Question

Research the different types of colostomies and differentiate the what kind of conditions would lead to developing them at different locations in the bowel. Provide rationales and reference sources in your answer.

Answer 1

Types of Colostomies and Pouching Systems:

A colostomy can be here and now (impermanent) or long lasting (perpetual) and can be made in any piece of the colon. The diverse sorts of colostomies depend on where they are situated on the colon.

Temporary colostomies

Certain lower entrails issues are dealt with by giving piece of the inside a rest. It's shielded purge by shielding stool from getting to that piece of the inside. To do this, a fleeting (transitory) colostomy is made with the goal that the gut can mend. This recuperating procedure may take half a month, months, or even years. In time, the colostomy will be turned around (expelled) and the inside will work as it did before – the stool will exit from the butt once more.

Permanent colostomies

At the point when part of the colon or the rectum ends up plainly infected, a long haul (perpetual) colostomy must be made. The ailing piece of the inside is expelled or for all time rested. For this situation, the colostomy isn't relied upon to be shut later on.

Transverse colostomies

There are 2 kinds of transverse colostomies: the circle transverse colostomy and the twofold barrel transverse colostomy. The transverse colostomy is in the upper mid-region, either in the center or toward the correct side of the body. This sort of colostomy enables the stool to leave the body before it achieves the dropping colon. A portion of the colon issues that can prompt a transverse colostomy include:

·         Diverticulitis: This is irritation of diverticula (little sacs along the colon). It can cause abscesses, scarring with stricture (unusual narrowing), or crack of the colon and disease in extreme cases.

·         Inflammatory gut malady

·         Cancer

·         Obstruction (blockage)

·         Injury

·         Birth deserts

On the off chance that there are issues in the lower entrails, the influenced some portion of the inside might require time to rest and mend. A transverse colostomy might be utilized to keep stool out of the territory of the colon that is kindled, contaminated, unhealthy, or recently worked on – this enables mending to happen. This sort of colostomy is generally impermanent. Contingent upon the mending procedure, the colostomy might be required for fourteen days, months, or even years. On the off chance that you mend after some time, the colostomy is probably going to be surgically switched (shut) and you will backpedal to having typical entrails work.

A changeless transverse colostomy is made when the lower segment of the colon must be evacuated or for all time rested, or if other medical issues make the patient unfit to have more surgery. The colostomy is then the perpetual exit for stool and won't be shut later on.

Loop transverse colostomy: The circle colostomy may appear as though one extensive stoma, yet it has 2 openings. One opening puts out stool, the other just puts out bodily fluid. The colon regularly makes little measures of bodily fluid to shield itself from the inside substance. This bodily fluid goes with the defecations and is typically not taken note. Notwithstanding the colostomy, the resting some portion of the colon continues making bodily fluid that will turn out either through the stoma or through the rectum and rear-end. This is ordinary and anticipated.

Double-barrel transverse colostomy: When making a twofold barrel colostomy, the specialist separates the entrails totally. Each opening is conveyed to the surface as a different stoma. The 2 stomas could conceivably be isolated by skin. Here, as well, one opening puts out stool and alternate puts out just bodily fluid (this littler stoma is known as a bodily fluid fistula). Infrequently the finish of the inert piece of the gut is sewn shut and left inside the stomach. At that point there's just a single stoma. The bodily fluid from the resting part of the inside turns out through the butt.

Changes in the recently framed transverse colostomy:

Directly after surgery, your colostomy might be secured with wraps or it might have a reasonable pocket over it. The kind of pocket utilized directly after surgery is normally not the same as those you'll use at home. Before you take a gander at your colostomy out of the blue, remember that it might be very swollen after surgery; there may likewise be wounds and join. While a stoma ordinarily is clammy and pink or red in shading, it might be darker at first. Your stoma will change a considerable measure as it recuperates. It will get littler and any staining will leave, leaving a soggy red or pink stoma. This may take a little while.

You'll soon see that, in spite of the fact that you can as a rule advise when your colostomy will pass stool or gas, you can't control it. Your colostomy does not have a valve-like sphincter muscle like your butt does. Along these lines, you'll have to wear a pocket over your colostomy to gather the yield. Your ostomy medical caretaker or specialist will enable you to discover a pouching framework believe it or not for you. This is likewise examined in more detail in picking a colostomy pouching framework.

