Small "stoma" has a lot of knowledge

Enterostomy is one of the common clinical treatment methods: it is an important way to save patients' lives and improve their quality of life. Postoperative stoma care plays an important role, not only helping to reduce the risk of infection, but also promoting the early recovery of patients. If the care is not done properly, it will cause a series of complications. Stoma care has developed into an important issue of global public health concern, but the current effective nursing countermeasures for stomas are still in the exploratory stage. How to improve their self-care ability, "enterostomy" care tips can greatly reduce patients' postoperative complications, let us explore it together.

First of all, what is a colostomy?

An enterostomy is an artificial opening, which is mainly separated by surgery to allow one end of the intestine to be led out to the body surface to form an opening for further excretion of feces. An enterostomy is not a disease, but an artificial opening for excretion. Since there is no sphincter around the enterostomy, it is difficult to control the excretion function, so a stoma bag needs to be attached to collect excrement.

Why is stoma care important?

Reasonable and efficient stoma care is essential for preventing infection, promoting wound healing, enhancing quality of life, and providing psychological support. During stoma care, you should follow the guidance and suggestions of the medical team, implement specific care instructions, and have regular follow-up visits to ensure the good condition of the stoma and respond to stoma problems in a timely manner.

The body shape of "stoma patients" changes, and they cannot control their excretion. They are troubled in social interaction, diet, use of stoma bags and related issues. Some patients may feel pessimistic and disappointed. Due to the existence of the stoma, psychological barriers and additional treatment burdens seriously reduce the quality of life of patients. Stoma care can provide important psychological support, promote patients to better adapt to and accept the stoma, and provide corresponding support and guidance.

Patients with colostomy have various forms of home care needs. We should focus on protecting the physical and mental health of patients with colostomy and provide them with emotional, social and other support to enhance their self-management level and improve their quality of life.

What should we pay attention to in colostomy care?

Psychological care is an important part of colostomy care. People with colostomy are a special group in society. Patients who need to rely on colostomy for a long time need the support and care of their families and society. Therefore, it is necessary to provide patients with targeted colostomy care health education, including the role of colostomy, care skills and precautions, etc., to help patients better understand and accept colostomy and relieve their anxiety and fear.

1. Emotional support and comfort: Emotional support and comfort are crucial for patients with colostomy. Listen patiently to patients' voices, understand their uneasiness and anxiety, and encourage and support them through gentle tones and body language. Encourage patients to express their emotions, share their feelings, and help them establish positive emotional coping mechanisms.

2. Self-image education: colostomy may lead to changes in the patient's body image, which in turn affects their self-identity. Therefore, it is particularly important to provide self-image education. Educate patients to actively accept their body changes and understand that colostomy is only part of the treatment and does not affect its intrinsic value. At the same time, guide patients on how to properly care for their stoma and enhance their confidence in their stoma.

3. Quality of life guarantee measures: To improve the quality of life of patients with colostomy, attention should be paid to their daily needs. Provide appropriate dietary advice to promote intestinal peristalsis and nutrient absorption; recommend suitable clothing to avoid friction and discomfort to the stoma; and recommend appropriate exercise methods to help patients restore their physical functions.

4. Information communication and guidance: Ensuring that patients fully understand the relevant knowledge of colostomy is an important part of the treatment process. Understand the causes, care methods, possible complications and countermeasures of colostomy to enhance the patient's self-care ability. At the same time, encourage patients to ask questions, answer doubts in a timely manner, and keep information flowing.

5. Strengthening family support: Family support is crucial for the psychological rehabilitation of patients with colostomy. Family members should understand the basic knowledge of colostomy, learn the correct nursing methods, and give care and support to patients in daily life. At the same time, family members are encouraged to participate in social activities with patients to help patients better integrate into society.

6. Psychological adjustment skills: Psychological adjustment skills are also important for patients with colostomy. Through deep breathing, meditation, relaxation training and other techniques, patients can be helped to relieve anxiety and stress and enhance psychological resilience. In addition, patients are encouraged to participate in hobbies and activities to divert their attention and improve their life satisfaction.

What are the specific measures for stoma care?

