About Colostomy

Often referred to as bowel diversion therapy, a colostomy is a procedure to bring one end of the large intestine out through the abdominal wall. In this procedure, the doctors divert one end of the colon to a stoma. The stoma is a pouch-like opening created with an incision that collects faeces.

Children with abdominal congenital disabilities usually undergo temporary colostomy. Patients with long term colostomies have pouches attached to their sides to collect the faeces. The faeces disposal is easy.

 

Why is Colostomy conducted?

Patients suffering from severe bowel problems go through colostomy. Temporary colostomies involve temporarily diverting stool away from the bowel. It further keeps faeces out of the colon region.

If in case, the colon is diseased, it is advisable to undergo a permanent colostomy. For example, the colon is removed permanently for a colon cancer patient. There are certain other conditions where a patient requires permanent colostomy, which are:

• Blockage
• Injury
• Crohn’s disease, an autoimmune form of inflammatory bowel disease
• Colorectal cancer
• Colonic polyps, extra tissue growing inside the colon that may be cancer or may turn into one
• Diverticulitis occurs when small pouches in your digestive system, called diverticula, are infected or inflamed
• Imperforate anus or other birth defects
• Irritable bowel syndrome is a condition affecting the colon that causes diarrhoea, bloating, constipation, and pain in the abdominal area
• Ulcerative colitis is an inflammatory bowel disease that causes the long-term inflammation of the digestive tract

 

Different types of colostomy

There are different types of colostomies which include:

1. Sigmoid colostomy
2. Transverse colostomy
3. A loop colostomy
4. A single-barrel colostomy
5. A double-barrel colostomy
6. Descending colostomy
7. Ascending colostomy

 

Preparing for Surgery

Before surgery- It's always advisable to discuss the surgical and post-surgical options with the surgeon beforehand to better prepare for the surgery. During this phase, even an ostomy nurse can help understand the surgery, including the precautions needed and the type of colostomy required. Even seeking help from a colostomy support group can go a long way in preparing for the surgery.

During Surgery- Depending upon the region of the affected colon, the surgeon usually targets any one of the four parts of the colon.

1. Transverse colostomy - In this type,  the surgeon performs the procedure in the midsection of the colon, and the stoma will be somewhere across the upper abdomen. This procedure treats diverticulitis, inflammatory bowel disease, cancer, blockage, injury or a birth defect.
2. Ascending colostomy- Generally performed on patients with blockage or severe disease. The colostomy prevents the development of blockage or spread of the disease further along the colon.
3. Descending colostomy - Here, the doctor performs descending colostomy on the lower side of the abdomen.
4. Sigmoid colostomy - The most common type of colostomy. It involves an area that is a few inches below the colostomy.

After Surgery- Some patients start eating within two days of surgery. At first, the colostomy site after the surgery may appear dark red and swollen with bruises. It shall heal on its own within a few weeks. The function of a colostomy is draining the stools into the pouch attached to the body. The faeces might look more watery than before, and the consistency also depends on the type of colostomy performed on the patient.

 

Benefits of Colonoscopy

A colostomy is for patients often suffering from several issues like:

• Obstructions of the large intestines and rectum
• Congenital malformations
• Medical problems affecting the colon
• Faecal incontinence

 

Risks of Colonoscopy

1. Blockage of the colostomy
2. Damage to other organs
3. A hernia occurs when an internal organ pushes through a weak area of muscle
4. Infection
5. Internal bleeding
6. Problems from scar tissue
7. Prolapse of the colostomy
8. Wound breaking open
9. Allergic reaction to anaesthesia
10. Excessive bleeding

 

Conclusion

Colostomy is vital in the role in the management of colorectal diseases. The result and success depend primarily on the surgical technique rather than the type of stoma. Advances in surgical technology and management have led to a decrease in numerous permanent stomas.