Having a new stoma, whether temporary or permanent, can be emotionally difficult. However, care of the stoma itself should not be difficult. Prior to discharge from the hospital, you will be seen by an enterostomal therapist, who is an individual specifically trained in stoma care and who will spend time with you instructing you on the proper care of your new stoma. Your stoma may be either a small bowel stoma (ileostomy) or a colon stoma (colostomy), which will determine the consistency of the stool that is released into the bag. Ileostomies usually drain liquid stool, whereas colostomies tend to drain more solid stool. If you have an ileostomy, you are more prone to dehydration from excessive diarrhea. Occasionally, Imodium is necessary to control the diarrhea.
The most important factor for proper stoma care is to ensure a good fit of the stoma appliance. If the appliance is not fitted correctly, you can have problems with leaking and subsequent skin irritation and breakdown. It is always easier to prevent this complication than to treat it. If you are having problems with your stoma once you are discharged, you should contact the Home Health Agency, who is providing your outpatient follow-up. You can also call our office, and we can contact the stoma nurse for you.
If your stoma is temporary, you can typically expect that it will be reversed in 3-6 months. If you have a colostomy, you will require another surgery to reverse it through a midline incision. If you have an ileostomy, you will also require additional surgery, but the operative procedure is less invasive, and can often be accomplished without reopening your midline incision. Expect 5-7 days in the hospital after stoma reversal.
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