What is an ostomy?

An ostomy is a surgical procedure that is done when there is extreme trauma to the abdomen or pelvic area due to accidents and injuries. This is also performed for individuals born with certain birth defects, or who have cancer, inflammatory bowel disease, diverticulitis, or incontinence, among other medical conditions. Also known as continent diversion surgery, this procedure can be performed on anyone at any age. While it does not reduce life expectancy, it does require one to get used to a new way of living. Following the procedure, patients require proper stoma care.

There are three different forms of ostomies:

• Colostomy
• Ileostomy
• Urostomy

These ostomies create a stoma. A stoma is an incision in your abdomen. It is connected to either your digestive or urinary systems. Urine or feces leave your body through the stoma. Patients wear a pouch over the stoma.

Stoma care: What conditions merit an ostomy?

Ostomies, particularly colostomies, are done to remedy medical conditions such as the following:

• Birth defects (blocked or missing anal opening)
• Diverticulitis (inflammation of sacs on the colon)
• Inflammatory bowel disease
• Colon or rectal injury
• Partial or total intestinal or bowel blockage
• Rectal or colon cancer
• Wounds, fistulas in perineum (fistulas are abnormal connections of internal body parts or of an internal organ and the skin)

Stoma care: How does an ostomy work?

The general procedure of an ostomy is basically the same for each type.

In a colostomy, one of the most common types, an opening for the large intestine (colon) is made through the abdomen. The results of this procedure may be either temporary or permanent.

Temporary

This is also known as a “loop colostomy”. This is usually performed in cases of an emergency, and can be reversed later on. Part of the colon is brought up to skin level and fixed in place using a stoma rod. The exposed bowel loop is cut and its ends are then rolled down and later sewn on the skin.

Permanent

This is also called an “end colostomy”. A section of the colon or rectum is removed and the remaining portion is lifted to the surface of the abdomen, creating a stoma.

In an ileostomy, a part of the small intestine forms the stoma. In an urostomy, the stoma is connected to the ureters.

Stoma care: How should a stoma be cared for?

Post-surgery, stoma care is of utmost importance. Although the opening should have the same coloration as any other part of the skin, its output can make it tender or sore. The following are some ways to mitigate effects of output:

• Using a pouch of the correct size and skin barrier opening can prevent injury to or swelling of the stoma. If the opening is too big, the output may irritate the skin.
• To prevent leakage and resultant skin irritation, the pouching system should be changed on a regular basis. Be sure to set a regular schedule for changing the pouch.
• Exercise care in separating the pouching system from the skin. To do this, push your skin away gently from the sticky barrier instead of pulling the barrier away from the skin.
• Skin around the stoma should be cleansed with water, and completely dry the skin before replacing the skin barrier or pouch.
• Be aware of any allergies you may have to the adhesive or skin barrier. Remember that these may not develop right away, but may occur after weeks, months or years. A stoma nurse can recommend certain types.

In ileostomies, or surgeries resulting from injury or disease in the small or large intestine, waste passes through the stoma into a pouch, similar to a colostomy. After the surgery, the stoma is likely to be swollen and will become smaller in the following weeks.

Key takeaways

Stomas are openings formed through a procedure known as an ostomy. The three types of ostomies—colostomy, ileostomy and urostomy—target different internal organs involving diverting output of the colon, intestine, or bladder into an external pouch or bag. These are life-saving procedures that do not reduce life expectancy of the patient, but only necessitate a new way of living.

Because an opening is created which empties out into an external bag, special care is necessary to keep it clean and free from irritation. Stoma care involves cleaning the opening with warm water and proper sizing of skin barriers and pouch openings.

Learn about Other Digestive Health Issues here.