Copyright ©  Living With A Stoma  -  2010-2017


A Guide To Living With A Stoma More For You


LIVING WITH A STOMA




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LIVING WITH A STOMA

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DISCLAIMER


100% accuracy at time of writing cannot be guaranteed.  A listing in this website is provided for informational purposes only, and does not mean it is an endorsement.  All companies listed are tried at the reader’s own risk.  All information provided is intended as a supplement to any professional help already

given.  Before acting on suggestions from anyone, ostomates are advised to check with a doctor or stoma care nurse that the course of action is suitable

for them. Whilst every care is taken, the author will not be held responsible.

QOL


See Quality Of Life.


QUALITY OF LIFE


Quality of life is an individual’s ability to pursue and enjoy life in relation to personal goals, standards

and concerns.








RADIATION


Radiation is the production of high-energy x-rays to kill cancer cells in a targeted area of the colon

or rectum.


RADIATION COLITIS


Radiation colitis is damage to the colon from radiation therapy.


RADIATION ENTERITIS


Radiation enteritis is damage to the small intestine from radiation therapy.


RADIATION THERAPY


See Radiotherapy.


RADIOTHERAPY


Radiotherapy is the treatment of disease by exposure to a radioactive substance.  It is generally used

as part of cancer treatment, in order to control or kill malignant cells.


RECTAL DISCHARGE


Rectal discharge is the secretion of fluids, e.g. faecal, mucous, blood, etc. from the anus.  There are many possible causes, and therefore it is advisable to consult a doctor.


RECTUM


The rectum is the lower end of the large intestine, leading to the anus.


REGIONAL ENTERITIS


See Crohn’s Disease.


RESTORATIVE PROCTOCOLECTOMY


See Ileoanal Reservoir.


RETRACTED STOMA


A retracted stoma is one which sits, fully or partially, below the level of the skin surface.


In some people, the retraction may not always be obvious and only occurs when the stoma is active or when there is a change in position (e.g. from lying to sitting).  Retraction may be caused by surgical technique or difficulties (e.g. poor mobilisation of the bowel and/or excessive tension of the suture line at the fascial layer), recurrent malignancy or weight gain.


A retracted stoma may cause problems in obtaining and maintaining a secure and leak-proof seal around the stoma, necessitating an in-depth assessment by a stoma care nurse.  A variety of products are available to manage this problem.


REVISION


A revision is a surgical relocation of the stoma to a new site, or reconstruction of the stoma at the present site of surgery, when the original stoma does not function well.








SBS


See Short Bowel Syndrome.  


SEPSIS


Sepsis is a severe illness in which the bloodstream is overwhelmed by bacteria.


SHORT BOWEL SYNDROME


Short Bowel Syndrome is a condition in which not enough of the small intestine remains to absorb nutrients necessary to sustain life.  It can occur with Crohn’s Disease after surgical removal of large segments of the small intestine.  Symptoms include diarrhoea, weakness, and weight loss.


It is also known as short gut syndrome.


SHORT GUT SYNDROME


See Short Bowel Syndrome.


SIGMOID COLON


The sigmoid colon is the lower part of the colon, which empties into the rectum.


SIGMOID COLOSTOMY


See Colostomy.


SIGMOIDOSCOPE


See Endoscope.


SIGMOIDOSCOPY


A sigmoidoscopy is a visual examination of the anus, rectum, sigmoid colon and part of the descending colon with a flexible or rigid tube, called a sigmoidoscope.  Biopsy specimens can be removed through the sigmoidoscope.


SKIN BARRIER


A skin barrier is a product (cream, lotion, wipe, etc.) placed on the body for the purpose of protecting the skin under a flange and around the stoma from irritation, which can be caused by faeces, urine or adhesives.  Some skin barriers may also help the adhesion of the flange.





SKIN CLEANSER


A skin cleanser is a water-based preparation, and may contain varying amounts of lanolin, urea, propylene glycol, fragrance and artificial colours.  They are available in a variety of applications, such as liquids and wipes.




