Body and Health

using the stoma when the bladder infection

Stoma is a hole made in the abdomen separately urine or faeces flow out of the body.
Stomas kinds:
1. Colostomy (artificial hole in the large intestine)
2. Tracheostomy (artificial hole in the throat)
3. Urostomy (artificial hole in the bladder)

A. Gastrointestinal Stomas
Generally made to ileum (ileostomy) or colon (colostomy). 2 types of gastrointestinal have Stomas:
1. Temporary (de-Functioning) stomas: covering ileostomy or colostomy is created to protect an anastomosis or decompression, or treatment of distal intestinal segment. Stoma has the 2 holes proximal hole is where the exit hole distal faeces and mucus discharge from the bowel distal part.
2. Permanent stomas: the hole made by the abdominal wall permanently attach the final part of the intestine to the skin surface. There are several forms of permanent stoma include:
a. Panproctocolectomy: permanent ileostomy is made from the terminal ileum, the colon rectum and anus removed.
b. Total colectomy: ileostomy was made but the tip remains rectum and distributed to the abdominal wall as a mucus fistula.
c. Abdomenoperineal (AP) excision: colostoly on the left fossa iliaca, rectum and anus removed, often accompanied by the appointment of 1 / 3 part of the posterior wall of the vagina
d. Hartmarn’s procedure, excision of the rectum or sigmoid colostomy was made and the end of rectum closed and left in the pelvis.
e. Pelvic exenteration: radical surgery for pelvic organ removal; made colostoly and urostomy.
a) abnormalities in the organs of digestion that cause gastrointestinal indications Stomas actions:
1. Esafagus: Cancer in this section will cause interference with swallowing, difficulty in swallowing and start if not removed will be blocked quickly, so the total could not swallow at all.
2. Stomach: As in the esophagus in stomach cancer will also cause gastrointestinal congestion, but depending on location, cancer in certain locations would cause congestion in the digestive tract until an advanced stage.
3. Colon: Colorectal cancer initially causing symptoms defikasi pattern means the patient gradually progressively uncomfortable stomach and heartburn are difficult to explain why continued with the diarrhea / dysentery diarrhea lenders are primarily for rectum cancer and gastrointestinal tract obstruction due to colon eventually clogging the stomach bloated because dirt accumulated in the intestine because they can not get out.
For rectal cancer, type of operation depends on how far it is from anal cancer and how deeply he grows into the wall of the rectum. Appointment of the rectum and anus requires patients undergoing permanent colostomy (creation relationship between the abdominal wall with a colon). With a colostomy, the bowel contents are emptied through a hole in the abdominal wall into a bag, called a colostomy bag.
4. Small Intestine: Most of the small bowel tumors are benign. Most benign tumors do not cause symptoms. But a large tumor that could cause the presence of blood in the stool, bowel obstruction (partial or total), or trapping a part of the intestine when the intestine into the colon in front of her (intussusception).
5. Pangkreas: pangkreas cancer because it is very difficult to diagnose, usually known as a complication of jaundice or bowel obstruction in 12 fingers.
6. Liver: a primary cancer located on the edge of an early state of mind, and when quick action is taken soon the operation will cure the disease. In common liver cancer secondary spread of cancer from other organs such as colon, lung, breast, genitalia, internal.
b) colostomy
Of the colon, which means the large intestine and stoma meaning mouth interpreted here as a mouth made of the large intestine and is better known as the artificial anus.
When did colostomy done?
Colostomy done / made in the circumstances:
1) Colorectal cancer is located in the distal colon, rectum (less than 5 cm from the anal margin)
2) genital cancer who have anal muscle
3) colon cancer who delayed surgery although located from 5 cm above the anal

Colostomy Care
1. A good explanation on the patient and the family both before and after surgery.
2. Empty the pouch (bag) several times a day and changed every 1-3 days or if there is leakage, how to:
a. Prepare a replacement pouch
b. Off / lift pouch is replaced
c. Note the state of the skin around the stoma (is there any injury, irritation, or inflammation), clean the skin with warm water without soap or alcohol or desinfektans
d. Install the new pouch.

