Stoma: Definition, Types, Indications & Nursing Care

Definition

A stoma (Greek: "mouth, opening") is a surgically created opening on the abdominal wall that brings a hollow viscus to the surface, diverting effluent (stool, urine) or providing access (feeding, drainage).

Major Types

Stoma	Organ	Indication	Effluent
Colostomy	Colon	Rectal cancer, diverticulitis, trauma, Hirschsprung's	Formed stool (descending) → liquid (ascending)
Ileostomy	Terminal ileum	Ulcerative colitis, Crohn's, FAP, trauma	Liquid, high volume, enzymatic (skin irritant)
Urostomy (Ileal Conduit)	Ileal segment → ureters	Bladder cancer, neurogenic bladder	Urine + mucus
Gastrostomy (PEG)	Stomach	Long-term enteral feeding	Feeding access
Jejunostomy	Jejunum	Post-gastrectomy, high aspiration risk	Feeding access
Tracheostomy	Trachea	Prolonged ventilation, upper airway obstruction	Airway access, secretion clearance

Stoma Characteristics

• Pink/red, moist, shiny (viable mucosa).
• No nerve endings → painless.
• Edematous initially (6–8 weeks), then shrinks.
• Flush, budded, or retracted – affects pouching.

Essential Nursing Care

• Skin protection: Barrier rings, paste, powder (prevent peristomal dermatitis).
• Pouching system: One-piece vs. two-piece; drainable (ileostomy) vs. closed (colostomy).
• Empty at 1/3–1/2 full; change q3–7 days.
• Monitor output, hydration, electrolytes (ileostomy).
• Patient education: Self-care, diet, complications (prolapse, retraction, stenosis, hernia, ischemia).