SMALL INTESTINE


The small intestine is a part of the digestive system, which connects the stomach and the large intestine.  Its function is to continue food digestion and absorb nutrients.  It measures about twenty feet long, and includes the duodenum, jejunum and ileum.


SMALL INTESTINE PERFORATION


A small intestine perforation is a hole in the intestine wall, where faecal matter is able to escape from

the bowel to the body cavity.


SPASTIC COLON


See Irritable Bowel Syndrome.


SPHINCTER


Sphincter is a ring-like muscle, which opens and closes an opening in the body.  An example is the muscle between the oesophagus and the stomach known as the lower oesophageal sphincter.


Two sphincters in the anus provide bowel control, and a bladder sphincter controls urine.


SPINA BIFIDA


Spina Bifida is a birth defect of the spinal column, which leaves part of the spinal cord unprotected.  This may result in bowel and/or bladder incontinence.


S-POUCH


See Ileoanal Reservoir.


STENOSED STOMA


A stenosed stoma is where the opening of the stoma becomes very narrow and tight.  This can be caused by retraction, continuous leakage, or recurrence of diseases like Crohn’s.  In addition, it can occur after surgical repair of a parastomal hernia.  It can be treated by surgical dilation but, in some cases, may be so severe that it requires a stoma reconstruction.


STENOSIS


Stenosis (also known as stricture) is the narrowing or shrinking of the stoma due to scar tissue.  It may also be caused by ischaemia, trauma, peristomal sepsis, retraction, excessive scar formation (following mucocutaneous separation) or narrowing after repair of a parastomal hernia.  It is often at the opening of a stoma, so the passage of stool or urine is partially or completely blocked.


Manual dilation may be considered depending on the cause.  If this is not successful, refashioning of

the stoma may be required to avoid obstruction.


STENT


A stent is a thin, plastic tube, which is used to keep narrow body passageways open, while they heal after surgery, e.g. the connection between ureters and the segment of ileum in an ileal conduit.  They are removed after healing is established.


STOMA


The word stoma is derived from the Greek for ‘mouth’, and means an opening or mouth.  A stoma is

a surgical-created opening in the abdomen, which allows the discharge of waste from the body.


The terms stoma and ostomy are general descriptive terms, which are often used interchangeably, although they have different meanings.  An ostomy operation creates the opening.  The stoma is the bud-like, visible portion of the ostomy, which is a piece of ileum, colon or ureter, which can be seen protruding through the abdominal wall.  The stoma is red and moist, and as there are no nerve endings in a stoma, there is no sensation or pain.  The opening must be covered at all times by a pouch, which collects faeces or urine.


A stoma can be either temporary or permanent, depending on the type of operation, and how much of the bowel or urinary tract has been removed.  The size and shape of the stoma will also depend on the type of operation.


A stoma may be necessary, if an operation involves the removal of all or part of the bowel or urinary tract.  Conditions that need this type of treatment may include inflammatory bowel diseases such as Ulcerative Colitis or Crohn's Disease, and certain types of bowel or bladder cancer.

See Colostomy, Ileostomy, Ostomy and Urostomy.


STOMA APPLIANCE


Stoma appliances are collection devices, which consist of a pouch and flange, worn by an ostomate

over the stoma.  The pouch contains waste, which has been eliminated from the body.


They are generally divided into three categories:










All categories of appliances are available in both one-piece and two-piece systems.  A one-piece is

where the pouch and flange are integral.  The two-piece product has a pouch, which is detachable

from the flange, enabling the ostomate to change the pouch without removing the flange.


See Appliance and Pouch.


STOMA BLEEDING


Sometimes an ostomate may incur some bleeding from the small vessels of the stoma, especially following pouch changes or some kind of other trauma.  However, should this be persistent or profuse, it is important to contact a stoma care nurse to make sure that there is no underlying disease or problem.  