B. Urinary Stomas:
In general a good permanent procedure using intestinal tract (ileum or can use the colon) or ureterostomy and both called urostomy. The term is only used for ileostomy faecal stoma. Ureterostomy can be made from one or the 2 ureters.
There are several types of urostomy:
a. Urostomy with total cyctectomy, a permanent urostomy, ileal usually use the channel
b. Urostomy without lifting bladder, often using ileum channels.
c. Percutaneus nephrostomy catheter is installed on the system pelviocaliceal through the abdominal wall.
1) Abnormalities in the urinal organs causing urinary indications Stomas action largely caused by malignant cells in these organs, as for these disorders include:
a) Blader: In Blader neoplasms often accompanied by pain hematuri is the first sign of cancer blader, which is usually intermittent often causes difficulties in seeking diagnostic services. As a result of the client progresses through iritable blader with dysuria. Finally, gross hematuria, obstruction or Vistula encourage clients to seek treatment.
b) Urinary Tract: A person who is suffering from a urinary tract stone disease when there are predisposing factors, lack of drinking so that the concentration of urine formation in a more concentrated form easily result in stone. Other predisposing Faktior: urinary tract stones factors / previous urinary tract infections, family history of suffering from urinary tract stones, gout (increased blood uric acid levels are high), consume more foods containing calcium or oxalat (chocolate, colas, peanuts, tea ) and urinary tract blockage.
c) Kidneys: At early stages, kidney cancer rarely cause symptoms. At an advanced stage, symptoms most commonly found is haematuria (blood in the urine). Haematuria can be known from the urine that looks reddish or known through urine analysis. High blood pressure caused by blood flow adekuatnya not to some part or the entire kidney, thus triggering the release of chemical messengers to increase blood pressure.
Secondary polycythemia caused by high levels of the hormone erythropoietin, which stimulates the bone marrow to increase red blood cell formation. Other symptoms that may occur in the form of pain in the affected kidney, weight loss.
d) Bladder: Symptoms in patients suffering from Bladder Can may be haematuria (blood in the urine), burning or pain when urination, urgency to urinate, frequent urination. Symptoms of bladder cancer resemble the symptoms of bladder infection (cystitis) and both diseases can occur simultaneously. A cancer suspect if the standard treatment for the infection, the symptoms did not disappear k.
e) the renal pelvis and ureter: Cancer of the renal pelvis and ureter can occur in cells that line the renal pelvis and ureter. Cancer in the cells lining the renal pelvis is called transitional cell carcinoma. The renal pelvis is part of the kidney that functions as a funnel that drains urine into the ureter. The ureter is the tube / tube that connects the kidney to the bladder. The initial symptoms are usually in the form of haematuria (blood in the urine). If the blockage of urine flow, painful cramps can occur in the area between the ribs and hip bones, or in the lower abdomen.
f) Urethra: Urethra Cancer is a rare malignancy, which is found in the urethra. The urethra is the channel where the discharge of urine from the bladder. In women, urethral length is approximately 3.75 cm and the end is a hole that is located above the vagina. In men, the length of the urethra is about 20 cm, through the prostate gland and ended as a hole in the tip of the penis.
The first symptom is usually of blood in the urine (haematuria), which may be known only by microscopic examination or can also appear as a colored urine reddish. Flow of urine can be blocked, so that patients have difficulty in urination or the urine flow to be slow and a bit.

C. Tracheostomy
Hole is made on the anterior tracheal wall to create air channels.
There are 2 kinds of Tracheostomy:
a. Tracheal stoma post laryngectomy: a permanent Tracheostomy. Tracheal cartilage surface directed towards the skin, attached to the neck. Maintain cartilage rigidity stoma to remain open so as not required Tracheostomy Tube (canule).
b. Tracheal stoma without laryngectomy: a temporary Tracheostomy. Trachea and upper airway was intact but there is obstruction. Used Tracheostomy Tube (canule) made of metal or non metal (especially in patients who were getting radiation and for the implementation of MRI Scanning.
Care Trachestomy:
a. Tracheostomy tube consists of iner tube (canule) and the outer tube
b. Iner tubes must be replaced every 7-14 days (maximum 30 days)
c. Iner tubes must be removed at least once a day to see the crust and clean with liquid soap and warm running water (do not use brushes, cleaner or Spong). If the discharge is thick and the crust comes clean with sodium bicarbonate and then rinse with warm water flowing.
d. Outer tube should be replaced every 30 days.
e. Suctioning: use a suction catheter with smaller sizes than half the size of the hole tube.
f. Clean the area around Tracheostomy with normal saline, and try to stay dry to prevent infection.
g. Humidifikasi with saline Nebulizer (through tracheal stoma).

A. Tracheostomy
1) When talking close to the screen or paper
2) Prepare always pelebar trachea, thermometer
3) Hisaplah when it started a lot of secretions
4) Do not take in water while bathing
5) If possible use a clothes that can protect the hole but free air in and out
B. Urostomy and Colostomy
1) Clean the skin around the stoma with warm water every day
2) After that dry the wet part
3) The hole can be sprayed dirty slowly
4) Give the pasta around the hole before installing bag
5) When the bag fills 1 / 3 began to empty the
6) For the colostomy bag was replaced 1-2 times a day
7) To urostomy bag was replaced 3-5 days
Which should be avoided in patients using Stomas:
A. Tracheostomy
1) Swim, conceded the danger because the water
2) Go without pelebar trachea and thermometer
3) Wear clothing that can close the stoma
B. Urostomy and Colostomy
1) with a shower spray directly into the stoma;
2) Wait until the full bag
3) Wait until the loose sac of skin
4) Wait until the tear sac
5) Open stoma

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