Colostomy

Definition

A colostomy is a surgical procedure that brings a portion of the colon through the abdominal wall to create a stoma for fecal diversion. It may be temporary or permanent, depending on the underlying condition.

Indications

• Colorectal cancer
• Diverticulitis with perforation
• Trauma
• Hirschsprung's disease
• Inflammatory bowel disease

Stoma Assessment

Normal: Pink/red, moist, warm, slightly raised. Abnormal: Dusky, purple, black (ischemia/necrosis). Notify surgeon immediately! Pale stoma may indicate anemia.

Stool Consistency by Location

• Ascending colostomy: Liquid, frequent.
• Transverse: Pasty.
• Descending/sigmoid: Formed, more predictable.

Patient Teaching

Change pouch every 3 to 7 days or when 1/3 to 1/2 full. Clean skin with water only (avoid soap residue). Cut barrier to fit stoma leaving 1/8-inch gap. Avoid gas-forming foods (beans, cabbage, carbonated beverages). Adequate hydration prevents constipation. Provide emotional support. Body image adjustment is significant.

NCLEX Relevance

Stoma color is the key assessment; red/pink is normal.