stoma

Question 1

what can cause stomal bleeding

Answer 1

Some degree of bleeding in between stomal bag changes is common.
However, it is important to ensure this is not luminal bleeding - as this may be pathological (e.g. a flare up of inflammatory bowel disease).
Dilated veins around the site however may be secondary to portal hypertension if there is a prior history of liver disease

Question 2

stoma with ribbon shaped stool and with high pitched wind passing through what is it

Answer 2

stomal stenosis

Question 3

what is stomal collapse

Answer 3

This is when the colon comes out into the stoma bag. Thus, it would not present with the opening flush with the skin as described here. It requires surgical correctio

Question 4

A loop ileostomy is deliberately spouted as its output is hugely irritating to the skin. Here, the bowel is no longer spouted, and the ileostomy contents have been able to excoriate the skin.

Answer 4

retraction

In the case of retraction, the terminal bowel needs careful inspection as it may be secondary to necrosis. Colostomies, by contrast, are made flush with the skin

Question 5

what cardiac drugs can cause bradycardia

Answer 5

digoxin for atrial fibrillation and verapamil for angina, which can both increase the risk of bradycardia.

Question 6

The patient presents with high output stoma. Patients with jejunostomy after extensive small bowel resection often have problems with water and electrolyte depletion. Correct management is with

Answer 6

is with restriction of hypotonic oral fluids, glucose-saline solution, antimotility drugs (loperamide is preferred to codeine as it is non-sedative and non-addictive) and anti-secretory drugs (PPIs). Hypomagnasaemia is common so serum magnesium should be measured and treated with oral magnesium oxide as required

Restrict oral hypotonic fluid intake, advise dextrose-saline solution, prescribe oral loperamide and omeprazole

Question 7

ileostomy output

Answer 7

higher than colostomy at 1200ml a day

Question 8

colostomy output

Answer 8

around 200-600 per day

Question 9

ileosotmy have spout why

Answer 9

as small bowel content are irritant to skin as acidic

Question 10

can crohns occur at site of anastamosis

Answer 10

yes

Question 11

why is an ileosotmy spouted

Answer 11

prevent the skin from coming into contact with the enzymes in the small intestine