Morbidity Pattren in Patients of Ileostomy: An Observational Study

Abstract

Introduction An ileostomy is an opening constructed between the small intestine and the abdominal wall usually by using distal ileum but sometimes more proximal small intestine. It is a lifesaving surgery that enables the individuals with co-morbidities to recover from the acute stress of a major surgery. An ileostomy may be permanent or temporary depending upon the reason for surgery. An ileostomy is associated with multiple morbidities. Aims & Objectives To study the morbidity in patients with ileostomy. Material and Method The present study was a prospective and descriptive study which was conducted on patients admitted in general surgery department of Shri Guru Ram Rai Institute of Medical and Health Sciences in patients who underwent ileostomy as a part of abdominal surgery. Total number of 50 patients were studied. The parameters studied were site of ileostomy, dermatitis, abdominal pain, stomal complications, odour, wound infection, nutritional status, anaemia, diarrhoea, electrolyte imbalance and psychological problems at 2wk, 1mth, 2mth, 3mth post-operative period. Conclusion The study shows significant morbidity like electrolyte abnormalities (52%), skin problems(32%), stoma diarrhoea(54%), psychosocial disturbances(50%) in first 2 week post surgery. It also shows that Typhoid and tubercular pathology is the commonest indication for loop ileostomy. It is of paramount importance that ileostomies are properly sited, improper siting may increase the incidence of dermatitis, leakage, foul odour and other complications. Whenever possible ileostomy should not be located too proximal to the terminal ileum, to avoid high output, electrolyte abnormalities and malnutrition. Despite of ileostomy, proper care of peristomal skin, nutritional status, taking food with high residue and proteins, electrolyte and fluid requirements of patients can be managed and can lead to near normal life style of patient.