What is a Colostomy?

A colostomy is an opening in the abdominal wall that is made during surgery. The end of the colon or the large intestine is brought out through this opening to form a stoma. The location of the stoma on the abdomen depends on the part of the colon used to make it. Some colostomies are large or small; some are on the left side, others on the right or the middle. A Wound Ostomy Continence Surgeon will figure out the best location for the stoma.

What does a Colostomy do?

After a colostomy is created, the intestines work just like earlier except the colon and rectum beyond the colostomy are removed. The anus is no longer the exit point for stool, but it will still pass mucus from time to time.

As nutrients are absorbed in the small intestine, a colostomy does not have any impact on nutrient absorption. The main functions of the colon are to absorb water, move stool toward the anus, and store stool in the rectum until passed out. When a colostomy changes the exit point of stool, this storage area is not there.

The higher in the colon colostomy is made, the shorter the length of the colon and the lesser time the colon gets to absorb water, and the more liquid stool is likely to be. A colostomy further down in the colon, near the rectum, will put out stool that has been in the intestine a longer time and hence more solid. Some people with colostomy find that they can pass this stool at certain times of the day with or without the help of stoma irrigation.

You will be in hospital for about 4-5 days.

After waking up from surgery, you will observe several tubes and medical equipment. Here’s a list of a few of the items you will notice

• A drain on your stomach that eliminates excess fluid from the surgical site and this is removed before discharge from hospital.
• An IV to administer drugs.
• A heart monitor.
• 2 stents or little plastic tubes coming from the stoma. After your urologist feels it is secure, these can be removed.
• An ostomy bag over your stoma.
• A tube put on the nose to manage oxygen.
• Massaging stockings to prevent blood clot formation.
• Dressing found over your incisions.
• For females, gauze might be put in the vagina to avoid bleeding.

Post-Operative Colostomy nursing care plan for your home

• Blood Clots – On returning home patients will have to minimize movement till they are stable. This places them at risk of developing blood clots. To minimize this risk, patients are taught to administer blood thinners – Lovenox took daily for around 28 days postoperatively. Before leaving the hospital, this is something that is taught to the patient as well as his/ her caregiver. Some individuals retain a home health nurse who instructs and helps patients to adjust to the new normal functioning of their body.
• Stoma or Ostomy Care – Requires some learning and patients get accustomed with time to manage their stoma. A few challenges or some queries, like leaking on their stoma, may persist. After arriving home from the hospital, patients normally must change their ostomy bag thrice daily, but that depends upon the individual and might be sooner or later for around 5 times.
• Blood in Urine – Many individuals wonder if it is common to see blood in the urine. The response to this question is yes, this is sometimes viewed after workouts. This kind of bleeding is much like bleeding from the gums after brushing or flossing your teeth. Not all kinds of bleeding are normal though. You must if the blood contains clots or into your urine is thick.
• Post-operative care of colostomy – After the operation, the patient has been accepted to the post-anaesthesia care unit or PACU and can be closely monitored by the nursing team before the anaesthesia wears off. The individual is moved into a hospital room if no issues are detected from the PACU.

The catheter that was inserted before the IV and operation, stays in place. The catheter will be removed based on recovery. As fluid and food cannot be quickly started from the mouth, the intravenous keeps the individual hydrated and nourished and the medicines are delivered via the IV.

As the patient commonly has pain, medicines are given to alleviate it. Severe pain could indicate a complication esp. if no prescribed drug provides relief, in this case, the physician must be contacted as soon as possible.

Until it is sure that gut function has resumed, nothing should be fed by mouth. This can be dependent on listening for bowel sounds like the passing of gas. Sounds indicate the normal movement within the colon has now resumed. The passing of faeces is just another good sign that the colon is recovery.

During surgery, a tube is passed through the nose and into the stomach. Sometimes this might stay in place for many days. After gut function yields fluids are normalized, the tube is removed. The diet starts with fluids and gradually evolves to solid foods.

On the day following surgery, many patients walk around a little bit and it is crucial to get up whenever possible, to assist blood flow and to stimulate bowel function.

Currently, the body is adapting to the colostomy or the opening is on the left or right side, based on where the part of the colon has been found. The stoma is reddish and following the operation, and there could also be a bandage. The colon is understood to have recovered when faeces begin to emerge out through the stoma.

