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What is a colostomy?

A colostomy is a surgical procedure that involves creating an opening in the abdomen called a stoma. It allows the diversion of a portion of the large intestine (colon) through this opening, thus changing the way stool leaves the body.

This surgical intervention is often necessary in cases where the lower part of the colon or rectum is damaged, diseased, or needs time to heal after surgical removal. Primarily, colostomies are performed to treat various medical conditions, including colorectal cancer, inflammatory bowel diseases (such as Crohn’s disease or ulcerative colitis), traumatic injuries, and congenital anomalies.

The stoma, which is usually located on the left side of the abdomen, is formed by bringing the healthy end of the colon through the abdominal wall. After the procedure, waste passes through the stoma into an external pouching system, which is placed over the stoma to collect fecal matter. This pouch can be emptied or replaced as needed to manage waste effectively.

Different types of colostomy

There are different types of colostomies based on the portion of the colon that is brought to the surface. The two primary types are:

  1. End colostomy: This type is created by bringing the end of the colon through the abdominal wall. It’s usually done when a portion of the colon is removed or bypassed.
  2. Loop colostomy: A loop of the colon is brought to the surface of the abdomen. It’s often a temporary solution and can be reversed after the colon has healed.
  3. Diverting colostomy: This is often performed to divert stool away from a diseased or healing part of the colon. It can allow the lower part of the colon or rectum to heal.

Having a colostomy can be a life-changing experience for individuals. It may lead to a range of emotional and physical adjustments. There might be concerns related to body image, lifestyle changes, and practical aspects of managing the stoma. However, with time and proper support, individuals can adapt and lead a full and active life.

Rehabilitation and support play a crucial role in helping individuals adjust to life with a colostomy. This includes education on how to care for the stoma, manage the colostomy pouch, and maintain good peristomal skin health.

Stoma care nurses, support groups, and educational resources provide essential guidance for adapting to this new way of living. Understanding and addressing the concerns associated with a colostomy can significantly improve the quality of life for individuals.

What are the reasons for colostomy surgery?

Colostomies are performed for various medical conditions:

• Colorectal cancer
• Inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis),
• Diverticulitis
• Anal cancer
• Bowel incontinence
• Trauma/injury to the colon or rectum
• Birth defects such as Hirschsprung’s disease or imperforate anus
• Wounds or fistulas in the perineum

Challenges faced after surgery

  1. Body image and self-esteem: Adjusting to the changes in one’s body can be emotionally challenging. Counselling and support groups can help individuals navigate these feelings and regain self-confidence.
  2. Diet and nutrition: After a colostomy, certain foods may need to be approached cautiously. An altered diet may be required to prevent blockages or control stool consistency.
  3. Physical activity: While most physical activities are still possible after a colostomy, individuals might need some time to adapt and regain confidence. It’s important to consult a healthcare professional before engaging in vigorous activities.
  4. Stoma care and hygiene: Proper care of the stoma and the skin around it is crucial to prevent complications such as infection or skin irritation.

Support from healthcare professionals, family, friends, and support groups is invaluable for those adapting to life with a colostomy. Receiving guidance, sharing experiences, and accessing resources are essential for a successful transition.

Ultimately, a colostomy is a life-saving and life-improving procedure for many individuals. It allows them to regain their health and continue their lives with some adjustments. The understanding, acceptance, and support from society and the individual’s community play a significant role in ensuring that those with a colostomy lead fulfilling and satisfying lives.

Stoma care

Emptying your colostomy bag regularly after surgery is important. You may find you need to do this once or perhaps several times a day. It is a good idea to empty the stoma bag when it is half full or less, otherwise it becomes heaving and may drag and possibly start to leak. There are two different types of colostomy bags:

• One-piece pouches attach directly to the skin around your stoma. The pouch has a hole in the middle, to incorporate the stoma and it is directly attached to the skin by a skin friendly wafer, known as skin barrier. It is applied and removed together as one-piece.
• Two-piece pouches include the skin barrier and a pouch which can be detached separately. Therefore, you can leave the skin wafer in place and change the pouch from the bag.

Looking after your stoma and the surrounding skin (peristomal) is an essential part of having a stoma. Checking your skin and stoma when you change your pouch needs to be part of your daily routine. Keeping the skin around your stoma clean and drying soft dry wipes, moistened with warm water and dry carefully before applying a new stoma pouch will help prevent any irritation or soreness. Monitoring your stoma and its shape or size is also important. Following surgery, the stoma tends to reduce in size over the first 6-8 weeks and will need to be re-measured so your stoma bag fits correctly. Your Stoma Nurse will help you with this.

If you notice your skin is becoming more irritated, and your stoma bag is no longer fitting correctly, contact you Stoma Care Nurse for advice and support.

Living with a colostomy

Once recovered from surgery, most people with colostomies can return to leading active and fulfilling lives. Modern colostomy bags are discreet, comfortable, so it shouldn’t stop you from doing the things you love. Your Stoma Nurse will help guide you with stoma bags and any other issues and there are also support groups such as the Colostomy Association and online resources available to help patients and their families adjust to life with a colostomy.

Coping with a colostomy can be emotionally and psychologically challenging for patients. Some ostomates may experience anxiety, self-esteem issues, or concerns about body image. Don’t feel alone, reach out and talk to someone such as your Stoma Care Nurse, friends or family and loved ones, they can make a significant difference in helping individuals adapt to these changes.

For more helpful advice following your stoma surgery, please visit our stoma care advice centre.

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