Managing with a transverse colostomy:

At the point when a colostomy is made in the correct portion of the colon (close to the rising colon), just a short part of colon prompting it is dynamic. The stool that leaves a transverse colostomy changes from individual to individual and even every now and then. A couple of transverse colostomies put out firm stool at rare interims, yet a large portion of them move frequently and put out delicate or free stool. It's imperative to realize that the stool contains stomach related compounds (chemicals made by the body to separate nourishment). These catalysts are extremely disturbing, so the close-by skin must be secured.

Endeavoring to control a transverse colostomy with unique weight control plans, drugs, purifications, or water systems for the most part doesn't work and is at times exhorted. By and large, a pouching framework is worn over a transverse colostomy consistently. A lightweight, drainable pocket holds the yield and shields the skin from contact with the stool. The pocket doesn't typically lump, and it is difficult to see under your garments.

Bowel movements with a transverse colostomy:

A transverse colostomy will put out stool regardless of what you do. Remember these focuses:

·         The right pouching framework (likewise called an apparatus) for you is one that will shield you from ruining your dress.

·         The solidness of your stool is influenced by what you eat and drink.

·         Gas and smell are a piece of the stomach related process and can't be counteracted. Be that as it may, they can be controlled with the goal that you won't feel humiliated.

·         Empty the pocket when it's around 1/3 full to shield it from releasing or protruding under your garments.

·         Change the pocket framework before there's a hole. It's best to transform it close to once per day and at least once every 3 or 4 days.

·         The ostomy yield can disturb your skin. You can help forestall skin issues by having an effectively fitted pocket framework and by utilizing unique materials for ostomy mind.

Ascending colostomy:

The climbing colostomy is set on the correct side of the gut. Just a short part of colon stays dynamic. This implies the yield is fluid and contains numerous stomach related catalysts. A drainable pocket must be worn consistently, and the skin must be shielded from the yield. This sort of colostomy is uncommon on the grounds that an ileostomy is frequently a superior decision if the release is fluid.

Tending to a rising colostomy is much similar to administering to a transverse colostomy.

Descending and sigmoid colostomies:

Situated in the sliding colon, the slipping colostomy is put on the lower left half of the gut. Regularly, the yield is firm and can be controlled.

A sigmoid colostomy is the most widely recognized sort of colostomy. It's made in the sigmoid colon, and found only a couple of inches lower than a diving colostomy. Since there's all the more working colon, it might put out strong stool on a more customary calendar.

Both the plummeting and the sigmoid colostomies can have a twofold barrel or single-barrel opening. The single-barrel, or end colostomy, is more typical. The stoma of the end colostomy is either sewn flush with the skin or it's played Judas on itself (like the turned-down best of a sock).

You will see with a sliding or sigmoid colostomy:

·         The stool is firmer than the stool of the transverse colostomy. It doesn't have as a great part of the disturbing stomach related proteins in it.

·         Stool yield may occur as a reflex at normal, expected circumstances. The solid discharge will happen after a specific measure of stool has gathered in the inside over the colostomy. Two or 3 days may go between developments

·         Spilling may occur between developments in light of the fact that there's no muscle to keep the stool down. Many individuals utilize a lightweight, expendable pocket to anticipate mishaps

·         Feeling the need to discharge the gut (reflex) will happen normally in a few people. Others may require gentle incitement, for example, juice, espresso, a dinner, a mellow diuretic, or water system.

Bowel movements with a descending or sigmoid colostomy

You can treat defecation through a colostomy like a typical development through the butt; simply let it happen normally. In any case, not at all like the butt-centric opening, the colostomy does not have a sphincter muscle that can stop the entry of stool

·         You must wear a pocket to gather anything that may come through, regardless of whether it's normal or not. Numerous lightweight pockets are difficult to see under garments. They adhere to the skin around the colostomy and might be worn constantly, or just as required.

·         For a few people, eating certain nourishments at specific circumstances can influence the entrails to move during an era that works best for them. A few people utilize just this technique to keep defecations on a normal timetable, while others utilize it with water system.

Constipation or loose stool

Many individuals surmise that you should have defecation consistently. In truth, this differs from individual to individual. A few people have 2 or 3 developments per day, while others have a solid discharge each 2 or 3 days or even less frequently. It might require some investment after surgery to make sense of what's typical for you.

