Surgical opening into the colon by means of a

stoma to allow for drainage of bowel content;

one type of fecal diversion. (Brunner &
Suddarth's textbook, 2008, 10th Edition)

1. Ascending colostomy – the feces are liquid

2. Transverse colostomy – feces are mushy
3. Descending colostomy – feces are semi-mushy
4. Sigmoid colostomy – feces are solid

- Providing a relaxed atmosphere & adequate

explanations helped the patient to become an active
participant in the procedure.
- To facilitate disposal or drainage
 - Many appliance have a build in skin barrier.
The skin should be thoroughly dried before
applying the appliance.
- Stomahessive is a substance that facilitate
healing of excoriated skin. It adheres we;; even
to moist, irritated skin.

- This will allow skin to heal while the

appliance is in place.
- Proper closure controls leakage.

A colostomy is irrigated to empty the colon of feces, gas

or mucus, cleanse the lower intestinal tract and establish
a regular pattern of evacuation so that normal life
activities may be pursued. A suitable time for the
irrigation is selected that is compatible with the patient’s
posthospital pattern of activity (preferably after a meal).
Irrigation should be performed at the time each day.

Before the procedure, the patient sits on a chair in front of the toilet or on the toilet itself. An irrigating
reservoir containing 500 to 1500ml of lukewarm tap water is hung 45 to 50cm (18 – 20 in) above the
stoma (shoulder height if the patient is seated). The dressing or pouch is removed. The following
procedure is used; the patient is helped to anticipate in the procedure to learn to perform it unassisted.
 Air bubbles in the set up are released so that air is
not introduced into the colon which would cause
crampy pain.
Lubrication permits ease of insertion of the catheter
/ cone.
The slow rate of flow helps to relax the bowel and
facilitates passage of the catheter.
Painful cramps usually are caused by too rapid flow
or too much solution; 300 ml of fluid may be all that
is needed to stimulate evacuation. Volume may be increased with subsequent irrigation to 500, 1000 or
1500 ml as needed by the patient for effective results.

Most of the water and flatus, feces will be

expelled in 10 to 15 minutes.
Ambulation stimulates peristalsis & completion
with hours of comfort
The patient should use an appliance until the
colostomy is sufficiently controlled.