgically created in the abdomen for

body wastes through.

The surgical procedure is called an ostomy.

  Colostomy:
A colostomy is a when small portion of the colon (large intestine) is
brought to the surface of the abdominal wall to allow stool to be
eliminated.
A colostomy may be temporary or permanent.
It is done due to cancer or trauma.

Ileostomy:
An ileostomy is an opening in the abdominal wall that`s made
during surgery . the end of the ileum (the lowest part of the
intestine) is brought through this opening to form a stoma in lower
right side of abdomen.
It is done in ulcerative colitis , crohn`s disease.

 Urostomy
A urostomy is a surgical procedure that diverts urine away from
defective bladder.
Main common method is called an ileal or cecal coduit.
A section at the end of the small intestine (ileum) or the beginning
of the large intestine(cecum) is relocated surgically to form a stoma
for urine to pass out of the body.
It performed due to bladder cancer, birth defects etc.

INDICATIONS
1. Imperforate anus
2. Ulcerative colitis
3. Spina bifida
4. Colon cancer
5. Inflammatory bowel disease like hirschprungs disease
 PURPOSE OF OSTOMY CARE:
1. To maintain integrity of stoma and periosteal skin
2. To prevent lesions, ulcerations
3. To prevent from infections
4. To promote general comfort and positive self image.
5. To provide clean ostomy pouch for fecal evacuation.
6. Reduces odour from over use of old pouch.
 Safety considerations: 
 Pouching system should be changed every 4 to 7 days, depending
on the patient and type of pouch.
 Always consult a wound care specialist or equivalent if there is
skin breakdown, if the pouch leaks, or if there are other concerns
related to the pouching system.
 Patients should participate in the care of their ostomy, and health
care providers should promote patient and family involvement.
 Encourage the patient to empty the pouch when it is one-quarter
to one-half full of urine, gas, or feces.
 Ostomy product choices are based on the patient’s needs and
preference.
 Follow all post-operative assessments for new ostomies according
to agency policy.
 Medications and diet may need adjusting for new ileostomies/
colostomies.
 An ostomy belt may be used to help hold the ostomy pouch in
place.
 Factors that affect the pouching system include sweating, high
heat, moist or oily skin, and physical exercise.
 Always treat minor skin irritations right away. Skin that is sore,
wet, or red is difficult to seal with a flange for a proper leakproof
fit.
 PRE-OPERATIVE NURSING CARE
1. Psychological preparation: Assure the patient that ‘Ostomy’
can be cared for without it interfering with daily activities and
social life

2. Nutrition: A low residue diet is given for at least 1-2 days

prior to the surgery.

3. Care of the Bowel: “Sterilization” of the bowel prior to

surgery to reduce bacterial flora can be achieved through
administration of poorly absorbed antibiotics such as
neomycin 1grm 4 hourly for 1-3 days; Laxatives and enema
may be done 
 COMPLICATIONS
 Problems breathing
 Reactions to medications
 Bleeding inside belly
 Damage to nearby organs
 Development of a hernia at the site of the surgical cut
 Falling in of the stoma (prolapse of the colostomy)
 Infection, especially in the lungs, urinary tract, or belly
 Narrowing or blockage of the colostomy opening (stoma)
 Scar tissue forming in your belly and causing intestinal
blockage
 Skin irritation
 Wound breaking open