Anthony, a 60 y.o. patient, has just undergone a bowel resection with a colostomy. During the first 24 hours, which of the following observations about the stoma should you report to the doctor?
A. Pink color
B. Light edema
C. Small amount of oozing
D. Trickles of bright red blood
Correct Answer: D. Trickles of bright red blood
After the creation of a colostomy, expect to see a stoma that is pink, slightly edematous, with some oozing. Bright red blood, regardless of amount, indicates bleeding and should be reported to the doctor. A colostomy is an operation that creates an opening for the colon, or large intestine, through the abdomen. A colostomy may be temporary or permanent. It is usually done after bowel surgery or injury. Most permanent colostomies are “end colostomies,” while many temporary colostomies bring the side of the colon up to an opening in the abdomen.
Option A: A normal stoma is moist and pink or red-colored. At first, the colostomy may appear dark red and swollen, with bruises. Within a few weeks, the color will lighten and bruises should disappear.
Option B: Don’t be alarmed by the size of the stoma for the first few weeks after surgery. The abdomen and the stoma will both be quite swollen. This is all quite normal after a stoma operation and nothing to be worried about. The stoma will go down in size quite considerably over the next 2-3 months.
Option C: The stoma may also ooze blood for the first few days. It can take a few days for the stoma to start producing any output. The bowel will have gone into a shock-like state following surgery. Aid this process by being mobile and eating small regular amounts of food.
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