A colostomy is an operation that allows the colon or a large intestine to open through an abdomen. It can be either permanent or transitory. It is mostly performed in cases of IBD or any injury. This opening is called a stoma. It is a route from the large intestine to the exterior of the belly. This allows all the waste material to leave the body via the stomach. The stool or pee is stored in a bag that a patient carries with him or her.
Large intestine:
Colon and rectum collectively made large intestine. It is linked with the small intestine. All the important nutrients are digested by the small intestine and then absorbed into the bloodstream. Important nutrients are carbs, proteins, fats, etc. The food that is left behind and can’t be digested is moved to the colon. The water is absorbed by the waste b the colon and then it waits for another bowel movement.
Why a Colostomy is performed?
A colostomy is performed to eradicate the lower part of the intestine due to:
This can be due to:
In case of the clogged or ruptured large intestine
Removal of any part of the large intestine
An infection caused by a damaged colon.
People with cancer in the ovaries, uterus cervix or prostate may have a colostomy. Also the patients with Crohn’s disease, pre-cancerous colon polyps can undergo colostomy.
How much time a Colostomy demands?
It depends on the condition and reports of the patient. Most of the patients demand a colostomy just for a few weeks after cancer until the colon and rectum get fully recovered. But in some cases, it might be for a lifetime.
Main types of Colostomy:
Every type is termed according to the region of the colon being involved:
Sigmoid Colostomy: 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.
Transverse Colostomy: It passes over the upper part of the abdomen. The water from the waste is reabsorbed by only a small portion of the colon, that is why the stool is soft in this region.
Three different versions of this colostomy are below:
A loop colostomy: In this colostomy, a stoma is which helps the stool to leave the body. In this situation, the rectum is in touch with the colon. That is why there is a possibility that a patient can eliminate waste via the rectum.
A single-barrel colostomy: This type involves openings of the rectum and anal, and a colon is removed below till the colostomy. This is a lifetime colostomy.
A double-barrel colostomy: In this type, two separate stomas are formed because the colon is divided into 2 endings. One stoma allows the feces to leave the body and the other one allows the mucus to pass out. This is the rarest type of colostomy.
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: 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.
Right before the surgery, you will be given anesthesia. The surgeon will connect one end of the colon to the stoma, so that patient can see it clearly and take care of it. Then at the last colostomy bag is placed at the stoma.
What happens during a surgery?
The operation may involve:
A hole as a result of the deep cut in the abdomen
Less protruding small cuts, such as laparoscopic operation. This lessens the pain and healing time.
Surgery may involve the following dangers:
Internal bleeding in the colon
Harm or damage to neighboring organs
Any kind of infection
Stomal bleeding
Recovery:
A patient can complete getting recover in almost 2 months but he gets discharged from hospital after I week of the surgery. For this whole time, you must be careful about your diet and activities
If your colostomy is temporary then you need conclusive surgery after the colon is recovered. This post-surgery occurs after 3 months.
Care:
Emptying your colostomy bag: 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.
Colostomy bags have two main types:
A single-piece pouch adheres to the skin barrier directly.
Double-piece pouches, having a separate skin barrier and bag that can be removed from the body.
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.
Skin Care:
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 stoma, please see your doctor immediately.
Main Concerns:
High feces output: It is observed that for few days after the surgery some patients have more stool production. As soon as the body of the patient gets used to colostomy and stoma it will get back to normal. But this should be just for a few days, in other cases, you must see your doctor. Continuous and too much feces can lead to dehydration. And you will end up with low electrolytic balance in your body.
Gas managing: The gas also needs to be released out of the pouch. It depends on your pouch. Some pouches are more well organized which helps you to avoid bursting or remove of the bag off the stoma.
The type of colostomy you had and the diet decides the amount of gas stored in a pouch. Food with more carbs and proteins such as alcohol, milk, onion can produce more gas. Avoid chewing gum or drinking via a straw it may lead to the swallowing of air in the colon. Your doctor can better help you with this issue.
Whole capsule seen in stool: When you notice the whole capsule or tablet in your pouch that indicated that the medicines were not completely absorbed in the body. Your doctor may help you to assist this issue by prescribing any liquid medication.
Stoma Obstruction: Sometimes happens that you feel pain in the stomach or any kind of discomfort in the belly. This is due to blockage of the stoma, which has occurred due to any piece of food or any necrotic tissue stuck in the stoma.
You can overcome this issue by drinking more water and you may also remove it at home. It also demands massaging sometimes. If you still face these issues, you must look for your doctor.
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