Intestinal stomas: managing the "unmentionable".

Learning to live with an intestinal stoma is a difficult adjustment for elderly patients. Thoughtful, sensitive preoperative counseling and postoperative education in caring for the stoma are essential, and both are often the responsibility of the primary care physician. Irrigation is the preferred method of colostomy management, and with proper instruction, most patients can learn the technique. The physician and nurse should work in concert to teach patients how to control bowel movements, prevent odor, and maintain the integrity of the stoma and the skin. Elderly patients are able to accept a stoma much more readily if they can manage it easily.