Sometimes we have health problems that we are embarrassed to talk about, but which greatly affect our lives. Such as having uncontrollable bowel movements, or not being able to defecate for days. This is a very difficult and mentally stressful experience for both a small child and an adult. This condition can be a big obstacle to going to school, going to work, and socializing with other people in society. So today we are talking about a special surgery that doctors are proposing as a solution to such problems.
Simply put, what is an appendicostomy?
Although the name may sound complicated, the procedure is very simple to understand. Appendicectomy, or as it is popularly known among doctors, the MACE (Malone Antegrade Colonic Enema) procedure , is a surgical procedure.
Simply put, this is what happens:
Using a portion of your own appendix , a small tube is created from the skin of your abdomen to your colon/large intestine. This procedure uses a special liquid (enema) to wash out the inside of your colon and help the stool to pass more easily.
The small opening made in the skin of the abdomen that connects this passage is called a stoma . This is usually made near the navel (belly button) or on the right side of the abdomen. So it is not very visible from the outside.
One of the biggest advantages of this method is that you can control the bowel movement process. That means you can decide for yourself when and how often you want to cleanse your colon.
Who really needs this surgery?
Doctors usually recommend this surgery for people who have not been able to control their bowel movements with other treatments, such as dietary changes, fiber supplements, or training such as biofeedback. It is performed on both children and adults.
If you or your child has any of the following conditions, you may want to talk to your doctor about MACE surgery.
| Medical condition | A simple explanation |
|---|---|
| Severe Constipation | Conditions that are difficult to cure even with medication, such as not having a bowel movement for days. |
| Fecal incontinence | Involuntary or uncontrolled bowel movements. |
| Spina Bifida | A birth defect in the spine and nervous system that affects bowel control. |
| Anorectal Malformation | Congenital abnormalities in the position of the anus or rectum. |
| Hirschsprung Disease | Difficulty passing stool due to improper development of nerve cells in the large intestine. |
Let's also learn about how the surgery is performed.
Before surgery
Your doctor will clearly explain to you what you need to do before the operation.
- Eating and drinking: You will be advised how long you should refrain from eating and drinking before surgery.
- Bowel Cleansing: A special procedure will be given to completely clean the intestines (Bowel Prep) the day before surgery.
- Other medications: If you are taking medication for other conditions, it is very important to ask your doctor whether you should take those medications before surgery.
During surgery
This surgery is usually done laparoscopically . That is, as a "key-hole surgery." It is done by inserting a camera and instruments through several small holes in the abdomen, rather than making a large incision. This results in less healing time and less scarring.
During the operation, the surgeon:
1. They take a small piece of your appendix or intestine and shape it into a tube.
2. That tube is connected to the inside of the large intestine.
3. The other end of the tube is attached to a small opening (stoma) made in the skin of the abdomen.
4. Initially, a thin tube, called a catheter, is temporarily inserted into the stoma to keep it open.
This surgery can usually take about two hours.
After the surgery
You will only stay in the hospital for a short time, about a day or two. During that time, the nursing staff will teach you how to flush your bowels through your newly created stoma. You will be trained to do this on your own when you go home.
What are the benefits and side effects of this surgery?
The main advantage is that you regain control over your bowel movements. This allows you to live a normal life, play sports, and go to work without shame or fear. Your privacy is also protected because others cannot see your stoma.
There is a risk of complications . Not everyone will experience these, but it is important to be aware.
- Sometimes a small amount of stool or fluid may leak from the anus.
- Sometimes the created passageway (stoma) can become narrow.
- Some people may experience some degree of constipation or bowel control problems after surgery.
It usually takes about a month to heal. Doctors advise you to avoid heavy lifting and strenuous sports during that time. After about a month, the temporary tube (catheter) that is placed in the stoma is removed. After that, you can insert the tube yourself only when you need to clean your bowels.
When should you see a doctor immediately?
If you or your child develop any of the following symptoms after surgery, call your doctor immediately or seek treatment.
| Symptoms to watch out for | |
|---|---|
| Fever | Increased body temperature. |
| Bloating | Abdominal distention and discomfort. |
| Nausea and vomiting | Nausea and Vomiting. |
| Pain, redness, or swelling at the surgical site | These may be signs of an infection. |
| Difficulty inserting the tube | This may be a sign that the stoma passage has narrowed. |
| Fluid leaking from the stoma | Continued leakage of fluid or stool even after the tube is removed. |
Is this surgery reversible?
Yes. If you or your child somehow regains the ability to defecate normally, this created passage can be surgically removed and restored to normal. This procedure does not harm the function of the large intestine.
Ultimately, bowel problems are something that can take away your joy and confidence in life. But modern medicine has effective solutions for them. Your doctor is the best person to decide if this surgery is right for you or your child. So, learn more about this, discuss your problem clearly, and get the best treatment.
Take-Home Message
- Appendicostomy (MACE surgery) is a surgical procedure performed for people with severe constipation or difficulty controlling their bowel movements.
- Here, the appendix is used to create a passage from the skin of the abdomen to the large intestine, and through it, the intestines are washed to help expel feces.
- This surgery is performed on both children and adults, and it can greatly improve the quality of life.
- If you develop symptoms such as fever, abdominal pain, or swelling after surgery , contact your doctor immediately.
- To determine if this is the right treatment for you, it is essential to talk openly with your doctor about all your concerns.
👩🏽⚕️ Additional questions (FAQs)
💬 What is Abnormal Walk / Gait Abnormality?
It is normal to limp for two to three days after a leg injury. However, 'Abnormal Walk' is a medical term that refers to a person losing balance while walking, dragging one leg on the ground, walking with their feet spread wide apart, or walking with one leg supported, which is a major sign of a serious neurological/bone disease!
💬 What are the main reasons for this sudden/gradual change in walking style (Abnormal Gait)?
There are 4 main causes of this: 1) 'Severe damage to the brain or nerves' - stroke, Parkinson's disease (walking with wide feet/slow), or spinal cord compression. 2) 'Osteoarthritis' - when the knee or hip joint wears down and becomes unbearable pain. 3) Diabetes causes loss of balance due to neuropathy in the legs. 4) Inner ear/Vertigo (Balance system disorder).
💬 When walking becomes abnormal, what are the 'fatal/emergency situations' in which you should go to the hospital immediately, without taking painkillers at home?
When you get old, it's not a big deal if your knees wear out and you limp. But the biggest danger! If a person who used to walk well, in a few minutes/hours, 1) 'One leg drags along the ground/one side is paralyzed (Unilateral weakness)', 2) If you can't speak at the same time and your face droops, it's definitely a 'Stroke' (paralysis/death in three hours)! 3) If you can't walk at all after a traffic accident, you should go to the hospital's emergency department immediately!
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