What is the difference between An Ileostomy and a Colostomy?

During clinicals, nursing students will follow a preceptor for 8-12 hour shifts for a couple of weeks. While following a nurse, students will be required to be present during shift report. If you are going enter into nursing school or if you are already there; it will become apparent that you need to be on your game during clinicals. No one will stop to explain medications, procedures or diseases. Some nursing schools have students get patient information the day before clinicals in order to be prepared for the next day.

Patients will have different kinds of tubes, drains and lines. During report you may be told that your patient has a colostomy or ileostomy to the abdomen. Your first thought may be what is that? The second question may be why do they have it? You may even wonder where on the abdomen is this appliance.

An ostomy may be needed when a defect or disease has obstructed or perforated the patient’s digestive. When a patient is unable to digest food, a diversion is created. The type of diversion to be performed influences the location of the stoma.

The colon, rectum and anus are the last sections of the body’s digestive system. These parts are an important but, they have little to do with digesting food or absorbing nutrients, therefore parts can be taken out and feces can be diverted. Some reasons why patients may have digestive diversions are traumatic injury, colon cancer, Crohn’s disease or constipation.

The type of diversion performed influences the location of the stoma. Colostomy’s are connected to part of the large intestine or colon and sutured to the abdomen and forms a stoma. Ileostomy means that the end of your small intestine or ileum was cut and sutured to the skin of the abdominal wall. Nursing students should be aware of the different parts of the small intestine like the duodenum, jejunum and the ileum and the large intestine has an ascending, descending and transverse part. The stool in the colostomy bag will be formed because the colon absorbs water and waste from the small intestine which forms solid stool. The stool in the ileostomy will be semi-solid fluid and has the least problems because it bypasses the colon, rectum and anus. Usually ostomy bags are on the right side of the abdomen. An ileostomy and colostomy will be in the right lower quadrant; however, due to the location of the descending colon, the location will be in the left lower quadrant.

A patient with an ostomy will need psychological support, education, and counseling. Nursing students should also have a care plan prepared in order to be prepared for patient teaching and questions the preceptor or nursing instructor may have for you.

References

Bowel Diversion Surgeries: Ileostomy, Colostomy, Ileoanal Reservoir, and Continent ileostomy. (2009). National Digestive Diseases Information Clearinghouse. Retrieved from: http://digestive.niddk.nih.gov/ddiseases/pubs/ileostomy/

Caring for a stoma is more than skin deep. (2010). Health Publications. Retrieved from: http://findarticles.com/p/articles/mi_qa3689/is_200105/ai_n8951011/

Ileostomy. (2010). MedlinePlus. Retrieved from: http://www.nlm.nih.gov/medlineplus/ency/article/007378.htm

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