Ostomy

Overview

An ostomy is a surgical procedure that changes the way waste exits the body by creating an opening in the abdominal wall. The opening extends from a part of their body to the exterior, typically through the muscles and skin of their abdomen. Several diseases of the digestive or urinary systems are treated with this treatment.

Ostomy surgery creates a different route for the removal of waste from the body. The removal of fecal matter, or stool, and maybe pee, are the common goals of such operations.

Reasons for undergoing the procedure

Ostomy surgery may become a necessary medical intervention for individuals facing certain digestive or urinary disorders. This surgical procedure may be recommended when a patient has any of the following conditions:

• Cancer (bladder, colon or rectal).
• An injury that affects either the large or small intestine.
• Bowel obstruction.
• Diseases like Crohn’s disease and ulcerative colitis that irritate the gastrointestinal tract.
• Diverticulitis, a disease that causes inflammation in the colon’s small pouches.

Risks

Complications can arise after ostomy surgery, as with any surgical procedure, varying in severity from mild to severe. These potential complications may include:

• Bleeding: Internal bleeding can occasionally result from ostomy surgery. The patient might need a blood transfusion if they lose too much blood.
• Blockage: This condition can occur as a result of eating foods that are difficult to digest and cause blockages in the digestive system. Obstructions typically resolve spontaneously when you consume clear liquids to allow temporary rest for your bowel.
• Diarrhea: It is a common experience for individuals with ostomies. To mitigate adverse effects, ensure to consume ample fluids. This will aid in replenishing depleted electrolytes and maintaining proper hydration levels in your body.
• Hernia: A hernia may occur if the abdominal wall weakens around the stoma. When stoma hernias are too big, surgery is frequently needed to rectify them.
• Narrowed stoma: Waste may find it more difficult to pass through the stoma if it narrows. This medical condition frequently needs to be surgically repaired.
• Prolapse: The bowel occasionally protrudes through the stoma. In some cases, it can be moved gently and fastened with a stoma shield. Alternatively, in some circumstances, surgery or a larger ostomy pouch may be required.
• Skin irritation: For those who have an ostomy, this is the most frequent problem. An ill-fitting ostomy pouch can cause waste to leak out around the stoma, causing skin irritation or redness. To lessen the possibility of skin irritation, ostomy powder is frequently used by those changing their bags.
• Infection: There are millions of bacteria in the digestive system. During surgery, they could leak out and result in an infection. The healthcare provider will use antibiotics to treat the problem if this happens.
• Electrolyte imbalance: The patient’s large intestine absorbs nutrients, water, and electrolytes from their diet. An imbalance in electrolytes may result from removal or bypassing of the large intestine.
• Vitamin B12 deficiency: The patient could not absorb vitamin B12 as well as they once did after the ostomy. Anemia may result from this.
• Phantom rectum syndrome: Even after having their rectum removed, some people still have the urge to go to the bathroom. Usually, this illness gets better on its own. However, the doctor may recommend painkillers if the patient experiences pain related to phantom rectum syndrome.
• Short bowel syndrome: This is a set of problems resulting from inadequate absorption of nutrients. The water, vitamins, and nutrients required for life support are not adequately absorbed by those who have this illness. Medication, dietary assistance, or surgery are possible forms of treatment for short bowel syndrome.
• Rectal discharge: There may occasionally be a discharge from the rectum in ostomy patients who still have their colon, rectum, and anus. With the right care, this illness can be controlled even though it cannot be cured.

Before the procedure

The patient will meet with the medical team to go over the specifics of their operation before the ostomy surgery. In order to assess the placement of the stoma during this visit, the healthcare provider will first ask the patient about their lifestyle, usual clothing choices, and personal preferences.

The patient will also be taught how to take good care of their stoma. Furthermore, the medical professional will present various ostomy appliance options that can enhance their quality of life.

During the procedure

General anesthesia is used during ostomy surgery to ensure patient comfort. The surgical technique involves either a lengthy abdominal incision or a laparoscopic approach. A laparoscopy uses a camera to look inside the body, usually results in a quicker recovery time, and smaller incisions. The healthcare provider can inform the patient about the specific incision type they will undergo.

Ostomy surgery procedures can change based on the individual patient’s needs. Here are some examples of the most typical ostomy procedure types:

• Colostomy: The colon or rectum’s diseased or damaged sections are removed by the surgeon. After that, healthcare providers create a stoma by passing the remaining colon through the abdominal wall and securing it to the skin. Next, the stoma is pouched around a colostomy bag.
• Ileostomy: In this treatment, the lowest portion of the small intestine, called the ileum, is attached to the abdominal wall by the surgeon to create a stoma. The ostomy stoma is then fitted with an ileostomy bag.
• Urostomy: Urine is redirected from a malfunctioning or diseased bladder with this treatment. A portion from the end of the small intestine or the beginning of the large intestine is removed and relocated during the procedure. After relocating to its new position, this segment of the small intestine forms a pathway that permits the passage of urine from the kidneys and its exit from the body through your stoma.

After the procedure

After ostomy surgery, the majority of patients will need to stay in the hospital. Hospital stays might be as short as one or two days, depending on the stoma and surgical technique.

During this time, the medical team will keep a close eye on the patient to ensure that they are healing properly. If the patient is dehydrated, they could require an intravenous (IV) drip. Urine may also be drained via a catheter insertion.

Outcome

Ostomy surgery plays a pivotal role in preserving lives in many cases. In other situations, it significantly improves patients’ quality of life by effectively addressing a wide range of digestive and urinary disorders.

The typical recovery period after ostomy surgery spans approximately eight weeks. During this time, patients are encouraged to maintain their mobility, even while needing to limit their activities and take precautions. This continued movement aids in expediting bowel movements, preventing infections, and fostering the healing process.

When something doesn’t seem quite right, call the healthcare provider immediately.

• Severe cramps that continue for longer than three hours.
• A change in size or appearance of their stoma.
• Nausea and vomiting.
• Bleeding excessively.
• Foul odor.
• Stoma with deep cut.
• Skin irritation.
• Having a watery discharge that lasts longer than six hours.