What are the key considerations for managing a patient with a new ileostomy or colostomy in primary care?

For a patient with a new ileostomy or colostomy, key considerations in primary care, based on the provided guidelines, primarily revolve around the initial assessment, referral, and patient information prior to stoma creation, rather than detailed ongoing primary care management post-procedure.

• Referral to Specialist Services: Individuals being considered as candidates for a stoma should be referred to a stoma care service NICE CG49. This implies that specialist services are central to stoma management.
• Patient Information: Patients should be informed about the potential benefits, risks, and long-term effects of the stoma procedure NICE CG49. Primary care professionals may be involved in reinforcing this information or addressing patient concerns.
• Context of Stoma Creation: Stomas may be considered for people with faecal incontinence that severely restricts their lifestyle, only after all appropriate non-surgical and surgical options have been explored NICE CG49. Additionally, stomas (diverting or end stomas) are offered during surgery for complicated acute diverticulitis, with the choice depending on factors like the person's age, comorbidities, and functional status NICE NG147.