"SINGLE BARREL" COLOSTOMY

Figure 7

DOUBLE BARREL COLOSTOMY. EXTERIOR

FRONT VIEW

Figure 8

Nursing Care

The rehabilitation of the patient who has a permanent colostomy begins with his preoperative preparation. The different procedures which he must learn to perform after surgery and the changes in body function which occur are usually emotionally trying. A nurse who understands that the patient is struggling to make adjustments can be very helpful. The patient will be taught to carry out his care while he is in the hospital but he will usually need the help and support of a public health nurse, for a time, when he returns home.

Many people believe that a colostomy is always embarrassing but this is not so when control is established by irrigation and/or diet. Control of the colostomy will be affected by the emotional status of the patient.

The patient may irrigate his colostomy every day, every other day, or every third day; depending upon his need and the instructions from his physician. Some patients may not irrigate at all, but establish control by diet alone. Evening is often the preferred time for irrigation as the patient may not be as pressed for time then. Also, absorbent padding can be left over the stoma to catch any retained fluid. Each patient should be encouraged to choose a time for his irrigation that will be most convenient for him in relation to his work or daily activities. A routine time aids in regulating the bowels.