Colostomy - Its Types - and Pouching System

What is Colostomy?

A colostomy is a hole in the lower left side of the patient's abdomen, created in a small part of the colon (large intestine). It has been fabricated in the result of an infection in the colon, colon cancer, blockage in the colon, injury in the colon, injury in the bowel, ulcerative disease, inflammation in the bowel, or any other serious bowel disease.

After the diagnosis of a specific disease related to the colon, large intestine, or bowel, doctors suggest some medicines. If the illness stays remain and bothers the anal system of the patient, then there is the need for colostomy. Moreover, in the case of cancer and radiation treatment of the colon, a person must need the colostomy opening for the proper functioning of the bowel and large intestine.

Therefore, surgeons design a round pit in the lower left side of the belly wall, it excretes stool through this stoma or opening. In the colostomy operation, the anus of the patient does not discharge the feces. A section of the colon (large intestine) takes to the stoma, and after this artificial practice, an ostomate releases the solid waste through the stoma. The stool or feces collects into a container or bag, called an ostomy pouch or stoma pouch. There is a complete pouching system that holds the waste, protects the opening, and provide comfortability to the patient. The colostomy can be for a few months, until the recovery of the disease, or for the entire life.

Types of Colostomy

There are different types of colostomies relying on the disease and the treatment of specific parts of the large intestine and bowel. Well, the two common names are temporary colostomy and Permanent colostomy.

Temporary Colostomy

This is a reversible process. Temporary colostomy means that your colon will attach to the anus, after the healing of the infection or disease. Thus, the stoma will get closed after the large intestine or a section of the bowel will bring back.

Permanent Colostomy

It is the building of stoma for the rest of the life of the patient. When there is a chronic bowel disease, radiation treatment, or colon cancer, then an infected section of the large intestine or bowel removed permanently. Then, for the rest of the life, an ostomate discharges feces through the stoma.

Transverse Colostomy

Transverse colostomy occurs due to Diverticulitis, obstruction, birth defect, blockage, injury, or inflammatory bowel disease. In this surgery, an upper portion or lower portion of the colon was removed due to the mentioned diseases. It appears on the right side or in the middle of the abdominal wall. The purpose of the removal of the transverse colon is to discharge stool before reaching to the descending colon. This could be permanent and temporary, depending on the removal portion.

Ascending Colostomy

It also fashions on the right side of the belly button. In the ascending colostomy, a small segment of the colon remains active, and the infected part removes from the large intestine. Moreover, it releases a liquid form of stool; therefore, in such defects, usually doctors suggest ileostomy.

Descending Colostomy

When a portion of the descending colon removes due to the injury or obstruction, and stoma appears on the left side, it is descending colostomy. It discharges a firm formation of feces.

Sigmoid Colostomy

A section of the large intestine is known as sigmoid. Thus, when an incision and removal required in the sigmoid colon, called a sigmoid colostomy.

Pouching System for Colostomies

The appropriate pouching system for colostomy patients is discardable pouches and bags. The drainable needs frequent emptying and cleaning, but a colostomy patient discharges a firm and solid form of stool; therefore, there is no need to drain a bag again and again. A colostomy knows the movement pf bowel; however, after the discharge of waste, a patient can go to the loo and empty the bag. Moreover, a colostomy person should wear a new pouching system including adhesive, stoma bag, skin barrier, and flanges after every two days. In the case of transverse or loop colostomies, you can wear a drainable pouching system.

Method of Irrigation for Colostomy Patients

What is Irrigation?

Irrigation is a regular process of washing and clearing the stool from the colon with water. It is an alternative name or method of enema for clearing out the feces from the large intestine or colon. Some colostomy patients choose the irrigation process of washing the solid waste from the colon to regulate the functions of opening or stoma in the abdominal wall. Due to this method, a colostomy person can predict the movement of bowel and able to use small ostomy bags. The smaller pouches may include stoma caps, place in between irrigations. Moreover, the irrigation method is not suitable for every colostomy patient. Well, not every ostomy person feels comfortable with the irrigation process. Therefore, there are a few key points for colostomy persons to initiate this process.

Irrigation for Descending Colostomy and Sigmoid Colostomy

Irrigation is a method to clear out the solid stool from the colon. Therefore, this is not appropriate for every ostomy patient. Urostomy and ileostomy persons cannot adopt the process of irrigation to clean the waste container. Well, the patients of descending colostomy and sigmoid colostomy can use this technique to wash out the feces. Moreover, patients with transverse colostomy and ileal conduit cannot irrigate the discharge with this method.

