Types of Ostomy

Ostomy

Ileostomy Colostomy
An artificial opening made in
the large bowel to divert feces
Stoma of the terminal part and flatus to external environment,
of the small intestine where it can be collected into an
external appliance.
 Type of Stoma

Stoma

Temporary Permanent
 Complications

•Complications
•Early
•Late

1. Ischemia 1. Prolapse
2. Bleeding 2. Peristromal hernia
3. Retraction 3. Recurrent disease
4. Skin excoriation 4. Bowel obstruction
 Ischemia
• Due to impaired blood flow
• Poor blood supply when stoma is formed
• Too tight stoma bag
• Too tight dresses over stoma
• Management
– Close observation during post-op period.
– A clear plastic appliance should be fitted
– Avoid tight clothing
– Inform your surgeon if you notice any colour change
 Bleeding
• Overenthusiastic cleaning
• When using template for measurement
• Bleeding from lumen is more serious
• Portal hypertension in cirrhosis
• Recurrence of colonic CA

• Management
– Do not rub your stoma
– Be careful when applying the bag
– Compress with gauze
– Usually resolve without interventions
 Retraction
• Recession of the stoma
• Away from the skin surface
• Due to excess tension of stoma
• Insufficient fixation
• Post-op weight gain

• Management
– Use an appliance with a rigid wafer
– Apply stoma adhesive paste before fixing appliance
 Excoriation of skin
• Make sure the wafer and pouch are well fixed
• Control excessive mucous discharge
• Be cautious of the size of the stoma and the wafer
• Use luke warm water and mild soap to clean the
peristomal skin
• Never use alcohol agents, savlon, creams, powder
or chemical agents to clean.
• Never use artificial drying methods. Eg. Hair dryer.
 Excoriation of skin
• Management
– Educate the patient about appliance change
– Consider a 2 piece appliance to allow healing
– Use stoma adhesive powder or paste
– Do not use antiseptics for cleaning peristomal skin
– Change the base plate as soon as it leaks
– A methyl cellulose skin wafer is helpful
Ostomy and your diet
 Avoid
• Vegetables – radish, cabbage, garlic,
cucumber
– are knowm to result in offensive odour

• Carbonated beverages, chewing gum and

smoking
– Causes excess gas in stoma appliance

• High and moderate fiber diet

 Advices
• Chew your food well and consume adequate
amounts of water