Colostomy irrigation: implementing structured protocol-led follow-up.

Colostomy irrigation is a procedure that allows patients to achieve a certain degree of bowel control, and a period free of stoma effluent. It has the potential to improve quality of life, body image and confidence, and reduce patient anxiety. It may also help reduce odour and flatus, prevent/address peristomal skin irritation and alleviate constipation. Because it can reduce or eliminate the need for a colostomy bag, it may also cut expenditure on stoma appliances. However, colostomy irrigation is not offered to patients as standard. A protocol was drawn up to ensure colostomy irrigation was routinely offered to suitable patients and to provide them with a structured follow-up to ensure they were well supported throughout the first year of carrying out the procedure. Quality of life and the efficacy of colostomy irrigation can be monitored using questionnaires on these two issues. Two case studies demonstrate how patients' quality of life can improve when using colostomy irrigation as part of their stoma care routine.

Patient-centred stoma care support: ileostomy patients.

Stoma patients require continuous support throughout their entire journey with a stoma. Although many Stoma Care Services across the UK offer patient follow-up pathways, there is not one unified pathway. Patients may not be prepared for life with a stoma because, depending on their stoma type, they will have specific needs, and if patients and healthcare professionals are not prepared to manage these stoma-specific needs, complications and hospital readmissions may occur, worsening patients' outcomes and quality of life. Ileostomy patients are known to be more likely to experience complications, including hospital readmissions, and therefore, special care should be taken when preparing these patients for life with a stoma. They should be informed and educated to prevent complications, and if this is not always possible, thye should at least be able to recognise and manage early signs and symptoms of complications. This will empower them to self-care and know when to seek medical attention.

Experiences from practice: using a stoma output absorbent cartridge.

Having a stoma is a life-changing event, and it can be an overwhelming and difficult experience. It may be very challenging managing stoma care in certain occasions and, without the proper support, this could affect patient's quality of life negatively. This is especially important when patients are faced with complex stomas, which may make stoma care problematic. Therefore, these patients require extensive postoperative support from skilled stoma nurses as their experience, continuous support, and knowledge of different products, including new innovative products, is essential in supporting stoma patients. This article explores the successful use of an innovative stoma output absorbent cartridge to improve patients' quality of life, restore confidence, reduce anxiety, empower them to self-care and effectively manage overactive stomas during appliance change, as well as potentially avoiding delays in hospital discharge, reducing waste of stoma products, and facilitating stoma complication management procedures and training in new stoma patients.

First case of ocular dirofilariosis in Bulgaria caused by gravid female Dirofilaria repens.

Dirofilariosis caused by Dirofilaria (Nochtiella) repens is recorded sporadically among people in Europe, Asia and Africa. Still a worldwide controversy exist upon human parasite hosting. Herein, the first case of ocular dirofilariosis in Bulgaria caused by gravid female is presented. A single nematode was removed from the eye of the 76- year-old patient in the course of cataract surgery. Microscopic examination of the histological slides revealed microfilariae in the parasite's uterus, but not in the blood. Knott's method for detection of microfilariae in the peripheral blood was negative and the rest of laboratory blood and biochemical tests were within reference limits. A comprehensive review of the etiology, pathogenesis and clinical presentation of Dirofilaria repens infection is also highlighted.

Nurse-led surveillance of ileoanal pouch patients post-stoma reversal: outcomes at 12-month review.

Restorative proctocolectomy with pouch anal anastomosis is the accepted treatment for suitable patients with ulcerative colitis, yet surveillance following stoma reversal remains contentious and involves several issues. While most patients are discharged from routine follow-up between 6 weeks and 3 months, some remain on surveillance pathways indefinitely. A high volume of patients require advice for many months or years after the stoma has been reversed, with the burden of surveillance on consultant-led clinics. Nurse-led follow-up after restorative proctocolectomy has been recognised for decades but has not been validated. This study reports the first protocol-based pathway for nurse-led follow-up. Using validated questionnaires, suitable pouch patients were followed up in nurse-led clinics over a 12-month period then sent an online survey to report on the service they received. Overall, most patients were satisfied with the nurse-led follow-up; however, further engagement and investment in the workforce and infrastructure is required to offer sustainable services.