Concerns over diet and nutrition are common among ostomists and their carers. It is important for healthcare professionals involved in the care of patients with a colostomy, ileostomy or urostomy to appreciate that stoma surgery changes the body's usual processes of nutritional absorption and excretion, so that informed support and advice on diet can be provided. A considerable proportion of patients admitted to hospital in the United Kingdom are malnourished, or at risk of becoming so. Patients undergoing gastrointestinal surgery resulting in stoma formation are at particular risk as a result of the potential for preoperative malnutrition caused by the effects of their underlying disease and prolonged periods of fasting during the immediate pre- and postoperative period. Screening and monitoring of the nutritional status of individuals with a stoma should be an ongoing process, beginning preoperatively and continuing after discharge from hospital. This article will examine the effects of stoma formation on diet and consider ostomists' potential for altered absorption of nutrients. Current issues relating to patient nutrition in the hospital setting, their relevance for stoma patients and the role of the nurse in the provision of nutritional care will also be discussed.

Many colorectal procedures can be performed laparoscopically and frequently involve the formation of a stoma. This study aims to demonstrate whether there is an association between stoma complications and the operative technique: laparoscopic or open. A review was conducted of all patients undergoing stoma formation at a single center throughout 2009. Forty-four had a stoma formed after an open procedure and 33 using laparoscopic technique alone. The most common stoma complication was parastomal hernias; these occurred after 18% of laparoscopic compared with 2% after open procedures (P = 0.04). The highest rate of parastomal hernia was seen when the resected specimen was removed from the site that was later used to create a stoma (60%). This study has suggested that the use of laparoscopic surgery may influence the rate of stoma complications. One potential method of reducing the incidence of parastomal hernias is to remove the resected specimen through a separate incision.

This article outlines the fundamental aspects of stoma care required by individuals undergoing surgery requiring stoma formation. For health care professionals who may be unfamiliar with the basic principles of stoma care and who are involved in the care of this group of patients, it aims to provide an overview of post−operative stoma care, emotional support for the patient and ongoing support after discharge. The importance of selecting the correct appliance, the role of the stoma care nurse specialist and common stoma complications are also addressed.

Reflections on the development of stoma care nursing practice through and beyond a global pandemic

This article describes an initiative to improve the quality of nutritional support and information provision to patients undergoing colorectal surgery and stoma formation. It was identified that several aspects of the established hospital routine and catering system overlooked the specific nutritional needs of this group of patients during the postoperative period. This led to the formation of a multidisciplinary strategy group responsible for focusing on the nutritional needs of both those with new stomas and those undergoing colorectal surgery without stoma formation. To ensure that patients had the opportunity to eat suitable foods at regular intervals, a 'colorectal patients' snackbox' was introduced, together with a strategy for individualized nutritional support and advice before admission and on discharge.