Sometimes we have to face health problems that we can't even imagine. Fecal incontinence without even knowing it or severe constipation that is unbearable is one of them. How challenging is it to live with these conditions? Many people suffer from the embarrassment and embarrassment of going out in public and doing their work. So today we are talking about a special surgery that can help with such problems and make life easier again.
Simply put, what is a cecostomy?
A cecostomy is a surgical procedure. In this procedure, surgeons make a small incision on the right side of your abdomen and insert a small tube into the cecum, the first part of the large intestine. One end of the tube is inside the cecum, while the other end is exposed above the skin of the abdomen. This is a surgical procedure that is performed on both children and adults.
You might be a little scared when you hear this. You might be thinking, "How can you have a tube in your stomach?" But it looks like a very small thing. And the benefits of it are very high. Let's talk about it further.
Who needs this surgery?
This surgery is not necessary for normal constipation or occasional bowel incontinence. It is recommended for people with very severe fecal incontinence or constipation, especially when other treatments have not been successful.
Some of the medical conditions that can cause these conditions are:
- Birth complications: For example, anus not forming properly at birth (Imperforate anus).
- Hirschsprung disease: This is a condition that causes difficulty passing stool due to a problem with the nerve cells in the large intestine.
- Klippel Feil syndrome: This is a rare condition caused by the fusion of vertebrae in the spine.
- Spina bifida: A birth defect in the development of the spine and spinal cord.
For a child or adult with these conditions, daily life can be very difficult. This surgery is of great help to them.
How does a cecostomy tube help us? The difference between an enema and a cecostomy tube
To understand this, we first need to know what an enema is. An enema is a procedure that involves introducing a liquid into the large intestine to help the stool pass more easily. The traditional method we know is to give an enema through the anus.
The specialty of cecostomy surgery is that it allows for a special enema method called antegrade enema . Now let's look at the difference between these two methods.
| Method | Description |
|---|---|
| Traditional enema (Retrograde enema) | This is a method of inserting the liquid through the anus. This requires you to lie down. You also have to wait for about an hour after inserting the liquid. This is a rather difficult and time-consuming process. |
| Antegrade enema (through the cecostomy) | The fluid is inserted through a cecostomy tube in your abdomen. You can do this while sitting on the toilet . Once the fluid is connected to the tube, it goes directly to the beginning of your large intestine, so your bowels are cleaned quickly and efficiently. This is a very convenient, private, and liberating method. |
Got it? With this antegrade enema method, you no longer have to lie down on the floor and do the enema awkwardly. You can do this task easily, sitting on the toilet, alone.
Preparing for surgery and what happens
The day before surgery, you will need to completely clean your intestines (bowel prep) according to your doctor's instructions.
During surgery:
- You will be given general anesthesia . This means that you will be given medication to put you to sleep so that you will not feel any pain.
- The doctor makes a small incision in the lower right side of the abdomen.
- Using special imaging techniques, the cecostomy tube is inserted through the incision into the cecum.
- The cecum is placed close to the abdominal wall and secured with several stitches.
- The other end of the tube is placed on the skin surface and secured to the skin with a plaster if necessary.
What are the benefits and risks of cecostomy surgery?
Like any medical procedure, this one has benefits as well as some risks.
Benefits:
- Significantly reduced soiling accidents: Since you can control your stool, you can stay clean throughout the day.
- Increased self-confidence: Feeling good about yourself as shyness and fear disappear.
- A more active life: You can freely do things like go to school, work, go out with friends, and swim without the fear of "always having to be near a toilet."
- No longer needing diapers or protective underwear.
Possible risks:
- Complications related to anesthesia: Things like sore throat and vomiting after waking up.
- Bowel perforation: A hole in the large intestine that occurs accidentally during surgery.
- Stomal stenosis: Narrowing of the part of the intestine around the site of the tube insertion.
- Stomal leakage: Enema fluid leaking from around the tube into the abdomen.
These risks are very rare, and your medical team will do their best to prevent them.
What happens after surgery?
There are a few things you should follow during and after your recovery period.
- Discharge from the hospital: Most people are able to go home the same day as their surgery.
- Pain: You may feel some discomfort and pain after going home. You can use painkillers prescribed by your doctor for this.
- Activity restrictions: You should avoid swimming for two weeks after surgery. You should also avoid sports and heavy lifting for four to six weeks .
- Long-term care:
- You need to see the doctor in a week or two to have the stitches removed.
- The medical team will best instruct you on when and how to start antegrade enemas using the cecostomy tube.
- Sometimes a temporary tube is placed during surgery and then changed to a permanent, long-term tube when you go to the clinic 6 weeks later. This is a small, painless procedure that is done without anesthesia.
- The most important thing is that this cecostomy tube needs to be changed every 6 to 12 months. This is also a simple thing that is done in the clinic.
If you have these symptoms, see a doctor immediately.
If you experience any symptoms of a complication after surgery, you should notify your doctor immediately.
| Warning signs to look out for | |
|---|---|
| - Abdominal pain | - If the cecostomy tube has come loose from its place |
| - If it is difficult to pass the enema liquid through the tube | - Fever. This may be a sign of an infection in the abdomen (peritonitis). |
| - If the difficulty in controlling bowel movements persists | - If there is pus, bleeding, or swelling around the tube |
Take-Home Message
- Cecostomy is a life-saving surgery performed to treat severe bowel control difficulties and constipation.
- This allows for a convenient method of bowel cleansing called an antegrade enema. This allows you to easily do this task while sitting on the toilet.
- This surgery reduces involuntary bowel movements, increases self-confidence, and allows for a more active social life.
- This is a long-term solution. Aftercare, such as changing the tube every 6-12 months, is very important.
- Never be afraid to talk openly with your doctor about any problems that may arise during or after the surgery.
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