STOMAS

STOMIES (nutrition)

1) Stomies, nutrition stomas and derivation stomies.

Stomies are openings in the epidermis that communicate internal organs or structures of the body with the outer surface. Nutrition ostomies are gastrostomy and jejunostomy; derivative ostomy is esophagostomy, ileostomy and colostomy.

2) The main factor that determines the accomplishment of an ostomy over the placement of enteral feeding tube

Performing the ostomy is indicated when enteral nutrition needs to be maintained for a prolonged period (over 3-4 weeks).

3) Gastrostomy is indicated and its advantages and disadvantages.

It is indicated for patients unable to eat, such as due to anatomical deformities, neurological syndromes, severe facial and laryngological trauma, or due to narrowing of the esophagus, cancer of the esophagus, stomach or upper airway in advanced stages. Advantages: greater tolerance to various formulas (intact, isolated proteins, aa. Crystalline); better acceptance of hyperosmotic formulas; allows faster progression to reach optimal total caloric value; allows the infusion of larger diet volumes in a shorter period of time. Disadvantage: higher risk of aspiration in patients with swallowing neuromotor difficulties.

4) Situations or conditions indicate jejunostomy. And its advantages and disadvantages

 It is indicated in the postoperative period of esophagectomy, total gastrectomy, total esophagogastrectomy, as a nutritional access route in gastric / esophageal lesions, in case of eventual anastomotic dehiscence or upper digestive fistula. Advantages: lower risk of aspiration; It allows enteral nutrition when gastric feeding is inconvenient or inappropriate. Disadvantages: risk of aspiration in patients who have altered gastric mobility or who are fed at night; need for normal or hypo-osmolar diet; increased risk of diarrhea.

5) Consequences of ileostomy and colostomy regarding stool consistency

 In patients with ileostomy, drainage is profuse and watery as the colon no longer exerts its function of reabsorbing fluid and electrolytes. Although the volume of stool is decreased, a minimum amount of 300 to 800 ml of fluid is still lost daily. In patients with colostomy, stool consistency will depend on the type of colostomy performed. When it is ascending (in the terminal portion of the ileum), the feces will be liquefied or pasty and will flow almost continuously. When descended, the feces will be pasty or semi-solid; transverse, semi-solid. When it is sigmoid (near the rectum), the stool consistency will be solid, very close to normal.