What is it?
An ostomy is a surgically created diversion that allows intestinal contents or urine to leave the body through an alternative pathway.
A stoma is the surgically created opening through which output passes.
Common Types
| Type | Structure | Output |
|---|---|---|
| Colostomy | Colon (large intestine) | Stool; consistency varies with location |
| Ileostomy | Ileum (small intestine) | Typically liquid to pasty intestinal output |
| Urostomy | Urinary tract diversion, often using a segment of intestine | Urine, often draining continuously |
Most conventional ostomies use an external collection pouch. Some diversions use internal reservoirs or other collection methods.
Why does it matter?
- Allows elimination when the normal intestinal or urinary pathway has been diverted.
- Requires attention to stoma appearance, output, and surrounding skin.
- Leakage can cause skin irritation and breakdown.
- Ileostomy output can cause significant fluid and electrolyte losses, increasing dehydration risk.
- Ostomies can affect body image, comfort, and independence.
What should I look for?
Stoma and Skin:
- Stoma appearance, typically moist and pink to red.
- New discoloration, swelling, bleeding, or unusual pain.
- Redness, irritation, or breakdown of surrounding skin.
- Leakage or poor pouch fit.
Output:
- Expected urine or intestinal output according to ostomy type.
- Unexpectedly high, low, or absent output.
- Unusual changes in consistency, appearance, or odor.
- Associated abdominal pain, distention, nausea, or vomiting.
Urgent Concerns:
- A stoma becoming dark purple, gray, or black.
- Significant or uncontrolled bleeding.
- Sudden absence of intestinal output with severe pain, distention, or vomiting.
- High-volume watery ileostomy output with signs of dehydration.
Report urgent findings immediately according to facility emergency procedures.
What should I do?
- Follow the resident’s individualized ostomy care plan.
- Observe the stoma, surrounding skin, and output during assigned care.
- Assist with pouch emptying only when trained and authorized.
- Maintain hygiene and protect surrounding skin.
- Record output when required.
- Report new skin damage, changes in output, leakage, or discomfort.
- Encourage resident independence and preserve privacy and dignity.
- Do not independently insert devices into a stoma, change treatment plans, or diagnose complications.
Related
- Ostomy Care
- Elimination Care
- Incontinence Care
- Skin Integrity & Breakdown Prevention
- Dehydration
- Measuring Intake & Output
Sources
- NIDDK — Types of Ostomy Surgery of the Bowel
- NIDDK — Complications of Ostomy Surgery
- NIDDK — After Ostomy Surgery
- WOCN — Peristomal Skin Assessment Guide
- Resident-specific ostomy care plan and facility procedure (verify at clinical site)
Flashcards
How does a colostomy differ from an ileostomy?03-application / diseases-conditions
Answer
Colostomy diverts colon output; ileostomy diverts small-intestine output.
What is a urostomy used for?01-foundations / diseases-conditions
Answer
Diverting urine through a surgically created opening.
Why is dehydration a particular concern with high-output ileostomies?02-mechanisms / diseases-conditions
Answer
Large fluid and electrolyte losses.
What concerning change in stoma color requires immediate reporting?03-application / diseases-conditions
Answer
A stoma becoming dark purple, gray, or black.