Stools out of a stoma are much looser and softer. The opening should be kept covered by a pouch. The pouch is changed after a bowel movement.

 An entire – stomal therapist educates the individual how to take care of the colostomy and supply help with any issues which happen with an ostomy. It is critical that their relatives understand the maintenance of the colostomy until the individual has been discharged from the clinic.

Hospitalization ranges from 3 to 10 times, and activity can be resumed within 1 to 3 months. Its strenuous effort and takes longer for your body to cure and lifting must be avoided for 4 to 6 months.

Using a colostomy places a constraint on the individual. However, once healing has happened, there are no limitations on activities, sports, diet, work, or travelling. Sports that involve tasks involving lifting and body contact are not advised.  

Post-Operative Complications after Colostomy are

• Infection
• Bleeding
• Leakage around the stoma
• Harm to surrounding organs throughout the process.

When there is a leakage/inflammation at the site/pain which is not relieved by drugs and relaxation steps/fever or rectal bleeding, the physician must be contacted immediately for the post-operative colostomy nursing care plan.

Exercises help restore muscle function and these exercises are intended to assist quick and sure recovery. They are exercises which everyone with an ostomy needs to perform. Prior to starting, if you have some concerns about whether you should perform the exercises, then speak with physician or your care physician.

1. Tummy Tightening Exercise

• When to begin – This exercise could be started within days of operation. As you are still in hospital contemplating all is well, you may begin, and your recovery is progressing.
• The way to get it done – Lie on your back making sure your head is comfortable. Take a deep breath and slowly exhale through the mouth.  When you exhale, gently tighten the heavy muscles in your lower abdomen. You should feel a trimming effect. Do not attempt to lift your butt or push on your back. Hold this brace feeling to get a count of 3-5 seconds, release. Breathe and unwind and repeat 3-5 times. As you advance, you can perform the workout on the ground with no cushion and aim to get a more powerful tightening feeling. Hold the brace to get a count of 10-15 and breathe deeply in and out two three times. Repeat up to five times. Put your palms on your abdomen so that you feel and may check that the muscles tightening.

2. Pelvic Tilt

• When to begin – This exercise may be performed following operation.
• The way to get it done – Lie on your back with your head comfortable. Rock your pelvis upwards and put your back to the floor or the bed. You ought to feel a bit tightens. Rock back to a starting position and repeat. Initially aim to get 5 repetitions and proceed. Allow your spine as you advance and tighten your belly ardently because you push your spine. Construct up towards 20 reps.

3. Hip Lift / Bridge

• When to begin – Introduce this workout 7-10 days following surgery and try to do it lightly with a motion that is little, as large movements / changes might be difficult to carry at one go.
• The way to get it done – Lie on your back with your head in a comfortable position. Gently tilt pelvis backward and twist pelvic floor muscles. Lift your butt and lift vertebrae by vertebrae until the butt is off the mattress. Lift your butt as high as you can. Hold this for a minute, then slowly decrease pelvis and your back down. Imagine you are lifting a series of pearls off the ground and back down again. Repeat 3-5 times creating up to 10-15 reps in lifting and time greater as you are feeling comfy.

4. Knee Rolls

• When to begin – Introduce this workout 7-10 days. Work in a pain free selection and maintain the motion little to start with.
• The way to get it done – Lie on your back with your head is comfortable. Arms out to the sides. Let your knees and keep your knees and ankles start to fall over to a side. Go as far as is comfortable tighten your muscles and then roll your knees to the side. Try to keep your shoulders and your mind relaxed, looking up along with your eyes. Aim for 5 rolls. As time continues, you’re able to boost the range so that your knees fall and develop to 20 repetitions.

How can we Assist in your pre and post-operative care of colostomy nursing care?

Post-operative care is a vital element of the curing process. Post-operative care for individuals might be easy and may be short term or long term or may entail procedure for a few.

In case of long term postoperative colostomy nursing care, a patient is much better off within the warmth of home rather than a hospital. Aiding this kind of care is something that we provide from our home care nursing services. As a part of our services, our group of nurses and other caregivers, would come and see you and offer care. In some cases, the nurse may remain with the individual for 24*7 monitoring and attention.

Therefore, if you require nursing care in your home, look no further and trust your loved ones’ care to Care24 and we guarantee a satisfactory and quick recovery of the individual in the most effective and fastest way possible.