Stoma care

Question 1

A stoma is an

Answer 1

artificial opening on the abdomen to divert the flow of faeces or urine into an external pouch located outside of the body. Colostomy and Ileostomy are the most common forms of Stoma.

Question 2

Medicines not suitable in stoma patients:

Answer 2

Enteric coated and modified-release medicines are not suitable for these patients, as there may not be sufficient release of active ingredient.

• Preparations containing sorbitol should be avoided, due to its laxative side effects.

Question 3

Medicines suitable in stoma patients:

Answer 3

Soluble tablets, liquids, capsules or uncoated tablets are more suitable due to their quicker dissolution.

Question 4

Recommended For analgesics,

Answer 4

• paracetamol would be the recommended choice as NSAIDs can induce ulceration and bleeding and Opioids can cause constipation.

Question 5

The gastric acid secretion increases stoma output; hence … are given

Answer 5

• The gastric acid secretion increases stoma output; hence PPIs or Somatostatin analogues are given.

Question 6

Patients with a stoma are more susceptible to

Answer 6

• hypokalaemia if taking digoxin, due to fluid and sodium depletion. Potassium supplements or a Potassium-sparing diuretic are recommended.

Question 7

• Diuretics should be

Answer 7

used in caution as patients can become dehydrated and potassium depletion can occur. Hence it is advised patients take a potassium-sparing diuretic.

Question 8

Laxatives

Answer 8

Laxatives should not be used for patients with an ileostomy as they may cause rapid + severe loss of water and electrolytes.

Question 9

Colostomy patients may suffer from

Answer 9

constipation and Bulk-forming laxatives may be used. If ineffective, a low dose stimulant laxative e.g. Senna may be used.