This section of my website is designated for Consultant Colorectal Surgeons and Colorectal Trainees.

I aim to provide educational resources as well as IT / internet based solutions such as email and online appointments.

Please contact me for more information.

Chris Macklin
Colorectal Surgeon

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Colorectal Website Review: Colonoscopy

This section provides a monthly review of websites both from the specialist colorectal surgeon, colorectal nurse specialist and the patient’s perspectives.

A different topic will be addressed every issue. If you have any topic or website suggestions then please send them to: website.review@colorectalsurgeon.org.uk

Intestinal Stomas

Intestinal stomas are often seen by surgeons as a necessary evil or a failure in the face of adverse pathology. To the patient, however, the stigma attached to ‘the bag’ means that they are often loathe to ask all the in-depth questions that they might otherwise. The internet is a valuable resource therefore to provide patient education without the embarrassment of a face to face discussion.

For the physician and specialist nurse:

Stoma Formation
	There are relatively few internet sites that help the physician or specialist nurse understand more about stomas and stoma formation. The American Society of Colon and Rectal Surgeons site includes details from the syllabus including the preoperative evaluation of patients who are to receive stomas, different techniques of stoma formation, and the management of enterostomal complications.
	This site gives an overview of forming a stoma and its post-operative problems but does not go in to great detail and is need of updating to include laparoscopic formation.

	For the non-specialist physician, a detailed overview of intestinal stomas is given by this site. It covers almost every aspect of the topic in a concise way that is easy to read.
	An excellent site but navigation is a little difficult as there are many webpages with snippets of information.

Stomas in Children
	There are even fewer internet sites that deal with stomas in children but this site gives an in-depth review of the indications, anatomy, procedure and post-operative complications. There are a number of excellent photographs and diagrams that illustrate the article.
	A very good article but requires a subscription to view the images in more detail.

For the patient:
The internet is the perfect media for the provision of information to patients and carers about an embarrassing subject such as intestinal stomas and stoma care. The sites range from formal ostomy organizations and those from the healthcare industry to sites run by people with stomas for the benfit of others. I have tried to concentrate on websites that provide information for patients rather than just recruiting them to join their local or national organisation.

Healthcare Industry
	Convatec has one of the best industry funded websites. It is available in several languages and as you might expect combines a lot of educational material with details of their stoma products.
	The site is a little busy, but with a little effort most information that a patients needs is available.

Medical Websites
	WebMD is one a growing number of specific medical information websites that provide patient information. This site has sections on ‘living with an ostomy’ and ‘caring for your ostomy’ which give basic education and advice for patients with stomas.
	Navigation between specific sections is not always easy and some of the explanations are very simple.

	The BestTreatments website aims to provide quality information for patients and is produced by the British Medical Journal Publishing Group. The ‘Living with a colostomy’ section gives encouragement to patients with a stoma along with useful tips on the common stoma problems.
	The information presented lacks detail especially for the pre-operative patient.

	The thorny topic of sexuality and sexual function with a stoma is often glossed over but this site discusses it all…from gay stoma sex to crotchless underwear to keep the appliance in place.
	A comprehensive review of sexuality for people with a stoma.

	This website for patients produced by The American Society of Colon and Rectal Surgeons gives a very basic overview of ‘What is an ostomy?’ It touches on information on controlling bowel movements, physical activity and sexuality but lacks any depth and any links to more information and other site.
	A poor site from an organisation that should be a leader.

Stomacare Organisations
	The United Ostomy Associations of America has an excellent and comprehensive section on stomas. It has an Ostomate Bill of Rights which is worth looking at as a physician or specialist nurse, there are links to downloadable leaflets, factsheets and guides and even includes travel tips. Though the chat room is not working at present, the discussion board has over 1500 members and over 22,000 postings.
	A comprehensive website which is easy to read with lots of resources and the discussion board means that any topics not covered can be asked about.

	The ileostomy and internal pouch support group is a UK organisation that has a website similar to the UOAA but deals specifically with ileostomies and pouches. There is a lot of support information and active discussion boards for both ileostomy and pouch discussion.
	The website is somewhat chaotic and amateurish and needs a makeover but with a bit of effort is functionally OK.

Patient’s Pages
	This website is one of my favourite patient’s sites as you cannot help but like Shaz and her stoma called Harriet! She has a funny and informative website, a discussion board with over 500 members, personal stories and even a stoma picture gallery!
	Not the most orthodox of sites but will appeal to many patients.

	‘Living With a Colostomy’ is an online book with 24 chapters that deal with almost everything there is to know about stomas. The site also hosts a discussion board and weekly online chatroom.
	Another excellent website provided by a patient for patients.

Next month: Anal fissure