1. In terms of clothing, soft and comfortable clothes are the principle, and no special clothes are needed. Avoid belts that press on the stoma, and avoid wearing tight clothes and pants to avoid compression and friction on the stoma, which may affect blood circulation.

2. Closely observe the skin around the stoma. Good skin condition around the stoma is particularly important for stoma care, so protective measures need to be taken to prevent direct contact with excrement. In addition, the stimulation of excrement may induce inflammation. Therefore, when changing the stoma bag, you should pay attention to cleaning the skin around the stoma to prevent the skin from being corroded and damaged by feces to prevent infection. Secondly, clarify the number of times the stoma bag is replaced and the wearing time of the stoma base, especially for elderly patients. When replacing stoma care products, after removing the stoma base and cleaning it, observe whether the base is leaking, dissolving, or soaking. If symptoms such as redness, swelling, ulceration, and inflammation are found on the skin, it should be cleaned and disinfected to ensure that the skin is dry. In severe cases, seek medical attention in time and use skin protectants, dressings, etc. for skin protection according to the doctor's advice.

3. Patients can perform low-intensity activities according to the doctor's advice, including walking, yoga, etc. It is recommended to avoid exercises that increase abdominal pressure within 3 months after surgery, such as lifting heavy objects, strenuous exercise, etc., to prevent stoma prolapse. After full recovery, you can choose some less strenuous exercises according to your physical endurance and hobbies, such as jogging, Tai Chi, etc.

4. In terms of diet management, follow the principle of balanced nutrition and frequent small meals. Eat less gas-producing foods, such as carrots, beans, sweet potatoes, carbonated drinks, beer, etc. Eat less foods that easily produce odor, such as onions, garlic, cheese, etc. Eat less foods that easily cause diarrhea, such as beans, spicy foods, fried foods, etc. People with constipation can eat more crude fiber foods, and pay attention to drinking more water to prevent dry stools. People with stoma stenosis should eat less crude fiber foods (such as corn, celery, sweet potatoes, leafy vegetables, etc.) to avoid stoma obstruction. The daily water intake for ileostomy should be no less than 2000 ml. Because the stoma diameter is small, high-fiber foods may block the stoma. Eat less difficult-to-digest foods, such as seeds (dried fruits, nuts, etc.).

5. In terms of bathing, you can start taking a bath after the wound is completely healed. The stoma mucosa is not afraid of water just like the oral mucosa. You should choose to take a shower: try not to take a bath, as taking a bath for a long time will affect the viscosity of the stoma base. Be sure to pay attention to the temperature of the water during the bath to avoid scalding the intestinal mucosa. Avoid directly flushing the stoma with a shower head to avoid damaging the mucosa. Choose a bath gel that does not contain alcohol or fragrance. At the same time, it should be noted that if you take a stoma base to take a bath, you must replace the base immediately after taking a bath to avoid the base falling off.

6. Of course, after mastering the stoma care skills, you can travel if your body allows. Prepare sufficient stoma care products before going out, pay attention to your diet during the trip, and keep antidiarrhea drugs on hand.

7. Regular check-ups are also necessary. After recovery from the disease, the health of the stoma and the skin around the stoma is an important guarantee for the quality of life of stoma patients. It is very important to conduct regular check-ups of the stoma after discharge. If the following problems occur, seek medical attention in a timely manner: abdominal cramps lasting for more than 2-3 hours; persistent nausea and vomiting; abnormal changes in the size and color of the stoma; unexplained continuous leakage of the stoma bag; heavy bleeding at the stoma, or continuous bleeding, or blood is found in the bag multiple times when the stoma bag is emptied; any other abnormalities of the stoma and surrounding skin, such as stoma obstruction, stoma prolapse, and inflammation of the skin around the stoma.

In summary, systematic colostomy care is an important guarantee for the early recovery of postoperative patients and a key link in enhancing the quality of life after surgery. Since patients and their families have limited knowledge of colostomy care, they may suffer from unsatisfactory postoperative recovery or related complications due to unreasonable colostomy management. Therefore, it is extremely important to do a good job in colostomy care. This requires the joint efforts and collaboration of patients, their families, and medical staff.

Author: Zhu Hui and Tang Ying, Guangming Hospital of Traditional Chinese Medicine, Pudong New Area, Shanghai