While many plummeting and sigmoid colostomies can be prepared to move consistently, some can't. Preparing, with or without incitement, is probably going to happen just in those individuals who had standard defecations previously they turned out to be sick. On the off chance that solid discharges were unpredictable in prior years, it might be hard, or inconceivable, to have normal, unsurprising colostomy work. Spastic colon, bad tempered entrails, and a few sorts of acid reflux are a few conditions that reason individuals with colostomies to keep on having episodes of stoppage or free stool.

Closing or reversing a colostomy

In case you will have your colostomy shut, the specialist may say intends to "bring it down" or "switch it" in half a month or months, yet some of the time the specialist doesn't say anything in regards to it. It's best to converse with your specialist about these things previously you leave the healing center so you recognize what the plans are and when to see the specialist once more. In case you're at home now and didn't get guidelines, call the specialist's office or center and discover what the specialist needs you to do. You must keep in contact with the specialist.

Numerous things must be considered when pondering shutting a colostomy, for example,

·         The reason you required the colostomy

·         Whether you can deal with more surgery

·         Your wellbeing since the operation

·         Other issues that may have come up amid or after surgery

Choosing a pouching system

Choosing what pouching framework or machine is best for you is an extremely individual issue. When you're experimenting with your first pouching framework, it's best to converse with an ostomy attendant or somebody who has involvement around there. There ought to be somebody in the healing facility who can kick you off with hardware and guidelines after surgery.

As you're preparing to leave the healing facility, make sure you are eluded to Wound Ostomy Continence nurture (WOCN or WOC nurture, likewise called ostomy nurture), a center, an ostomy producer, or a section of the United Ostomy Associations of America. Regardless of whether you should leave town to get such help, it's advantageous, as you need to get a decent begin and stay away from botches. Indeed, even with help, you may need to attempt diverse composes or brands of pouching frameworks to locate the one that best suits you.

There are numerous things to consider when endeavoring discovering the pouching framework that will work best for you. The length of the stoma, stomach solidness and shape, the area of the stoma, scars and overlap close to the stoma, and your tallness and weight all must be considered. Uncommon changes may must be made for stomas close to the hipbone, waistline, crotch, or scars. A few organizations have uniquely designed items to fit uncommon circumstances.

A good pouching system should be:

·         Secure, with a decent airtight seal that goes on for up to 3 days

·         Odor-safe

·         Protective of the skin around the stoma

·         Nearly undetectable under attire

·         Easy to put on and take off

Types of pouching systems

Pouches come in many styles and sizes, yet they all have an accumulation pocket to gather stool waste that leaves the stoma and a glue part (called a rib, skin boundary, or wafer) that secures the encompassing skin. There are 2 fundamental kinds of frameworks accessible:

·         One-piece pouches are appended to the skin hindrance

·         Two-piece frameworks are comprised of a skin obstruction and a pocket that can be taken off and returned on the hindrance

Some pouching frameworks can be opened at the base for simple exhausting. Others are cut off and are taken when they are full. Still others enable the cement skin hindrance to remain on the body while the pocket might be taken off, washed out, and reused. Pockets are produced using scent safe materials and fluctuate in cost. They can be either evident or murky and come in various lengths.

The opening of the skin hindrance or wafer of the pocket needs to fit your stoma. The opening ought to be close to 1/8 inch bigger than the stoma. Contingent upon the pocket plan, you may need to remove an opening for your stoma, or the wafer might be measured and pre-cut. The span of the gap is critical in light of the fact that the wafer is intended to shield the close-by skin from the stoma yield and be as delicate to the skin as would be prudent.

After surgery, your stoma might be swollen for around 6 to two months. Amid this time the stoma ought to be estimated about once per week. An estimating card might be incorporated into boxes of pockets, or you can influence your own format to coordinate your stoma to shape and get the best fit.

Stoma cap

In the event that your colostomy puts out stool at standard, expected circumstances, you might have the capacity to utilize a stoma cover rather than continually wearing a pocket. You can put flawlessly collapsed cloth or tissue, spotted with a little measure of water-solvent ointment over the stoma, and cover it with a bit of plastic wrap. This can be held set up with medicinal tape, underclothes, or a versatile piece of clothing. Plastic, instant stoma tops are likewise accessible.

Resources:

1. Potter et al. Canadian Fundamentals of Nursing 3rd ed.2006, Elsevier Canada.p1393
2. Jump up^ Potter et al. Canadian Fundamentals of Nursing 3rd ed.2006, Elsevier Canada. p1393-1394
3. Jump up^ "Archived copy". Archived from the original on 2015-12-10. Retrieved 2015-06-09.