About

A surgery in which an opening is created for the passage colon and large intestine out to the abdomen is called a colostomy. It can be temporary or it can be permanent. Colostomies are generally performed due to any bowel injury or surgery. In most cases, a permanent colostomy is an end colostomy whereas in temporary surgery the end of the colon is brought to the abdominal wall.

In a end colostomy, the surgeon brings the end of the colon to the abdomen, and it may be turned down just like a cuff. The ends or edges of the colon are with the skin of the abdomen, forming an orifice called a stoma. A bag or a pouch is attached over the stoma on the abdomen that is used to collect the feces through the stoma.

During a loop or temporary colostomy, an incision is made in one of the sides of a colon, and then it is sewed with the skin of the abdomen. This process is preferred because it can be reversed easily by only removing the colon from the abdominal wall. Holes that were made earlier can be closed to ensure the normal passage of stool through the colon.

Why is surgery needed?

Colostomies are performed to treat different conditions and illnesses. They can be:

• Any kind of birth defect like imperforate anus, a condition in which there is blockage of anal opening or it is missing.

• Fatal infections such as diverticulitis, bloating of sacs in the colon.

• Inflammatory bowel disease

• Any harm or injury to colon or rectum

• Cancer i.e. rectal or colon

• Any type of wound in the perineum. In women, the perineum lies between the anus and vulva, and in men it lies between the anus and scrotum.

The type of colostomy depends on the reasons for the surgery. For instance, a permanent colostomy is needed in case of more fatal and incurable diseases, such as the rectum

How a digestive system works?

The functioning of the digestive system is not disturbed by colostomy. Typically, the food you take after chewing goes through the esophagus and then into your stomach.

From the stomach, it moves into the small intestine and then travels into the large intestine or colon. After some hours or days, the undigested food leaves your body in the form of feces. When the feces pass through the colon it remains in liquid form. This helps in the reabsorption of water. The feces get firm.

The ascending colon moves up to the right side of the body. The feces present in this part is a little acidic and has digestive enzymes. The transverse colon then goes to the upper abdomen and descending and sigmoid colon move to the left side of the body moving till the rectum. The stool becomes less liquid when it reaches the left colon.

When the colon disturbed or interrupted it allows the feces to pass out. It is necessary to keep your colon hydrated after the passing out of the stool.

Risks:

The surgery is not very complicated but it can change your life dramatically. You will be given general anesthesia so you won't feel anything. Like many other surgeries the risk that comes along with anesthesia are breathing issues and ineffective medication. The other risk factors are:

• Bleeding

• Harm to surrounding organs

• Infection i.e. bacterial or viral

• The risks that can hit after the surgery are:

• Colostomy opening becomes narrow

• Intestinal blockage due to scar tissues

• Skin irritation

• Opening of the wound

• Hernia

Before the surgery:

It is recommended to visit your surgeon before the surgery and get all the necessary details about the procedure. You can also get help from any Ostomy nurse. The ostomy experts can guide about the life after colostomy and how to adapt to living with it.

Types of colostomy:

• Transverse colostomy:

In this colostomy, the stoma is created across the abdomen and it is performed in the middle part of the colon. This is mostly temporary and is performed in case of intestinal blockage, birth defects, cancer, and IBD. In this Ostomy, there can be two stomas. One stoma is used by the feces to pass out. In some cases, there is mucus that is produced in the colon. The other stoma allows the passing out of the mucus.

 

•           Descending colostomy:

 In this situation, the waste is carried by descending colon down to the left side of the abdomen. The waste produced in this area is mostly hard and firm.

• Ascending colostomy:

In this colon moves from the beginning of the large intestine to the right side of the body. The left part of the colon still works in this process. That’s why a small amount of water is reabsorbed from the waste. This is the reason that stool in this region is in liquid form. An ileostomy can be the better option for this area of the colon

•           Sigmoid Colostomy: 

It is the most occurring form of colostomy. It resides in the lower or bottom part of the large intestine. The waste is moved to the rectum by the sigmoid colon. The feces or waste produced by the sigmoid colon is more hard or congealed than other ones.

After the surgery:

After the surgery, you are allowed to have ice chips. You can have liquids in the coming day. Some people start normal eating 2 days following the surgery.

Just after your Ostomy, your stoma will look dark red and it may look swollen. This will get better in some days and become pink or red. There is nothing to worry about this. The scars and bruises will take some time to heal.

Care:

At Hospital:

A colostomy patient is required to stay at the hospital for 3 or for more days. In case of emergency colostomy patients need to stay longer.

The nurse will help you to learn about the cleaning of the stoma. Then you can perform it at home without any problem. You can only use warm water .Pat dry or leave it for drying. Don’t use a towel may irritate the wound. Don’t panic if you notice a little blood while cleansing

In the case of ascending or transverse colostomy the patient is asked to wear a any light-weighted drainable pouch throughout the day.

People with descending or sigmoid colostomy usually have a prediction before the bowel movement and they can simply put on a pouch when they think there will be a bowel movement

Before leaving the hospital have a discussion with an certified Ostomy nurse or expert. They can guide you how to use Ostomy equipment.

In some cases, the rectum and anus may be completely removed and it can cause a wound often termed as posterior wound. During your stay in the hospital, you will use dressings, pads, or warm water with a soft cloth to clean this wound. Take care of this wound till its recovers fully.

At Home:

The skin that covers the nearby areas around a stoma is termed ad peristomal skin. There might be bleeding from this skin and it always gives a red shade, that is fine. But be careful that it doesn’t bleed for a long time.

 The most important fact is that you must ensure that your pouch is linked with stoma properly. It might bring discomfort to the skin if not attached properly. This area needs to be neat and clean, it must be dried completely. There are chances to get an infection, so if you feel any changes in the stoma, please see your doctor immediately. You can push your skin barrier from the skin rather than pulling it.

If you feel any of these signs it means you must see your doctor immediately:

• Cramps for more than 2 hours

• Vomiting or nausea

• Foul-smelling for up to7 days

• Alterations in stomal size or orientation’

• Wound or cut in stoma

• Any discomfort or irritation in the skin

• Stomal bleeding

You must empty your colostomy bag many times every day. It will be not under your control to pass waste the waste out in the pouch. It is recommended to empty the pouch when half of its part is filled.