STOMA BLOCKAGE


See Colostomy Blockage and Ileostomy Blockage.


STOMA CAP


A stoma cap is a small, closed pouch, which is generally worn by an ostomate, who practises irrigation

to manage their colostomy.  In addition, a stoma cap can be used on a short-term basis during water activities, e.g. swimming, bathing, hot tubs, etc., or during intimacy.


A stoma cap can provide freedom from wearing a standard-sized pouch system, but it is not intended

to contain faeces, and is more for mucous and venting of gas.  They are available as a one-piece or

two-piece system, and have an integrated filter to vent gas, and an absorbent pad inside the pouch to absorb mucous, etc.  They are mostly round in shape and flesh-coloured to blend in with the skin.




STOMA CARE NURSE


A stoma care nurse is a medical, healthcare professional, who has specialised training in ostomy care and related fields.  They are a very important part of the medical team, since they help ostomates care for their stoma, and can be consulted on many matters in respect of stoma management.


They will visit an ostomate on the hospital ward to discuss the stoma, stoma care appliances and ongoing care issues.  They will also talk to patients, family and carers, about the transition from hospital to home, which can be a time of great anxiety and uncertainty, especially for a patient with a newly-formed stoma.


In some cases, following discharge from hospital, the stoma care nurse will visit a patient at home for a short period, as a means of maintaining continuity of care. They will also work together with a GP, district nurse and other relevant community services, to provide care in the community.


STOMA MEASURING GUIDE


A stoma measuring guide is a card, which is used to measure the stoma.  This information is useful in selecting the correct size hole for the flange or pouch.


Standard measuring guides are usually provided in the box of pouch stoma supplies, and have measured openings or slots of different sizes.  The guide is placed over the stoma, ensuring a snug fit, but allowing for a gap of 1 mm. to 2 mm. around the actual stoma.  Choosing a size, which is too tight, can cause irritation and soreness at the site of the stoma.


If a stoma is not a standard size, a personal template may be made in order to measure the size of the stoma for flange and pouch purposes - once again allowing for a gap of 1 mm. to 2 mm. around the actual stoma.


Over a period of time, a stoma may change shape or size, and therefore it is advised that measurements are taken periodically, so that the fit remains correct in order to prevent leakage.


STOMA REVERSAL


Depending on how much and which part of the bowel has been removed, some patients may have a temporary stoma, as opposed to the permanent stoma.  Temporary stomas may be formed for bowel cancer, inflammatory bowel disease, diverticulitis and traumatic injuries to the bowel, which means that it has to be rested to allow for the healing process.  In this situation, after healing has taken place, it may be possible for the stoma to be reversed.


See Temporary Colostomy, Temporary Ileostomy and Temporary Ostomy.


STOMA SUPPLIES


Stoma supplies are products, which an ostomate will require, to manage their stoma.  If an ostomate has a permanent stoma, they are entitled to claim exemption from prescription charges by obtaining

an exemption certificate from the doctor.


There are several stoma product suppliers and manufacturers, many of which offer a free home

delivery service.




STOOL


See Faeces.  


STRESS INCONTINENCE


Stress incontinence is the most common form of incontinence.  Involuntary urine leakage can occur, when coughing, sneezing or exercising.  It occurs when the pelvic floor muscles, which support the bladder, are weakened.


The main treatment for stress incontinence is pelvic floor exercises (PFEs).  Surgery to tighten or support the bladder outlet may also help, in those that have not responded to PFE’s.  


STRICTURE


A stricture is a narrowing along a segment of the GI or urinary tract.

















Closed appliances are generally worn over a colostomy.


Drainable appliances are worn for a more liquid output and in ileostomy management.


Drainable appliances with a tap are worn for ease of emptying in urostomy management.


Closed


Drainable



Drainable With A Tap


Accessories, Stoma Caps




Suppliers




Accessories, Skin Cleansing Gels



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GLOSSARY

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Accessories, Skin Barrier Creams

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