Ostomy Types

 
 
Colostomy     Ileostomy     Urostomy
 

Colostomy

Reasons For Colostomy Surgery Colostomy surgery is usually performed as a result of ulcerative colitis, Crohn's disease,cancer, diverticulitis, or trauma. A portion of the colon, or rectum are either removed or bypassed. As a result a colostomy can be either permanent or temporary.

What Is A Colostomy? A colostomy is an opening made into the large bowel. The opening is called a STOMA from the Greek word meaning "mouth". Generally, the stoma is placed in the lower left part of the abdomen close to the midline. If possible the opening is made below the belt-line so that belts and clothing do not interfere with the stoma. The colostomy pouch or appliance should not be visible under your clothing. Whatever clothes you wore before your operation you will be able to continue to wear, with very few exceptions.

Construction of a Colostomy There are two kinds of colostomies - an end or loop colostomy. Through a small opening in the abdomen, the surgeon draws a loop or an end portion of the colon to the skin surface. The bowel is turned back on itself almost like a cuff and the surgeon stitches the edges to the skin.

Appearance of a Colostomy The colon is lined with a mucus membrane very similar to the tissue inside the mouth. Like the mouth, a healthy stoma is a pinkish red color and moist at all times. Stomas may be round or oval in shape. Initially, the stoma is swollen. This is due to the handling of the bowel during the operation. It takes approximately six weeks for the swelling to decrease.

A loop colostom4/27/10 placed beneath the loop of bowel and left in place on the abdomen until it has become fixed in place. The care of a loop colostomy does not differ from the care of an end colostomy. A loop colostomy is generally temporary while an end colostomy tends to be permanent.

Function of a Colostomy A colostomy provides no voluntary control over the passage of stool or gas (flatus) because unlike the anus, the stoma does not have a sphincter muscle. As a result, an appliance must be worn at all times. The amount of stool passed through a colostomy varies with each individual. You may need to empty the appliance one or two times a day. With time, some people are able to see a pattern occurring in the passage of stool while others find their movements to be irregular. What you eat or drink, your mood and health all affect the time it takes for stool to pass through the gastrointestinal tract to the colostomy. Immediately after surgery, the output from your colostomy may be loose. Later, as you begin to take foods and fluids the discharge will thicken and become brownish in color. The stool in time may become quite formed.

Let's Review A colostomy is an opening of the colon onto to the surface of the abdomen, usually in the left lower quadrant, through which stool and flatus pass. The end or loop of the colon is brought through the opening to form a stoma. A portion of the colon or rectum are either removed or bypassed for a period of time. The stoma is flexible, soft, moist and red in color. There is no control of the passage of stool or flatus because there is no sphincter muscle. An external appliance must be worn at all times.

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Ileostomy

What Is An Ileostomy? An ileostomy is an opening made into the small bowel. The opening is called a stoma from the Greek word meaning mouth. Generally, the stoma is placed in the lower right part of your abdomen, close to the navel. The place for the stoma opening on the abdomen is ideally chosen by a clinical nurse or Enterostomal nurse before the operation. When choosing a stoma site the nurse asks you to stand, sit and lie down so that any areas of scarring or skin folds can be identified. It is important for the nurse to see your abdomen in different positions because the contours of the abdomen change with movement. If possible the opening is made below the belt-line so that belts and clothing do not interfere with the stoma. The ileostomy appliance should not be visible under your clothing. Whatever clothes you wore before your operation you will be able to continue to wear, with very few exceptions.

Construction Of An Ileostomy There are two kinds of ileostomies - an end or loop ileostomy. Through a small opening in the abdomen, the surgeon draws a loop or an end portion of the ileum to the skin surface. The bowel is turned back on itself almost like a cuff and the surgeon stitches the edges to the skin.

Appearance Of An Ileostomy The ileum is lined with a mucus membrane very similar to the tissue inside the mouth. Like the mouth, a healthy stoma is a pinkish red in color and moist at all times. Stomas may be round or oval in shape. Initially, the stoma is swollen. This is due to the handling of the bowel during the operation. It takes approximately six weeks for the swelling to decrease.

A loop ileostomy requires that a small white plastic rod be placed beneath the loop of bowel and left in place for approximately one week. The purpose of the rod is to hold the bowel in place on the abdomen until it has become fixed in place. The care of a loop ileostomy does not differ from the care of an end ileostomy. A loop ileostomy is generally temporary while an end ileostomy tends to be permanent.

Function Of An Ileostomy An ileostomy provides no voluntary control over the passage of stool or gas (flatus) because unlike the anus, the stoma does not have a sphincter muscle. As a result, an external appliance must be worn at all times.

The amount of stool which passes through an ileostomy varies with each individual. You may need to empty the appliance six to eight times in a 24 hour period. The passage of stool can occur between 20 minutes to several hours following a meal or snack. With time, some people are able to see a pattern occurring in the passage of stool, while others find their movements to be irregular. What you eat or drink, your mood and health, and the length of the remaining small bowel, all affect the time it takes for stool to pass through the gastrointestinal tract to the ileostomy.

Immediately after your operation, the output from your ileostomy may be loose, thin, watery and greenish looking in color. This is known as bile. The greenish color is caused by bile pigment. Later, as you begin to take foods and fluids, the discharge thickens and becomes brownish in color. Stool from an ileostomy is always semi-formed in consistency due to the loss of water absorption that normally takes place in the colon.

The stool from an ileostomy contains many harsh enzymes and if it comes in contact with the skin, irritation can occur. To avoid skin irritation, the surgeon makes the stoma so that it protrudes one inch or so above the skin and fits well into the opening of the appliance.

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Urostomy

A urostomy is the result of an operation which diverts the passage of urine.

One type of urostomy operation is an 'ileal conduit' which is created by detaching the ureters from the bladder and joining them to a short length of the small intestine (ileum). One end of this section of ileum is sealed off and the other end is brought to the surface of the abdomen to form a small spout - this is the stoma. This is where the urine will come out. It has no muscles to regulate the passage of urine which will need to be collected in a bag.

Another type of urostomy operation is ureterostomy, Uretero-cutaneostomy. Using this technique, the surgeon detaches the ureters from the bladder and brings one or both ureters to the surface of the abdomen. A ureterostomy can be made as a "single" ureterostomy (only one ureter is brought to the surface), a "bilateral" ureterostomy (one ureter in each side of the abdomen), a "double-barrel" ureterostomy (both ureters are brought to the same side, two holes) or a "transuretero" ureterostomy (both ureters are brought to the same side, one hole).

The stoma is moist, pinky red in color, and protruding slightly from the abdomen. Despite being red, there is no sensation in the stoma and it is not painful.

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