What is a cecostomy? Is it a solution to bowel problems?

Does your little one suffer from constipation? Does he or she go days without a bowel movement and feel very uncomfortable? Or does he or she have fecal incontinence without even realizing it? You, as a child and as a parent, must be suffering a lot from these problems. Today, we are going to talk about a special treatment that can help when these conditions are difficult to control with regular medications.

What is a cecostomy in simple terms?

Simply put, a cecostomy is a minor surgery. It involves inserting a tube through the skin of your abdomen directly into the first part of your large intestine. This first part of your large intestine is medically called the cecum . This tube is called a cecostomy tube or C tube.

Now you may be thinking, "Why would they put a tube in like this?" The reason is, they're going to do an enema through this tube. An enema is a liquid that is injected into the colon to cleanse it. Usually, we do an enema through the anus, which is the lower end of the colon. The liquid goes up. This is called a retrograde enema . But this method doesn't really cleanse the entire colon.

But when you do an enema through a cecum tube, the liquid enters at the top of the large intestine. Then the liquid travels down the entire intestine, carrying the stool, and comes out through the anus. It's like pouring water down a pipe. We call this antegrade enemas . This method is very effective because it can cleanse the entire large intestine. This treatment is temporary for some people, but may be needed long-term for others.

Who really needs this treatment?

Cecalostomy is most commonly used in pediatric medicine . It is especially helpful for children who have severe constipation and are unable to control their bowels (fecal incontinence). Imagine how frustrating it would be for a child to accidentally leak stool while playing with friends at school. This treatment can make a big difference in the lives of such children.

In addition, this is also very useful for children who are born with certain intestinal problems. For example:

• Anorectal malformations: Anorectal malformations are congenital malformations of the anus.
• Hirschsprung disease: A problem with the nerve cells in the intestine that causes stool to not move properly.
• Spina bifida: A birth defect of the spine and spinal cord that affects bowel and bladder control.

Cecalostomy is not usually recommended for adults, but in special cases, daily antegrade enemas can help to keep bowel movements on a schedule and prevent unexpected bowel movements.

What types of tubes are used?

There are several main types of pipes used for this. See the table below for a simple understanding of these.

How is this procedure performed?

This process can be divided into several parts.

How do you prepare before surgery?

Before surgery, your doctor will likely ask you to do a bowel preparation . This means restricting your food and drink for a few days, then taking a laxative to completely empty your bowels.

What happens during the surgery?

During the surgery, the doctor makes a small hole through the skin of your abdomen into a part of your large intestine called the cecum.

• Sometimes this is done with a needle-like device. This is called a percutaneous cecostomy . This usually involves numbing the area.
• Sometimes this is done through a small incision. This is called a surgical cecostomy . For this, you or your child will be put to sleep under general anesthesia.

After making the hole, the doctor uses special camera technology (fluoroscopy or endoscopy) like X-rays to insert a C-tube through the hole into the intestine. The tube is then attached to the intestine, and the intestine is attached to the abdominal wall.

What happens after the surgery?

The surgery itself will take about an hour. You will then be in the hospital for a few days. During this time, the medical team will take good care of you. You will be given IV antibiotics to prevent infection. You will be given painkillers if you are in pain. Your intestines will be a little "lazy" after the surgery, so you will need to eat a liquid diet until they start working properly again.

What are the benefits and risks of this?

Like any medical treatment, this one has both benefits and risks.

How long does it take to heal and how do you use the tube?

It takes about two weeks for the surgical site to heal. During that time, it is not a good idea to do things like swim or shower. You will need to come back after two weeks to have your stitches removed. You can usually start using the tube after the first week.

The C-tube that is initially placed is temporary. It is used for about 6 to 8 weeks . After that, you need to see your doctor. He or she will remove that tube and insert a permanent tube that looks like a "button" as mentioned earlier. It is very simple.

This button-like tube is flat against the stomach, so it is not very visible from the outside. When you need to do an enema, there is a separate piece of tube that can be connected to the button. The enema liquid is inserted through it. This permanent tube can be used as long as needed. However, doctors recommend changing this tube every 6 to 12 months for hygiene reasons.

Any other occasions when you need to see the doctor

If you or your child has any of the following symptoms, call your doctor immediately.

• Signs of infection: fever, pus-like fluid draining from the tube site.
• Unusual pain: Unbearable pain, swelling, or bleeding around the tube.
• Pipe problem: If the pipe seems to have moved from its place, or if it has come completely off.

Cecostomy, constipation, fecal incontinence, constipation in children, antegrade enema, bowel surgery