A colostomy is a surgical procedure that creates an opening for the large intestine through the abdomen. In colostomy, the end of the colon is brought through the abdominal wall, and the ends of the colon are then sutured to the skin of the abdominal wall to form an opening called a stoma. Stool passes through the artificial opening into a colostomy bag attached to the abdomen. Colostomy can be either permanent or temporary depending on the patient's case.
The main causes that can lead to a colostomy are inflammatory diseases of the colon (Crohn's disease, ulcerative colitis, etc.) and serious diseases, such as cancer, that do not respond to systemic treatment. These are treated surgically by resection of the affected part of the intestine and the creation of a colostomy.
In a temporary colostomy - when the colon simply needs time to heal- a hole is made in the side of the colon and sewn to a corresponding hole in the abdominal wall. The temporary colostomy can be more easily reversed later by simply disconnecting the colon from the abdominal wall and closing the colostomy to restore the flow of stool through the colon.
What to Expect Before a Colostomy Surgery
Before surgery, it is normal to feel some degree of fear or anxiety. Don't forget that colostomy surgery is a therapeutic intervention that is done to improve your quality of life, put an end to debilitating symptoms and minimize your health risk. Initially, the doctor will make sure that you fully understand the procedure, the potential risks that may be involved as well as the lifestyle changes you will make after the operation. Before the surgery, you will need to give a blood sample or you may have an electrocardiogram (ECG) to check that your heart is in good condition.
On the day before surgery, it would be best to avoid consuming large amounts of food or drink. Also, the doctor may give you a laxative for the bowel, as is usually done before the colonoscopy examination.
The colostomy operation is done painlessly, following the administration of anesthesia so that you fall into a deep sleep and feel no pain. There are two ways to perform a colostomy:
- Either surgically through a large incision in the abdomen.
- Either laparoscopic with many small incisions where the doctor uses a tiny camera and surgical tools to perform the operation.
What is very important to know before the colostomy operation is that after the colostomy operation a colostomy bag will now be placed into which the stool will be channeled. Ostomy bags are ergonomically designed to offer comfort and safety. There is a wide variety of stoma bags to choose the one that best suits your stoma and your daily life. You can choose between one-piece stoma bags with a built-in stoma base or two-piece stoma bags with a detachable base (the bag and base are two separate pieces).
In any case do not choose a bag blindly. You can experiment by trying different types of bags and from different companies to find the one that works best for you. It's up to you whether you choose a one-piece or two-piece stoma bag.
If there is frequent leakage at the base of the bag then you may need to try Convex bases. The curved bases are designed to create enough pressure around your stoma and protrude into the pouch. This contributes to a better seal and helps the stoma to be directed into the bag rather than under the base. Learn more about ostomy bags and how to choose the one that suits your needs here.
Colostomy surgery
The colostomy operation can be done in 4 different places. A distinction is made between ascending colostomy, transverse colostomy including descending and sigmoid colostomy.
A transverse colostomy is performed in the middle part of the colon and the stoma will be somewhere in the upper abdomen. This type of colostomy surgery is often temporary—usually performed for diverticulitis, inflammatory bowel disease, cancer, obstruction, injury, or birth defect. In a transverse colostomy there may be one or two stoma. The second possible stoma is for the mucus that normally continues to produce in the part of the colon that is resting. If you only have one stoma, the mucus will pass through your rectum and anus.
An ascending colostomy is made on the right side of your abdomen, leaving only a small part of the colon active. It is generally performed only when obstruction or severe disease prevents a colostomy further along the colon. A descending colostomy is placed on the lower left side of the abdomen, while a sigmoid colostomy - the most common type - is placed a few centimeters lower. Depending on the location of the stoma, the composition of the stool varies from liquid, semi-liquid to formed colostomy.
Recovery After Colostomy Surgery
At the hospital
After a colostomy operation, recovery is required with a hospital stay of approximately 3 days to one week. If the colostomy operation was performed as an emergency, the hospital stay may be longer. During your hospital stay, you will learn to care for your colostomy following the doctor's instructions. A normal stoma is wet and pink or red in color but in the first few days after surgery it may appear dark red and swollen, bruised. You don't need to worry. Within a few weeks, the color will lighten and the bruises will disappear.
A clear colostomy bag will be placed over the stoma so that the contents of the bag can be easily monitored. Don't panic if the first bag is quite large. He won't always be this big, that's just for starters. It is then replaced with a smaller bag when you go home. Recovery in the hospital involves a slow readjustment to fluids and food to ensure there are no digestive problems. On the first day, you will probably only be given ice cubes to quench your thirst, and then clear liquids and soft foods. Once the doctors are sure that your gut is working normally, you can gradually start introducing more foods into your diet.
At home
When you return home, avoid strenuous activities that could strain your stoma, such as lifting heavy objects. After colostomy surgery, rest and patience are needed until your body recovers and adjusts to the new lifestyle. Don't forget that you yourself need time to get used to the new routine.
Your stools will probably be looser than they were before surgery. The consistency of your stool will also depend on the type of colostomy you have and the foods you eat. Take advantage of your time in the hospital to learn how to care for and clean your colostomy. There is no need to panic if you see some blood in your stoma, this is normal for days after the operation. However, if the bleeding does not stop, it is good to contact your doctor. Your doctor will generally equip you with all the necessary information you need to know what is normal and what is not to happen in a colostomy.
Don't forget that a colostomy does not mean the end of your life. You can do exactly what you did before colostomy surgery such as work, exercise, have fun, go on vacation and have relationships. Having a colostomy bag improves your quality of life compared to before and helps you regain control of your body. In the beginning you'll need some adjustment time to learn how your body works in terms of food - which foods affect you and which don't - and what works for your lifestyle. You will learn to plan and plan your meals in advance to plan when you will need to change your colostomy bag so you don't have to worry about any accidents. It is important when you are out and about to always have stoma supplies with you in case you need them. One thing is for sure, you don't have to feel alone! You can get in touch and meet people by registering at Ostomy Hellas.