Getting to the Bottom of the Matter: Anal discharge and fecal diversion

Following the formation of a defunctioning stoma there may continue to be a discharge from the anus. There is little comment in research literature, but anecdotal evidence suggests that anal discharge with a defunctioning stoma can cause distress and confusion for both nursing staff and the patient in understanding why this is happening, and how to cope and manage in this situation.
This research identifies the prevalence and characteristics of discharge from the anus following fecal diversion. The data was gathered by a quantative nonexperimental approach that involved a cross-sectional, nonrandomised survey  of 50 people who had a defunctioning stoma. It determines the impact that this discharge had on the lives of these people and provides baseline data that can be used to inform future research.
There was an 82% response rate with 63% reporting a discharge. Seventy seven percent of those with the anal discharge reported some degree of distress.  The characterisics of the discharge were identified as likely to occur after one week following the formation of the stoma, with a wide variance as to how often it occurred; it was most likely to be less than a teaspoonful, inoffensive in smell, and clear in colour.
The questionaire was validated as a tool and the results identified some clinical trends. Those respondents living away from the base hospital and having the inabilty to control the discharge were more likely to be distressed. Being informed about the possibility of a discharge does not appear to have decreased the level of distress.
It is recommended that the term diversion reaction be adopted to describe discharge from the anus following fecal diversion.This term should be used by nursing staff to alert those who have a diversion stoma of the potential of anal discharge following  fecal diversion.