Many ostomy patients do no know about the type of stoma they have. Doctors clear this in the pre-operative session, but many patients skip this meeting because they think it is useless and futile. Therefore, before adopting the irrigation method to wash the stool or waste content, consult your surgeon and ask about the kins of ostomy you have. Moreover, in a few cases, your doctor does not suggest your irrigation method even you have sigmoid or descending colostomies; thus, ask your Enterostomal Therapy Nurse (ET) before adopting the irrigation method. Furthermore, the ostomy patients who have a continent diversion or Kock pouch, cannot use the irrigation method for washing the solid stool.

Is Irrigation Appropriate for Every Colostomy Patient?

As I mentioned above, the descending and sigmoid colostomy can use the method of irrigation; however, there are a few more reasons to adopt this process. Well, this is not an appropriate technique for everyone even with sigmoid or descending colostomies. If a colostomy person has undergone or will go through the chemotherapy or radiation treatment for the abdomen or pelvis, then this is not an adequate method for you to clear out the stool.

Due to the radiation and Chemotherapies, the functions of the stoma may get disturbed or alter for a few months or permanently' therefore, you should not adopt irrigation for washing the colon. This would be problematic for colostomy persons. Moreover, for parastomal hernia patients, it is an inappropriate technique. If a colostomy patient has a hernia and the lump is reducing continuously, still it is not safe for them to use the irrigation method. It can lead to further complications of the bowel. Apart from these diseases, stoma prolapses can create problems for ostomy patients. For diarrhea patients, irrigation would be a risky solution. Thus, they should also not try this method to wash out the colon and clear the feces.

Who can use the Method of Irrigation?

Irrigation is an appropriate method for a few colostomy patients and that are sigmoid and descending colostomy. The patients whose stomach form a semi-thick or thick feces cam adopt the method of irrigation to wash the stool and colon. Moreover, the regulation of bowel is necessary for the formed stool. Therefore, you should eat five to six meals per day, so that your digestive system gets active and to regulate the bowel. Do exercise, perform small physical activities, take more fluids to an active bowel, and proper functioning.

What is Parastomal Hernia? - Causes of Parastomal Hernia

Hernia

A hernia is a bizarre lump in the weakened part of the abdominal wall. A protrusion appears near the bowel on the flat layers of the belly muscles. In the case of ostomy patients, the muscles and the walls around the stoma become sensitive and fragile; therefore, in this section, a hernia can build up. In the initial symptoms, an ostomate only feels a bulging part in the lower abdomen. A person realizes the protrusion around the opening or hole in the belly wall. It takes time to become it large and noticeable under clothes.

Parastomal Hernia

A hernia or lump around the opening in the abdominal wall (stoma) is called a parastomal hernia. This disease does not appear in every ostomate; however, 5 to 10 % of ostomy patients suffer from the disease. Usually, colostomy people suffer most from the parastomal hernia. However, only 3 to 9% of ileostomy patients suffer from parastomal hernia. Moreover, this is not an ultimate measurement, every stoma patient can suffer from this illness. Therefore, it is unpredictable and unsure to say about the accurate percentage and reasons of the parastomal hernias. It may develop due to any reason except colostomy or ileostomy in the ostomates.

Causes of the Parastomal Hernia

A hernia is one of the common problems in ostomy patients. Every person has a different cause of a lump in the abdomen or near the opening. A parastomal hernia can occur due to the following reasons:

Stoma in Rectus Abdominus

When a stoma or hole appears in the abdomen of the patients, the whole muscles of the internal organs and abdomen get disturbed. The entire system feels up and down due to the incision and an artificial passage of the colon or ileum. The stoma occurs in the abdominal muscles, called rectus abdominous. This area can lead to the stomal hernia creation.

Obesity in Ostomy Patients

Obesity is another reason for the hernia formation in ostomy persons. Many ostomates gain weight after the stoma surgery, this can lead to the hernia. Moreover, some ostomates are already obese; therefore, they develop a lump around the stomal wall. Patients with normal weight do not suffer from the parastomal hernia or they develop fewer chances of developing lump as compared to the fat people.

