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What is a colostomy?
The colon, rectum and anus are the last sections of the body’s digestive
system. Although they are an important part of the system, they have little to
do with digesting food or absorbing nutrients. In fact, the large intestine can
be thought of as the body’s trash compactor. As "leftover" liquid
flows through the colon, it becomes solid waste (feces). The solid waste
material is then passed through the various sections of the colon, then onward
to the rectum. From there, it is eliminated from the body through the anus.
When the colon, rectum or anus is unable to function normally because of
disease or injury, or needs to rest from normal function, the body must have
another way to eliminate the waste. A colostomy is an opening – called a stoma
– that connects the colon to the surface of the abdomen. This provides a new
path for waste material and gas to leave the body. A colostomy can be permanent
or temporary.
Why is a colostomy performed?
There are many reasons why a colostomy may become necessary. Some of the
conditions that may require a colostomy include:
- Colorectal cancer
- Traumatic injury
- Intestinal obstruction
- Diverticulitis (an inflammation or infection of small sacs or
outpouchings, called diverticula, of the inner lining of the intestine)
- Crohn's disease (a chronic inflammatory disease that involves all
layers of the intestinal wall and that can disrupt the normal bowel function)
- Incontinence or constipation
How is a colostomy performed?
A colostomy results from a surgical procedure performed under general
anesthesia. During the surgery, healthy colon is brought through an opening in
the abdominal wall and stitched to your skin. Unlike the anus, the opening
(stoma) has no sphincter muscle, so you cannot control the exit of waste. You
will need to wear a pouch (called an ostomy collecting device) to collect the
waste flow.
Is a colostomy permanent?
A colostomy can be permanent or temporary, depending on the condition being
treated and the surgery performed. A temporary colostomy may be done to allow
part of the intestine to rest and heal.
How will a colostomy change my life?
For most colorectal cancer patients, a colostomy will not be needed. Today’s
modern surgical techniques and instruments have decreased the number of
operations that require colostomy. Only 10 percent of patients with rectal
cancer and less than 1 percent with colon cancer will ever need a permanent
colostomy. If you do need to have a colostomy, there will be some changes in
your lifestyle, but you will receive education to help manage and adjust to
these changes.
While in the hospital after your surgery, you will be educated about the care
of your colostomy and given some tips to help make the necessary adjustments.
Some patients find the advice and support of other colostomy patients helpful.
There are ostomy support groups available to provide additional information and
emotional support.
Once you have learned how to care for your colostomy, you will have to
regulate your diet to avoid constipation and diarrhea. Some patients find that a
process called colostomy irrigation, which uses an enema through the stoma,
clears the colon for the day so a pouch may not be necessary. Medical supply
stores and many drug stores carry supplies to help you care for your colostomy.
You will need to check with your insurance carrier to determine if they cover
colostomy supplies.
Here are some additional tips to help you adjust to your colostomy:
- Monitor your medications – Some medicines can cause
constipation or diarrhea.
- Eat a well-balanced diet – Avoid foods that cause excessive
gas, such as cabbage, beans, eggs, or carbonated beverages. A dietitian can
help you choose a balanced diet that will not interfere with your colostomy.
- Live your life – Having a colostomy is not the end of life as
you knew it. Modern colostomy supplies are odor proof and designed to lie flat
and are not noticeable under clothing. Most colostomy patients are able to
return to work and to many of the activities – including sex – they
enjoyed before surgery.
Be sure to talk with your doctor or nurse about resuming your normal
activities and about any concerns you have about living with your colostomy.
What are the complications of a colostomy?
In some cases, skin irritation can result from stool that leaks under the
pouch. A hernia can develop around a colostomy, and the bowel may become narrow,
or prolapse. Proper sitting of an ostomy pouch can help prevent skin irritation.
The enterostomal therapy nurse or the "wound, ostomy, continence"
nurse can help choose an appropriate pouch and suggest ways to care for your
skin.
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