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Published on: August 1, 2019
Randomized controlled trial of laxative use in postcolostomy surgery patients
Carol Stott1, Lisa Graaf, Patricia Morgan
1Stomal Therapy Nursing, Stomal Therapy Department, Prince of Wales Hospital, Sydney, New South Wales, Australia. carol.stott@sesiahs.health.nsw.gov.au
Summary
A standardized postoperative laxative protocol effectively prevented constipation in colostomy patients compared to ad hoc regimens. This approach reduced fecal loading and stomal therapy nurse interventions, improving patient outcomes.
Area of Science:
- Gastroenterology
- Surgical Nursing
- Clinical Pharmacy
Background:
- Postcolostomy surgery patients are at risk for constipation.
- Current laxative administration is often inconsistent, relying on surgical team preference.
- Optimizing bowel management is crucial for patient recovery and reducing healthcare resource utilization.
Purpose of the Study:
- To compare the efficacy of a standardized postoperative laxative protocol against an ad hoc approach in preventing constipation after colostomy surgery.
- To evaluate the impact of different laxative strategies on patient comfort, stomal therapy nurse activity, and hospital stay.
Main Methods:
- A randomized controlled trial involving 45 postcolostomy patients in two acute care facilities.
- Intervention group received a structured protocol using bulking agents, stool softeners, and osmotic agents.
- Control group received laxatives as determined by the surgical team.
Main Results:
- The standardized protocol group showed significantly less fecal loading (constipation) compared to the ad hoc group (P = .05).
- Stomal therapy nurse activity, measured by empty bag changes, was significantly lower in the intervention group (P = .03).
- The protocol's effectiveness led to its adoption into routine surgical practice.
Conclusions:
- A standardized postoperative laxative protocol is beneficial for preventing constipation in patients following colostomy surgery.
- This structured approach can reduce complications and optimize nursing resource allocation.
- Further research is warranted to refine constipation prevention strategies for this patient population.
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