Poor Nutrition of Ostomates

Poor nutrition is another major reason for the formation of a parastomal hernia. Most ostomy patients do not pay much attention to their healthy diet after stoma creation. Moreover, many ostomates even do not eat properly. Therefore, poor diet or malnutrition can lead to the disturbance of rectus abdominal muscles. This can weaken the process of healing of stoma, internal organs, and muscles around the opening; therefore, there is a sky-high probability of parastomal hernia.

Age of the Ostomate

The age of the ostomy patient does matter a lot in the case of parastomal hernia. If an ostomate is old, there are high risks for the development of a lump in the abdominal wall. The muscles around the stoma and belly become weaken with the age; therefore, such patients are vulnerable to the parastomal hernia.

Increased Pressure in the Abdomen of Ostomate

Due to the increased intra-abdominal pressure, an ostomate may develop a parastomal hernia. Due to chronic coughing, intense sneezing, and lifting heavyweight, an ostomy person can lead to a parastomal hernia. Such habits can weaken the muscles of the abdomen and around the stoma; thus, a simple pressure on the internal muscles can create hernia in ostomates.

Infection in Stoma

After an ostomy surgery either colostomy or ileostomy, many patients suffer from infection in the stomal or internal organs. Due to carelessness, an ostomate's stitches and opening walls d not heal on time; therefore, such patients develop a parastomal hernia.

Stoma - Purpose of Stoma - Care for Stoma

Stoma

A stoma is an artificial surgical opening in the abdomen of a patient who suffers from the large intestine, small intestine, rectum, or bladder diseases. The main operation that creates a stoma, called ostomy surgery. As a result of ostomy, a surgeon opens a hole in the abdomen.

Ostomy and Types of Ostomy

Ostomy is the fabrication of a stoma in the abdomen. As a result of chronic disease in the ileum, colon, bowel, rectum, or bladder, doctors change the organic tack of excretion in a person. After the alteration of the tubes or ducts, they open a small round pit in the belly wall of the patient, called a stoma, and the surgery is called an ostomy.

There are three primary kinds of ostomies.

1.    Colostomy.

2.    Urostomy.

3.    Ileostomy.

Colostomy

A human's digestive system consists of several tubes, ducts, and canals. It starts from the esophagus and ends at the colon (large intestine). The large intestine must discharge solid waste (stool) from the body. However, when a person suffers from a severe disease in the colon or large intestine, he is unable to pass the feces through the anus; therefore, doctors remove the infected section of the colon or bowel, bring the remaining portion to the outside of the abdomen, for the excretion of stool. This colostomy.

Urostomy

A few patients suffer from bladder cancer or kidneys diseases; therefore, there is a problem in the uterus. When there is a problem in the urine duct, a patient cannot discharge liquid waste through the natural pathway. Therefore, surgeons remove the defected part of the small bowel or the entire bladder. After this operation, a patient excretes urine through the stoma.

Ileostomy

It is the removal of a defected portion of the ileum or small intestine. Ileum cancer or chronic bowel disease can lead to ileum ostomy. The stoma appears as a result of ileum removal, called an ileostomy. It discharges liquid and solid stool depends on the digestive system and bowel movement habit.

Purpose of Stoma

The purpose of the stoma is to provide and creating an artificial passage for the discharge of waste of the body, either solid or liquid. A stoma receives stool or urine from the colon, ileum, and bowel.

A pouching system needs to collect solid and liquid waste. You cannot leave the hole open and wait for the oozing of stool or urine. Thus, an ostomate needs to cover the new organ of the body. Your pit will need a bag or pouch to hold and collect the discharge material. Moreover, a stoma bag will protect the opening.

Care for Stoma

The health of stoma is your primary responsibility. For this purpose, you should know how a normal and healthy opening looks like. The general and hale appearance of the stoma is round or oval, red or dark pink, 1/4 to 1/8 in inches. Moreover, there would be any specialty depending on the type of stoma and overall health and weight of the patient.

A healthy stoma should not bleed, it should not get dark brown or black. The size should not be more than 2.5 inches. The hale opening in the men should not burn, itch, or red.

Therefore, to keep the stoma and peristomal healthy, you should empty your bag three to four times a day. The output should not come out of the pouch and connect to your skin. You should replace the used bag with the new one after every two days. You can adopt a changing habit according to the life of the adhesive and skin barrier. Always use high-quality material for your pouching system and good products for the stoma.