[Fat Bear Science] Get well, patient | What should you do after returning home after undergoing colostomy surgery?

After completing treatment and recovery in the hospital, he was discharged

What should I pay attention to when I get home?

Are there any dietary restrictions? How long is the follow-up?

......

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Q&A

What is an enterostomy

Enterostomy refers to the use of surgical methods to artificially open the abdominal wall and lead a section of the intestine out of the abdominal cavity due to treatment needs. The opening is sewn to the abdominal wall for excretion of feces. The purpose is to output intestinal contents, reduce intestinal decompression, and relieve obstruction. Protect the anastomosis or damage of the distal intestinal tube, promote the recovery of intestinal diseases, and even save lives. Some patients with digestive tract diseases and urinary system diseases, such as rectal cancer, intestinal obstruction, etc.

Patients with ostomies have undergone physical changes, and their excretion cannot be controlled at will. If not properly cared for, patients will have some troubles in social interaction, diet, odor management, use of ostomy bags, and complication management. Therefore, ostomy patients should pay special attention to home guidance and daily care.

Q&A

Characteristics of bowel movement

Enterostomy is divided into ileostomy, double-lumen transverse colostomy, descending colostomy, and sigmoid colostomy. Different types of stomas have different characteristics of defecation.

Characteristics of ileostomy: The stool is generally unformed, watery or pasty, rich in digestive enzymes, and highly irritating to the skin around the stoma.

Characteristics of transverse colostomy: The excrement can be liquid, pasty, semi-formed or formed. At the same time, a small amount of mucus or feces may be discharged from the original anus.

Characteristics of descending colostomy and sigmoid colostomy: Generally, the stool is formed.

Q&A

Home Guidance

01

diet

Avoid eating too fast, eat regularly, drink plenty of water, chew thoroughly, eat slowly, avoid eating too much at one time, eat a balanced diet, eat more fresh vegetables and fruits. Try to choose high-calorie, high-protein, vitamin-rich, low-residue foods, such as lean meat, fish, steamed eggs, and soft tofu.

Eat less foods that easily produce gas, such as: beans, radishes, onions, sweet potatoes, chocolate, carbonated drinks, beer, etc.

Eat less food that easily produces odor, such as corn, onion, fish, eggs, garlic, etc.

Avoid eating foods that may cause diarrhea, such as fried foods, alcohol, beer, cabbage, spinach, loofah, and mung beans.

Avoid eating foods that are highly irritating to the intestines: such as cold drinks, raw or undercooked foods, alcoholic beverages, etc.

Avoid eating foods that may cause obstruction, such as high-fiber foods: celery, leeks, corn, persimmons, dried fruits, etc.

At the same time, you can choose the following foods according to different needs.

Foods that promote stool formation: starchy foods such as bread, potatoes, rice, noodles, etc.

Foods that can relieve constipation: increase fluid intake, eat fresh fruits, vegetables, and whole grains.

Foods that can reduce gas and odor: tomato juice, coriander, skimmed milk or yogurt, etc.

02

clothes

Clothes should be soft, comfortable and loose. However, avoid wearing tight clothes to avoid compression or friction on the stoma, which may affect blood circulation. If the belt compresses the stoma, it is recommended that men wear loose overalls and women wear dresses.

03

Bathing or swimming

Water does not harm the stoma. You can choose to shower to clean your body and stoma. Pay attention to the water temperature and speed. Remember not to flush the stoma vertically. You can take off the stoma bag to shower, wait for 1 hour after showering, and then wear the stoma bag again.

You can also choose not to remove the ostomy bag: cover the ostomy bag with plastic wrap before showering to keep the area around the ostomy bag airtight, and then remove it after showering.

A mini bag or stoma plug can be used when swimming, and a one-piece swimsuit is appropriate for female patients.

04

sports

In order to maintain the health of the body's physiological functions, you can do moderate exercise, such as swimming, Tai Chi, jogging, walking, etc. Avoid participating in collisions and strenuous sports, such as boxing, weightlifting, football, basketball, etc. When exercising, you can selectively use a stoma belt to increase abdominal support and avoid increased abdominal pressure, which may cause stoma complications.

05

Work

You can go back to work when you have recovered your strength, but you need to pay attention to the combination of work and rest, and avoid overwork and heavy physical labor. You should try to avoid lifting heavy objects, as this may cause parastomal hernia. Keep enough stoma care products ready when you are at work.

Q&A

Nursing precautions

01

Replacement cycle

There is no absolute replacement cycle, but it needs to be replaced immediately in the following situations:

1. Chassis leakage.

2. The chassis is not leaking but the area that is white and foamy exceeds 1/2.

3. The skin around the stoma feels itchy, burning or tingling.

02

Replacement frequency

The factors that affect the replacement frequency are as follows:

1. According to the condition of the skin around the stoma

If the surrounding skin has inflammation, ulcers, bleeding, itching and other adverse conditions, the replacement frequency needs to be increased. In severe cases, you need to seek help from professional medical staff.

2. According to their defecation situation

If the stool is unformed and more loose stools are discharged, it is recommended to change it every 2-3 days; if the stool is formed, it can be appropriately extended to 3-5 days.

3. According to the weather and skin condition

If the weather is hot and your skin sweats a lot, you need to increase the frequency of replacement, and replace it once a day if necessary.

03

Cleansing of the skin around the stoma

It is recommended to use alcohol-free wipes to clean the stoma and skin. There is no need to use alkaline soap or any disinfectants, as they will affect the normal barrier function of the skin, thereby affecting the adhesion of the base adhesive and affecting the use of the stoma bag.

04

Self-Observation

Stoma abnormalities: stoma retraction, stenosis, skin and mucosal separation, prolapse, para-hernia, bleeding, unabsorbed sutures, etc.

Abnormal skin around stoma: moisture-related skin damage around stoma, allergic dermatitis, mechanical skin damage, granuloma, etc.

Q&A

Outpatient follow-up

The period from stoma surgery to half a year after surgery is the peak period for stoma complications and stoma skin complications. It is necessary to go to the stoma wound clinic for follow-up on time and receive professional evaluation of the stoma to reduce the occurrence of complications and thus improve the quality of life.

Follow-up visit time

Follow-up visits should be conducted half a month, one month, three months, and six months after discharge from the hospital after surgery, and then once a year thereafter. If stoma-related complications occur, see a doctor at any time.

The Affiliated Cancer Hospital of Chongqing University has opened an ostomy wound clinic, which is open all day every Monday, Wednesday and Thursday. International ostomy therapists and ostomy wound specialist nurses provide professional guidance and treatment for ostomy wound patients.

Text/Fat Bear Photos/Partially from the Internet (Please contact us to delete if there is any infringement) Review/Gastrointestinal Tumor Center

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