Have you or someone you know ever been told by a doctor about a colostomy? It's normal to feel a little scared and nervous when you hear about it. "What does it mean to have a bag?", "Will I ever be able to go back to my old self?", etc. You may be wondering. But don't worry. It's not as scary as you think. Today, we'll talk about it in a very simple way that you can understand.
Simply put, what is a colostomy?
A colostomy is a surgical procedure that changes the way your body passes stool. Normally, our stool comes out through the anus. But when a part of our colon is damaged due to some disease or accident, it may be necessary to give that part a rest or remove it permanently, and a new path for stool to come out.
In this procedure, a surgeon makes a small opening, or hole, in your abdominal wall that is exposed to the skin. We call this a stoma . Then, a part of your large intestine (colon) is taken and connected to this stoma.
So after the surgery, you won't need to go to the toilet as usual. Instead, your body waste, which is your stool, will come out of the stoma that was created in your stomach and collect in a special bag (colostomy bag) that is attached to it.
Some people have this colostomy temporarily, for only a few months. But some people have to live with it for the rest of their lives. This all depends on your medical condition. Your doctor will explain this to you in detail.
Are there types of colostomy?
Yes, there are several types of colostomies. These are classified according to which part of the large intestine (colon) is connected to the abdominal wall. Let's look at the main types.
| Type of colostomy | Description and nature of feces |
|---|---|
| Sigmoid Colostomy | This is the most common type. In this procedure, the last 'S'-shaped part of the large intestine (sigmoid colon) is attached to the skin on the left side of the abdomen. Because stools travel a long way through the intestine and come out, they are usually thicker . |
| Descending Colostomy | Here, the part of the large intestine on the left side, just above the 'S'-shaped part (the descending colon), is connected to the skin. The stool that comes out here is mostly solid . |
| Transverse Colostomy | In this procedure, the upper part of the large intestine (transverse colon), which runs through the abdomen, is connected to the skin. This is often done temporarily. This is done to give the damaged part of the intestine a rest while it heals. The stool that comes out here is a little watery and soft because only half of the intestine has traveled. |
Your doctor and surgeon will decide which type is best for you.
Why would someone need to have a colostomy?
There are many reasons why a colostomy may be performed. Some are temporary, while others are permanent.
When a temporary colostomy is needed:
- Diverticulitis: An infection or inflammation of the large intestine.
- IBD (Inflammatory Bowel Disease): Conditions that affect the intestines, such as Crohn's disease.
- Injuries to the intestine: Damage to the intestine due to an accident.
- Intestinal obstruction: A blockage in the passage of stool somewhere in the intestine.
- Anal fistula: An abnormal tube between the anus and the skin.
- Some bowel surgeries: After a section of bowel is removed, to give the area time to heal before the remaining parts are connected together.
When a permanent colostomy is needed:
- Inability to control stool that cannot be cured (Fecal Incontinence).
- Advanced Colorectal Cancer.
- When the rectum and anus are permanently removed surgically.
How do you prepare before surgery?
Since this is a major surgery, there are a few things you need to prepare for beforehand.
- Talking to your doctor: Before your surgery, your surgeon will talk to you about the procedure, its risks, and how your life will change after the surgery. They may also discuss pain management.
- Tests: They will do things like blood tests and an EKG to see if you are suitable for surgery.
- Determining where to place your stoma: A Wound Ostomy Continence Nurse (WOCN) will usually teach you how to use your stoma and pouch. They will also help you choose the most comfortable place for your stoma, one that won't interfere with your clothes or daily activities.
- On the day of surgery: You should avoid eating for 6 hours before surgery. You should also stop drinking fluids, such as water, for 2 hours before surgery. Your doctor may recommend that you take a bowel prep to help cleanse your intestines.
What happens after surgery? And possible complications
After the surgery, you will stay in the hospital for 3 to 7 days. During this time, you will gradually start eating normally. The nursing staff will also teach you everything you need to know about caring for your stoma and changing your bag.
Colostomy surgery is generally a safe procedure, but like any surgery, there are some risks.
| Possible complications | Description |
|---|---|
| Skin irritation | The skin around the stoma can become red and sore from contact with stool. This is a common problem. Using a properly fitting bag can go a long way towards solving this. |
| Bowel Obstruction | Scar tissue that forms after surgery can make it difficult to pass stool. This can often be treated with constipation medications. |
| Changes in the stoma | The stoma can either retract (retraction) or protrude too far from the skin (prolapse). This can make it difficult to fit the bag properly. |
| Parastomal Hernia | The muscles around the stoma become weak, causing part of the intestine to push through. This looks like a lump near the stoma. |
When to call your doctor
- Persistent constipation or diarrhea.
- Nausea or vomiting.
- Blood in the stool.
- Changes in the color or size of the stoma.
- A bad odor coming from the stoma or it becoming blocked.
- Fever or severe stomach pain.
If you have any of these symptoms, you should call your doctor immediately . In an emergency, go to the Emergency Department (ETU) of the nearest hospital.
How is life with a bag?
This is the biggest problem for many people.
- How going to the toilet will change: After surgery, stool will come out of the stoma. If you still have an anus, you may occasionally have a small amount of mucus. This is normal. The new stool will come out of the stoma. The important thing is that, unlike the rectum, the stoma does not have muscles that can stop the stool. Therefore, you cannot control the passage of stool. It happens automatically.
- Do you always need to carry a bag?
Many people wear a bag all the time. Bags these days are so thin that they are invisible over clothing. So you can wear any clothes you want. Some people with a sigmoid colostomy can predict when they will have a bowel movement. They may only use a bag at those times.
- Can a temporary colostomy be reversed?
Yes. If your colostomy is temporary, you can have another surgery to fix it back to its original shape when your health improves. Your doctor will decide when to do this. It could take a few months or a year.
Take-Home Message
- A colostomy is a life-saving, often necessary surgery. Don't be unnecessarily afraid of it.
- After surgery, stool is collected in a bag that is attached to an opening (stoma) made on the skin of the abdomen. This cannot be controlled.
- It is very important to keep the stoma and the skin around it clean. You will be given detailed instructions about this in the hospital.
- If you have any questions or concerns, talk to your doctor or nursing staff about them openly. Don't be shy.
- You can live a completely normal, full life with a colostomy. You are not alone, there are many others who are living like this.
💬 අදහස් (0)
තවමත් කිසිදු අදහසක් පළ කර නොමැත. ඔබේ අදහස පළමු වරට මෙහි එක් කරන්න.
ඔබේ අදහස එක් කරන්න