Essential Stoma Care Catherine Murray, Lead Stoma Care Nurse, GHT

What is a Stoma? Derived from Greek word meaning mouth or opening. Diversion of bowel or bladder contents onto the abdomen. First performed in 18th Century on wounded battle casualties. Red/pink in colour and moist.

Types of Stoma Colostomy - Loop or end Ileostomy - Loop or end Urostomy - Ileal conduit

Colostomy- Diversion of Large Bowel Colon Left iliac region Temporary or permanent End / loop Formed stool Flush to skin Closed pouch

Conditions Necessitating Colostomy Diverticular Perforation Bowel Cancer Obstruction Irradiation damage Bowel ischaemia Incontinence Trauma Volvulus Congenital abnormalities Hirschsprungs disease Imperforate anus Spinal injury Colovaginal / colovesical fistula

Ileostomy - Diversion of Small Bowel Ileum Right iliac region Temporary or permanent End/loop Semi formed stool Spout Drainable pouch

Conditions Necessitating Ileostomy Anastomosis protection Crohns disease Ulcerative colitis Familial polyposis Obstruction Irradiation damage Trauma

Urostomy/Ileal Conduit Bladder cancer Interstitial cystitis Congenital Abnormality Ileum used as channel Spout Usually permanent Appliance with tap

Urostomy/Ileo Conduit Reason for: Bladder Cancer Interstitial Cystitis Incontinence.

Choice of Appliance Colostomy formed stool closed pouch Ileostomy semi formed stool drainable pouch Urostomy urine pouch with tap

Choice of Appliance One Piece Flexible Low Profile Discreet Convex Appliance Two piece Robust Frequent pouch change Less skin disturbance

Changing an Appliance Gather supplies Bowl warm water Wipes / kitchen roll New appliance Scissors Measuring guide / pen Disposal bag

Changing Appliance Ensure privacy at all times Be aware of body language Empty pouch Gently remove soiled pouch Fold in two - disposal bag Wash around stoma and surrounding skin Inspect skin and stoma Pat skin dry Measure stoma and cut appliance - snug fit Remove plastic backing Apply from bottom up Check closure secure Secure disposal bag Wash hands

Diet and the Ostomist

Diet and the Ostomist No hard and fast rules Promote healthy balanced diet Trial and error Introduce new foods slowly Post op - Regular grazing Transit of food erratic through operated bowel 4 - 6 weeks lower fibre diet Do not diet!

Diet and the Ostomist Colostomy Ileostomy Can tolerate most foods Avoid constipation Fibre and fluids Medication Eat regularly Ileostomy Initially some foods difficult to digest May need long term Loperamide Care taken with Fruit and veg skins Green leafy veg Spicy foods Fizzy drinks Onions May need to avoid Nuts,seeds,dried fruit Sweetcorn,oranges

Urostomist and Diet Plenty of fluids Cranberry juice to reduce mucus Asparagus / fish - odour Some medication can colour urine Avoid constipation

Who we are and where to find us Gloucester Royal Hospital Level 5, Tower Block Tel: 0300 4226702 24hr answermachine

Who we are. Where to find us Cheltenham General Hospital West Block – opposite vascular lab Tel: 0300 4224363 24hr answermachine