Ostomy, Colostomy, Ileostomy
These
three words and the images they convey produce dread in many people who know
very little about them. An ostomy is a surgical procedure that creates an
opening on the abdominal wall for waste products to move out of the body. It is
performed when a medical condition is so severe that an ostomy offers a better
alternative. The quality of life is usually much improved for patients with an
ostomy, because their previous medical condition was so debilitating.
To really understand an ostomy, it helps to know a little about the body's
anatomy. The gastrointestinal tract begins with the esophagus (the tube
connecting the mouth and stomach) and continues through the stomach, small
intestine, large intestine (colon), rectum, and anus.
Food is swallowed in the esophagus, mixed and churned in the stomach, and
digested and absorbed in the small intestine. The waste leaves the small
intestine as liquid. The colon absorbs water from the liquid material and stores
the remainder as formed stool until it is passed voluntarily out of the body
through the rectum.
What Is an Ostomy?
A Colostomy?
An Ileostomy?
An ostomy is an artificial opening on the abdominal wall through which
waste material passes out of the body from the bowel or urinary tract.
A colostomy indicates that the opening is from the colon. When the
colostomy is in the left colon, only a pad may be needed to cover the opening.
When the opening is in the right side of the colon, some type of appliance or
bag is required. There are various types of colostomies. The physician and
surgeon recommend the appropriate one for each patient.
An
ileostomy involves bringing the ileum (the last portion of the small
intestine) to the abdominal surface. When waste matter reaches the ileum it is
liquid, so an appliance is needed to collect it. However, a type of ileostomy
called a Koch's pouch or continent ileostomy does not require an appliance. The
physician and surgeon discuss these choices with the patient.
Why Is an Ostomy Performed?
A number of conditions call for an ostomy as part of the treatment and recovery.
These include cancer of the colon and rectum, trauma, malformations present from
birth, obstruction of the bowel, complications of diverticulosis, and Crohn's
disease. In each of these, an ostomy may be the best and safest form of
treatment. In certain conditions the ostomy may be temporary and can be reversed
at a later date. In the past, surgery for ulcerative colitis required a
colostomy. Now, a rectal pouch can usually be created out of the small
intestine. Liquid stool is then passed through the rectum 3-6 times a day.
The Psychology of an Ostomy
When the physician first mentions an ostomy, every patient, without exception,
has negative feelings. The younger the patient, the harder it is to accept an
ostomy. There is probably no surgical procedure that produces more
misunderstanding and fear than an ostomy.
After the surgery, the patient needs time to heal, to learn how to manage the
ostomy, and to mentally adapt to these changes. In time, the patient usually
finds that life is only slightly altered, if at all. Most would rather have the
ostomy than their previous medical conditions.
Appliances and Care
A covering or appliance is necessary for all ostomies. Typically, a colostomy on
the left abdomen may require only a pad. A colostomy on the right side and an
ileostomy need a small, odor-proof bag that adheres to the body and cannot be
seen through clothing. All hospitals and many physicians' offices have nurse
specialists who are extremely knowledgeable about the care of ostomies, and how
to treat and prevent their problems. Odor from an ostomy is seldom a problem.
Again, assistance is available.
Bathing -- Tub or shower bathing is done much the same as before the
ostomy. If an appliance is used, bathing can be done with or without it
attached.
Clothing -- Generally, the types of clothing worn before an ostomy
can be worn after surgery. Only minor changes may be needed, such as larger
pantyhose and panty girdles for women, or a larger athletic supporter for men
who exercise.
Exercise -- There are few, if any, limitations on exercise and
sports. People with ostomies swim, water-ski, play tennis and football, jog,
scuba dive, and participate in practically any sport or activity.
Diet -- Some minor changes may be required. The patient may find
that certain foods and liquids cause diarrhea and/or flatus (gas). He or she
then simply avoids these foods. There are many other foods available which
work fine with an ostomy. A little experimenting may be necessary.
Sex -- A strong, loving relationship always assures satisfactory
sexual relations. An ostomy certainly does not make a person less masculine or
feminine. The patient's attitude is very important in maintaining sexual
performance. In some cases, professional counseling is necessary, and the
physician can assist the patient in obtaining help.
Travel -- The only steps needed for traveling are advance planning
and packing adequate ostomy supplies.
Social relationships -- Each year about 100,000 people of all ages
have this surgery. So, chances are you have socialized with people who have
ostomies and you didn't know it. Today's devices are secure, lightweight, and
unnoticeable. Who and what you tell about your surgery is up to you. Remember,
this is an alteration to a part of your body. You are the same person, and
there is no reason why your relationships with family and friends should
change.
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