Instructions for taking care of patients with colostomy at home

This is an automatically translated article.

The article is expertly advised by Mr. Dr. Duong Xuan Loc - Gastroenterologist - General Surgery Department - Vinmec Da Nang International General Hospital

Bleeding colostomy or blocked colostomy is one of the typical complications of colostomy. Therefore, when performing colostomy for patients, certain precautions must be taken to avoid unfortunate complications.

1. What is colostomy?

An colostomy is an opening in the ileum on the abdominal wall. This is a method used to treat a number of diseases related to the ileum or colon, including 2 types: loop colostomy and terminal colostomy.
Some indications for colostomy are as follows:
Colorectal cancer Inflammatory bowel disease Diverticulitis Ulcerative colitis Traumatic Incontinence Sphincter sutures The opening of the colostomy for patients in certain disease groups The above is intended for the following purposes:
Disabling the colon when performing anastomosis and treating lesions in the colon and bladder Reduce obstruction, possibly due to tumors in colon cancer

2. Some notes in the process of placing an ostomy

Open colostomy is a complicated technique and requires a lot of experience in this field, especially colostomy for babies, it is necessary to avoid errors so as not to cause any complications. Some notes to mention in the process of colostomy placement are as follows:
Determine the location of the colostomy in a position with a flat abdominal wall, no old surgical scars around, no colostomy In the position of bulging bones, the colostomy should not be located at the waist of the pants because it will cause inconvenience to the patient as well as difficult to self-observe and monitor during the colostomy. After determining the location of colostomy opening, it is necessary to mark that position with specialized ink. Ensure a number of principles such as the two sides of the stoma need to be fully perfused, the colon for the colostomy should not be stretched, the abdominal wall should be shared with a large enough size to avoid complications of posterior stenosis. the abdominal wall, ensuring that the abdominal wall and colon wall are closed so that fluid and stool cannot enter the abdominal cavity.

3. Common complications in patients with colostomy

3.1 The colostomy is blocked

After opening the colostomy, there may be some dangerous complications, including a blocked colostomy.
The cause of this condition is explained as follows: During the opening of the colostomy, the opening is too narrow, causing obstruction, or because the front of the colostomy is damaged, leading to narrowing. and cause colonic obstruction.
Another possible case is that the colostomy was twisted many times during surgery or because the care was not performed properly, so the stoma was blocked.
It is also possible that the hernia of the abdominal wall right next to the artificial anus has led to this complication. For treatment, the treating doctor will prescribe surgery to reopen the stoma and treat intestinal obstruction.

3.2 Bleeding colostomy

Bleeding colostomy is a medical condition because the patient has disorders of clotting and hemostasis function but before surgery is not examined and tested for these problems, usually due to the use of certain drugs that lead to this condition or possibly a blood clotting disorder caused by cancer.
Patients with bleeding colostomy will be sutured and stopped bleeding, then treated with hemostatic drugs.

3.3 Peri-anal dermatitis

Is a complication that often occurs in patients with an ileostomy. The patient should be instructed to put the bag back on in order not to let the fluid from the intestines get around to cause infection.
At the same time, it is necessary to clean around the stoma with neutral soap and use Zinc Oxide ointment to apply it around. If the inflammation is severe, it can be treated with antibiotics.

3.4 Abscess – car around the colostomy

Caused by severe infection during ostomy or infection during care. The patient will be sutured and part of the anal mouth separated from the edge of the skin to drain the pus out, and will be treated with combined antibiotics.

3.5 colostomy ulcer

Because the segment of colon performed colostomy is twisted or the blood vessels are not suitable, leading to ischemia at this site, or because of cancer, occlusion of the feeding mesenteric artery.
The patient will be operated again or monitored to investigate whether the necrotic tissue has spread to the abdominal wall or not?

3.6 Relapse of the colostomy into the abdominal cavity

Due to the colon stretching or fixing the colon improperly and the state of necrosis of the artificial anus. The patient will be indicated for surgery or closure of the colostomy.

3.7 Hernia on the edge of the artificial anus

This is a complication caused by the colostomy opening too wide or the wrong technique of fixing the colon. The patient will be sutured so that the opening is narrower than before and the colon is fixed to the abdominal wall, if possible, the colostomy will be closed.

3.8 Prosthetic prolapse

Occurs with loop colostomy, or colostomy in infants. Treatment in this case will be to put back the colostomy or seal the anal bag, even close the stoma in some cases.

4. Care after colostomy surgery

After the colostomy, the patient needs care and support to recover quickly, some of which can be noted as follows:
Medical staff or family members support the patient The patient is familiar with the stoma, how to use the faecal bag correctly, do not let the mouth of the faecal bag be too large, do not leave the faecal bag open, closely monitor the patient's progress when having the colostomy. for the immediate detection of dangerous complications. Change the faecal bag immediately after having feces from the stoma. Support and exercise the patient to walk gradually. nursing. Patients should not drink alcohol, beer and foods that can create a lot of gas in the abdomen. Patients should be instructed on proper body hygiene, oral hygiene and genital hygiene. In particular, it is necessary to thoroughly clean the skin around the colostomy site. In case the patient has a permanent colostomy, it is necessary to be instructed to remove the colostomy at home.

5. Conclusion

Artificial colostomy is a fairly common indication in colorectal pathologies, in which there may be colostomy in infants. The placement of an colostomy can cause many dangerous complications, including a blocked colostomy or bleeding. Therefore, patients need to perform this method at reputable medical facilities and have the right postoperative care to limit these complications.
Any questions that need to be answered by a specialist doctor as well as customers wishing to examine and treat at Vinmec International General Hospital, you can contact Vinmec Health System nationwide or register online HERE.