Bowel stomas
Ileostomy – formed in the Ileum
Colostomy – formed in the Colon
Health disorders which may require a stoma:
Colorectal Cancer
Ulcerative Colitis
Crohn’s Disease
Familial-adenomatous-polyposis (FAP)
Radiation Sequalae
Ischaemic Bowel Disorder
Volvulus
Diverticulitis
Gynaecologic Disorders
Trauma
Defaection Disorders
Hirschprung’s Disease
Anorectal Anomalies
Necrotising Entero Colitis
Bowel Trauma
Types of stomas:
End Ileostomy – Often permanent
Loop Ileostomy – mostly temporary
Split Ileostomy – not common
Abcarian – end stoma with distal lumen brought out flush with skin beside proximal stoma
End Colostomy – sigmoid colon, rectum and anus removed
End Colostomy and mucous fistula – the fistula is either exteriorised or sutured under distal end of abdominal incision
Transverse Colostomy
Number of stomas:
5,182 stomas were performed in Australia during 2004
Management tips of stomas:
- Where possible all patients having formation of a stoma should be sited with abdominal marking by a Stomal Therapy Nurse (STN) pre-operatively. This allows for good vision of the stoma by the patient, avoiding belts lines and old scars and abdominal creases.
- Drainable pouch either with or without a flange placed over Ileostomies and Transverse Colostomies. Mostly performed on right side of Abdomen.
-Closed pouch either with or without a flange placed over Colostomies mostly formed on the left side pf the abdomen.
-If leakage under the patients appliance occurs, they need to seek assistance from an STN as the skin will become excoriated very quickly especially from a small bowel stoma.
-Many different appliances are available from varying degree of convexity or flat flange or pouch, seals of differing types, pastes and belts to enable the appliance to fit well.
-There is no charge for appliances as the Australian Government pays for them. There is a small charge to join a Stoma Association and for postage.
-A patient may with a permanent end Colostomy can be taught by the STN to irrigate into the bowel. They then need to wear only a small stoma cap over their Colostomy.
-Some medications will be passed through the Ileum into the stoma pouch without being absorbed
Brenda Sando RN
Clinical Nurse Consultant
Stomaltherapy / Wound Management (Cred)