Stoma Care requires knowledge, patience, and empathy. If you are at the beginning of dealing with a stoma yourself or caring for a loved one with a stoma, the following information should provide some insight and understanding into the different types of stomas alongside essential tips for home carers.
So, what is a stoma?
It’s important to remember that needing a stoma is a normal part of many people’s lives. A stoma is a surgically created opening on the surface of the abdomen that diverts the flow of faeces or urine. It can be used to assist people of all ages, from newborns to the older generation, for a variety of reasons.
Some of the reasons might include trauma to the abdomen (caused by a car accident or another major injury), surgery to remove bowel cancer or other cancers in your pelvic area, and diseases such as Crohn’s disease or ulcerative colitis.
Remember, having a stoma is manageable with the appropriate level of stoma care. There are three main types of stomas: colostomy, ileostomy, and urostomy. This article aims to provide insight into how a stoma works, why an individual may need one, and, most importantly, how to manage it effectively.
What is a Colostomy, and why might I need one?
A colostomy is an opening in the large intestine (or colon) formed by drawing the healthy end of the colon through the abdominal wall and stitching it into place. A pouch can then be placed over the opening to collect stools.
A colostomy may be necessary if you are unable to poo. This could be the result of an illness, such as cancer or Crohn’s disease, injury, or a problem with your digestive system.
There are three types of colostomy: an end colostomy, a loop colostomy and a double-barrel colostomy. The specific procedure will be determined by your circumstances.
An end colostomy is a surgical procedure that involves pulling one end of the colon through a cut in the abdomen and stitching it into the skin to create an opening called a stoma. It is often permanent; however, a temporary end colostomy is sometimes used in emergencies.
A loop colostomy, on the other hand, is a procedure that redirects the colon to a stoma in the abdomen to allow the colon to rest and heal.
This type of colostomy is generally used if the colostomy is temporary, as it’s easier to reverse.
In a loop colostomy, a loop of the colon is pulled through an opening in your tummy to form a stoma. This stoma has two openings near one another. One is connected to the functional part of the bowel, which allows waste to leave your body following surgery. The other is connected to the inactive part of your bowel, which will enable you to heal.
Finally, a double-barrel colostomy is a procedure that involves removing problem areas from the bowel and creating two separate stomas in the abdominal wall. The surgeon then brings the two ends of the bowel to the stomas and stitches the bowel edges to the skin. One stoma drains stools and the other drains mucus.
Ileostomy vs Colostomy: What’s the difference?
The difference between an ileostomy and a colostomy is that an ileostomy is connected to the small intestine (ileum), whereas a colostomy is connected to the colon.
Its purpose is to allow intestinal waste to pass out of the small intestine and collect it in an external ostomy system next to the opening.
There are many reasons for having an ileostomy, such as inflammation (such as inflammatory bowel disease), infection (such as an abscess), not enough blood getting to your colon (such as ischaemic bowel disease), or bowel obstruction, when your colon becomes blocked so faeces and wind cannot move through it.
Like the colostomy, there are three types of ileostomy procedures. An end ileostomy usually involves removing the whole colon through an incision in the abdomen.
The end of the small intestine is then divided, brought out of the abdomen through a small incision, and stitched to the skin to form a stoma.
A loop ileostomy is a procedure that also creates a stoma, or bowel opening, on the skin by pulling a loop of the small intestine through an incision in the abdomen and stitching it into the skin.
A double barrel ileostomy, on the other hand, is usually performed to offer a temporary diversion and allow an area of the bowel to rest.
What is a urostomy?
Finally, the third main type of stoma is a Urostomy. This procedure creates a stoma for the urinary system, where drainage of urine through the bladder and urethra is not possible, e.g. after extensive surgery or in case of obstruction.
Some examples where someone might need a urostomy include where an individual has been diagnosed with bladder cancer, received radiation to the prostate or bladder, or encountered nerve damage to the bladder.
Neurological disorders (such as multiple sclerosis, stroke or cerebral palsy), along with spinal cord injuries, pelvic trauma, chronic infection, inflammation of the bladder, or severe urinary incontinence, can also be factors in deciding if a urostomy is necessary.
Stoma care: How do I care for someone with a stoma?
According to www.tewv.nhs.uk, the following protocol should be followed for stoma care:
- Wash hands using soap and water/ or alcohol-based hand rub.
- If using a drainable bag, empty contents into a disposable container before removing the bag.
- Peel the adhesive away from the skin slowly and gently with one hand while applying gentle pressure to the skin with the other hand.
- Fold the bag in two to ensure nothing spills out, and place it in a disposable bag.
- Remove the excess faeces or mucus from the stoma using a piece of gauze soaked in tap water.
- Check your skin and stoma for any abnormalities, such as ulcers or sores. If the skin and stoma are healthy, you can continue. If abnormalities are present, report them to your Stoma Care Nurse, Physical Healthcare Practitioner, or Medic.
- Wash the skin and stoma with gauze soaked in warm water until it is clean.
- Dry skin gently but thoroughly.
- If you do not have pre-cut bags, measure and cut the appliance, leaving a 3mm gap.
- Apply the clean bag.
- Dispose of all soiled tissues, containers and used bags.
- Wash hands using soap and water or alcohol-based hand rub.
This is just a brief introduction to stomas and understanding how to care for them yourself. If you have a loved one or if you care for someone living with a stoma and have questions, you might find some guidance and help from our other articles regarding stoma care that focus on specific issues you might also be facing. It’s also worth noting that our carers can provide stoma care as part of our Personal Care Service should you need any additional support.
Our aim is to provide tips, advice, and comfort through our guides and blogs to ensure you do not feel isolated or overwhelmed. However, if you have any further questions about our personal care services, please don’t hesitate to give us a call or fill in the enquiry form.
