Proper understanding of artificial anus and patient self-management

For many rectal cancer patients whose masses are located close to the anus, in order to achieve better surgical results and prolong the patient’s survival as much as possible, the cancer and the anus are usually removed at the same time, and then the proximal colon is opened in the lower left abdomen, resulting in an artificial anus to help the patient defecate. This kind of permanent single-lumen colostomy brings great concern to patients. Patients are psychologically burdened by the thought that they cannot pass stool through the physiological channel like normal people but through the artificial anus in the abdomen, and it is very difficult to accept it psychologically because it is mostly loose stool at the beginning of the postoperative period, which brings some embarrassing troubles due to improper handling. Therefore, patients with colostomy must have a correct understanding of artificial anus, put down the burden of thought and maintain optimism. In fact, the artificial anus is to move the original anus to the abdomen, and it does not affect the digestive function and the quality of life of individuals. Daily management of patients with colostomy (artificial anus): a. Correctly use the artificial anal pouch and protect the skin around the anus. The diameter of the pouch should be 1 cm larger than the diameter of the stoma. Do not compress the anal opening and change the pouch after each bowel movement. At home, if the situation permits, the artificial anal bag can be removed to facilitate the ventilation and drying of the artificial anus. Since feces, digestive juices and sweat can stimulate the skin and cause edema and infection, it is best to wash the skin around the artificial anus with saline cotton balls and dry it regularly, and apply zinc oxide ointment to keep the stoma hygienic. Second, protect the intestinal mucosa and prevent the artificial anus from being narrowed. Since the intestinal mucosa of the artificial hepatophore is slightly higher than the surrounding skin, the artificial anal opening is often stimulated by friction with the artificial anal pouch and is prone to bleeding, edema and erosion, so a small amount of sterilized paraffin oil should be applied externally to keep the intestinal mucosa red and edema-free. In order to prevent the formation of stenosis in the artificial anus, which affects the smooth discharge of stool, one should learn to self-expand the anus, starting from the second week after surgery, put on latex gloves, apply liquid paraffin oil or edible sesame oil to the index finger, gently reach inside the artificial anal opening, pass through the stenosis ring, then gently turn the finger and withdraw after 3-5 minutes, twice a day, keeping the stool as thick as the index finger is appropriate. Because the formed stool has a certain dilating effect when passing through the artificial anal opening to prevent the narrowing of the anal opening, so if there is diarrhea, it should be treated early. Third, reasonable adjustment of diet and living rules, to develop good bowel habits. Dietary adjustment is the first condition to keep the stool formed and cultivate the habit of regular bowel movement. Pay attention to the regularity of the three meals every day, the diet is based on less dregs, high nutrients, such as yogurt, milk, orange juice, etc.. Eat less fatty, raw, cold and hard foods to prevent indigestion and diarrhea. Eat less high-fiber foods to prevent undigested crude fiber from blocking the intestinal tract. Eat green leafy vegetables also in moderation, too much vegetables will cause an increase in intestinal peristalsis, changing the bowel pattern and poor stool control. Avoid swallowing such as air; avoid eating foods that produce bad odor, such as onions, garlic, beans, eggs, etc. Every morning after waking up that drink a glass of warm water, in order to contribute to about half an hour after breakfast stool discharge, so that about six months to achieve artificial stool semi-controlled state. Usually, you can take some oral deodorant, such as chlorophyll tablets, which can increase the comfort. After surgery, a certain amount of labor intensity should be mastered to avoid movements that excessively increase abdominal pressure. In addition, postoperative patients should review regularly and go to the hospital in time to find abnormalities.