Information on Stoma's

Okay so my name is Sylvia, I'm one of the Stoma Care Nurse Specialists based here at St Mary's site and my job involves counselling patients and their relatives, supporting staff to look after patients and also carers in nursing homes and also the rehab places. So, stomas in general, there's three types of stomas. That's your ileostomies, your colostomy and your urostomy. So the ileostomy is a stoma formed from the small bowel or the ileum. And your colostomies are the stomas formed from the colon or the large bowel. And your urostomy is mainly anybody without a bladder. So the ureters are brought out onto the surface of the abdomen with a small piece of bowel. The general principles of managing a stoma, I would say, are the same, but in particular with an ileostomy, the output is a bit more on the loser side, more a porridge consistency, and it comes with a few more issues, which can be high output because the output is much more liquidy, so you're losing fluids, you're losing nutrients, so you would need to make sure that these nutrients are replaced by what you eat, So a low fiber diet to slow down the process of output. And you will also have to sometimes have a top up in the form of maybe St. Mark's solution or a double strength diurelite to make sure that your electrolytes are balanced to prevent dehydration. And you also have to be aware of how much water you drink and the way you drink it, you should be drinking slowly. And for colostomy generally is a little bit more manageable because the output is formed, you don't have a lot of issues with it per se, and you can eat mainly a lot of things generally. And you just need to drink water. You can have constipation as we do normally. And again, it will be trying to increase your fiber, drinking loads of water, and sometimes you might need some medication. Urostomy is pretty straightforward. Again, you have to drink a lot of water to make sure you are producing clear urine. if you have any issues the best way will be to speak to your specialist or my care nurses who would work with you to find out whether you've got the route right pouch, whether it needs to be a different pouch or whether you need some kind of skin protection or a barrier wipe and just your day-to-day activity to be able to advise you how best to do that. We would also normally encourage our patients to use some kind of a support belt to prevent hernias because it's one of the commonest things that can occur when you have a stoma. There is already a weakness in the muscle so a hernia is very, very common in patients with a stoma. So also the other things that we do with our patients, when you've got a stoma we'll have to teach you how to look after it and we show you how to change the bag, how you have to keep your skin clean and the things you need and also how you get your supplies because every patient is entitled to get their supplies free.