Ostomy

Ostomy description

An ostomy aims to divert the evacuation of urine or fecal matters using means other than natural ways.

An ostomy is a surgical bypass of a natural canal that consists in drifting temporarily or permanently feces or urine or both in some cases to protect the patient’s health. The surgery is made when the natural canal (intestine) no longer has the capacity to fulfill its role, following an injury, a disease or an ablation. Feces or urine are collected in an airtight pouch.

Ostomies can be of digestive (colostomy and ileostomy) or of urinary nature (urostomy).

What can lead to an ostomy

The path that can lead to an ostomy can be complex. In some situations, it is due to an illness that you must undergo a bypass surgery while in other cases, it is due to an accident. In essence, the decision to operate is always taken in order to preserve the patient's health.

 

·         Prostate cancer

·         Bladder cancer

·         Colorectal cancer

·         Hirschsprung disease

·         Inflammatory bowel disease 
(Ulcerative colitis and Crohn’s Disease)

·         Bowel obstructions

·         Familial adenomatous polyposis

·         Lynch syndrome

Types of ostomies

Colostomy

A colostomy is a surgical incision of the colon with the purpose of creating an opening in the abdominal area to derive the feces, temporarily or permanently.

-The terminal colostomy, also known as single pouch colostomy involves the use of an opening in the abdominal wall. In case of an ablation of the intestine distal portion, the operation is permanent.

-The colostomy-sided (loop) or two pouches colostomy consists of two openings in the abdominal wall, the ends near the proximal and distal loops. This ostomy may be temporary if there is a subsequent closure of the ostomies; identification of distal and proximal loops is necessary to ensure proper management of the colostomy.

Ileostomy

An ileostomy allows the ileum to be linked to the outside through the abdomen wall. Such an operation is necessary when disease or injury has made the large intestine unable to deal properly with the waste it carries, or when it had to be removed in its entirety.

In the recent years, it has been possible to make a continent ileostomy which allows many patients to avoid carrying a permanent and external pouch. A continent Kock ileostomy is a connection of the end of the small intestine, called the ileum, to the skin of your abdomen. It allows waste to be drained. Unlike other ileostomies, the Kock ileostomy consists of a valve created by sewing the intestine in a special way so that waste material doesn't leak out but is rather diverted with a tube called a catheter that is inserted when it's time to empty the pouch.1

Urostomy

Urostomy consists of the evacuation of urine. It is the rerouting of ureters through a segment from the small intestine to the abdominal cage.

  1. Source : Plans de soins et dossier infirmier : diagnostics infirmiers et problèmes traités en collaboration de Lynda Juall Carpenito-Moyet, Lynda Juall Carpenito, Marie-Thérèse Celis-Geradin, Dominique Barbier, Christiane Coopman-Mahieu, 2004

How to live with an ostomy

 

·         Diet and nutrition

·         Pregnancy

·         Hygiene and care

·         Sports

·         Clothing