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Routine care of patients with an ileostomy or colostomy and management of ostomy complications

Author
Ron G Landmann, MD
Section Editor
Martin Weiser, MD
Deputy Editor
Wenliang Chen, MD, PhD

INTRODUCTION

Ileostomy or colostomy creation may be required temporarily or permanently for the management of a variety of pathologic conditions, including congenital anomalies, colon obstruction, inflammatory bowel disease, intestinal trauma, or gastrointestinal malignancy [1]. Anatomic location and type of stoma construction have an impact on management. Loop colostomies tend to be larger and somewhat more difficult to manage than end colostomies. The type and volume of output (effluent), and therefore fluid loss, is determined by the location of the stoma relative to the ileocecal valve. Fluid loss is primarily a factor with end or loop ileostomies.

With proper stoma care and attention to nutrition and fluid management, most ostomy patients are able to have full, healthy, active social and professional lives, and normal sexual activity. In many cases, quality of life can be improved, even in the context of a permanent ostomy, with treatment of the underlying disease.

The routine care and management of common issues and complications of stoma creation are reviewed here. The types and indications, and principles of ostomy construction and reversal are discussed separately. (See "Overview of surgical ostomy for fecal diversion" and "Parastomal hernia".)

ADAPTION

Patient preparation for adaptation to life with a temporary or permanent ostomy begins in the preoperative period, whenever possible. (See "Overview of surgical ostomy for fecal diversion", section on 'Preparation and counseling'.)

The patient must adapt to new patterns of fecal elimination and to their altered body and image of themselves. Successful adaptation requires the patient to master new skills and to deal effectively with the many emotional issues associated with their altered anatomy and with altered continence. Interventions that promote adaptation include:

                             

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Literature review current through: Jul 2015. | This topic last updated: May 20, 2015.
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