It explores the anatomy and physiology of the urinary and gastrointestinal system, and looks at topics including familial adenomatous polyposis, continence issues, nutrition, and conditions leading to stoma formation, complications, fistulae and intestinal failure. It also discusses the role of the nurse in surgery and in pre-and post-operative care.
1 Stomas: The Past, Present and Future (Jennie Burch).
The history of stomas.
Stoma care nursing.
Roles of the stoma specialist nurse.
Present day stoma care.
The future of stoma care.
2 Anatomy and Physiology of the Urinary and Gastrointestinal System (Jennie Burch).
Wound healing process.
The abdominal wall.
The gastrointestinal tract.
The digestive process.
The bowel wall.
Jejunum and ileum.
Accessory organs associated with the GI tract.
3 Colorectal Cancer and Adjunct Therapy (Deep Tolia-Shah).
Possible causal factors.
Symptoms and clinical presentations.
Assessment, staging investigations and the multidisciplinary team.
Effects of chemotherapy on stomas.
Surveillance and follow-up.
Further information and websites.
4 Infl ammatory Bowel Disease (Jennie Burch).
Infl ammatory bowel disease statistics.
Signs and symptoms for ulcerative colitis.
Crohn’s disease: signs and symptoms.
Aetiology of IBD.
Medical therapy for IBD.
Dietary therapy for IBD.
Surgery for Crohn’s disease.
Surgery for ulcerative colitis.
Malignancy in ulcerative colitis.
Malignancy in Crohn’s disease.
Other medical issues in IBD.
Fertility in IBD.
5 Familial Adenomatous Polyposis (Jacquie Wright and Kay Neale).
The Polyposis Registry and research.
Bowel screening of relatives ‘at-risk’.
Colectomy with IRA.
Upper GI disease.
Extra-colonic manifestations (ECMs).
An accessible expert centre.
6 Continence (Julie Duncan and Christine Norton).
Normal bladder and bowel control.
Risk factors for incontinence.
Obstetric trauma to the pelvic floor.
Treatment of incontinence.
7 Other Conditions Leading to Stoma Formation (Jennie Burch).
Cystic fi brosis.
Hereditary non-polyposis colon cancer (HNPCC).
Solitary rectal ulcer.
Spinal cord injury.
8 Surgery (Alistair Windsor and Gemma Conn).
Enhanced recovery after surgery (ERAS).
References and further reading.
9 Pre- and Post-operative Care (Steve Wright and Jennie Burch).
Referral to health care professionals.
Pre-operative assessment and investigations.
Meeting another ostomate.
Stoma siting assessment.
Cultural/religious issues related to siting.
Nausea and vomiting.
Post-operative stoma assessment.
Normal stoma outputs.
Post-operative faecal stomas.
Post-operative stoma care teaching.
Small bowel obstruction.
10 Intestinal Pouches (Zarah Perry-Woodford).
The coloanal or colonic ‘J’ pouch.
The Kock pouch/reservoir.
The ileoanal pouch.
Patient suitability and selection.
The ‘S’, ‘J’ or ‘W’ pouch.
Pre-operative counselling (surgical vs. medical approach).
Anal skin care.
Fertility, pregnancy and childbirth.
Pouch absorption and diet.
Problems following RPC.
Research and current development.
Quality of life.
11 Urinary Diversion (Sharon Fillingham).
Reasons for urinary diversion.
The ileal conduit.
Internal urinary pouches.
The Mainz Sigma II pouch (modified ureterosigmoidostomy).
12 Appliances (Jo Sica and Jennie Burch).
History of stoma care products.
Additional drainage bags.
One- and two-piece appliances.
Adhesive coupling system.
Toilet fl ushable colostomy appliances.
Appliances for high-output stomas.
Convex fl anges.
Seals and washers.
Flange securing tape.
Odour treatment options.
Pancaking prevention agents.
Discharge solidifying agents.
Pouch clips and soft ties.
Flatus fi lters.
Hernia support garments.
Stoma appliance costing.
13 Discharge to the Community (Jennie Burch).
Disposal of appliances.
Obtaining further supplies.
Post-operative psychological adjustment.
Returning to work.
Resuming social activities and hobbies.
14 Nutrition (Morag Pearson).
Digestion and absorption of nutrients.
‘The Balance of Good Health’.
Dietary management of functional problems post-colostomy formation.
Dietary management of functional problems post-ileostomy formation.
Dietary management of functional problems post-ileoanal pouch formation.
Dietary management of functional problems following urostomy formation.
Provision of nutrition support.
15 Complications (Jennie Burch).
Allergy and skin sensitivities.
Cancer recurrence locally.
Discolouration of the stoma.
Ileus (paralytic ileus).
Urine crystal formation.
16 Fistulae and Intestinal Failure (Jennie Burch).
Defi ning fi stulae.
Parenteral nutrition (PN).
17 Bowel Irrigation (Jennie Burch and Julie Duncan).
Antegrade colonic enemas (ACEs).
Percutaneous endoscopic colostomy (PEC).
18 Other Stoma Issues (Jennie Burch).
Age related issues.
Quality of life.