What is an ostomy?


An ostomy is a surgical procedure used to create an opening (called a stoma) made in the abdomen to allow urine or feces to leave the body.


COMMON TYPES OF OSTOMIES


COLOSTOMY: A surgical procedure where a portion of the colon (large intestine) or the rectum is removed and a portion of the remaining colon is brought through the abdominal wall to form a stoma to carry stool out of the body. Colostomies may be temporary or permanent. There are several common types of colostomies:

COLOSTOMY (Sigmoid & Descending):

Possible Reasons for Surgery: rectal cancer, cancer of the sigmoid colon, diverticulitis, bowel obstruction, congenital defects, trauma, paralysis, imperforate anus (absent or displaced anus)

Discharge: semisolid to solid consistency (resembling normal bowel movements), can be regulated in some individuals and not in others

COLOSTOMY (Transverse & Ascending):

Possible Reasons for Surgery: diverticulitis, bowel obstruction, Hirschsprung's disease, colon cancer, penetrating trauma (gunshot or knife wound, etc.), birth defects, paralysis

Discharge: semisolid consistency, unpredictable


ILEOSTOMY: A surgically created opening in the small intestine, usually at the end of the ileum. The intestine is brought through the abdominal wall to form a stoma. Ileostomies may be temporary or permanent, and may involve removal of all or part of the entire colon.

Possible Reasons for Surgery: ulcerative colitis, Crohn's disease, familial polyposis, complications of cancer, necrotizing enterocolitis

Discharge: liquid or paste consistency, unpredictable drainage, contains residual digestive enzymes


UROSTOMY (or ileo-conduit): A general term for a surgical procedure which diverts urine away from a diseased or defective bladder. The ileal or cecal conduit procedures are the most common urostomies. Either a section at the end of the small bowel (ileum) or at the beginning of the large intestine (cecum) is surgically removed and relocated as a passageway (conduit) for urine to pass from the kidneys to the outside of the body through a stoma. It may include removal of the diseased bladder.

Possible Reasons for Surgery: bladder cancer, spina bifida and other birth defects, spinal cord injuries, chronic inflammation of the bladder, neurologic dysfunction of the bladder

Discharge: urine, some mucus, continuous drainage


ILEOANAL RESERVOIR (J-Pouch): The colon and most of the rectum are surgically removed and an internal pouch is formed out of the terminal portion of the ileum. An opening at the bottom of this pouch is attached to the anus so that the existing anal sphincter muscles can be used for continence. In addition to the "J" pouch, there are "S" and "W" pouch modifications. It is also called ileoanal anastomosis, pull-thru, endorectal pullthrough, pelvic pouch and ileal pouch anal anastomosis (IPAA).

Possible Reasons for Surgery: ulcerative colitis, familial polyposis


CONTINENT ILEOSTOMY (Kock Pouch): In this surgical variation of the ileostomy, a reservoir pouch is created inside the abdomen with a portion of the terminal ileum. A valve is constructed in the pouch and a stoma is brought through the abdominal wall. A catheter or tube is inserted into the pouch several times a day to drain feces from the reservoir.

Possible Reasons for Surgery: ulcerative colitis, familial polyposis

Discharge: liquid or paste consistency, contains residual digestive enzymes


CONTINENT UROSTOMY (Indiana Pouch): A reservoir or pouch is created inside the abdomen using a portion of either the small or large bowel. A valve is constructed in the pouch and a stoma is brought through the abdominal wall. The ileocecal valve, that is normally between the large and small intestines, is relocated and used to provide continence for the pouch, which is made from the large bowel. With a Kock pouch version, which is similar to that used as an ileostomy alternative, the pouch and a special "nipple" valve are both made from the small bowel. In both procedures, the valve is located at the pouch outlet to hold the urine. A catheter or tube is inserted into the pouch several times daily to drain urine from the reservoir.

Possible Reasons for Surgery: bladder cancer, neurologic dysfunction of the bladder, birth defects



COMMON TERMINOLOGY USED WITH OSTOMIES


Adhesion - A band of fibrous tissue, usually resulting from inflammation

Anastomosis - The joining together of two ends of healthy bowel after diseased bowel has been cut out (resected) by the surgeon

Anus - The last 4 cm (1.5 inches) of the large bowel below the rectum, forming the excretory opening or anal canal

Appliance - The pouch and flange worn over the stoma by an ostomate to contain body wastes

Catheter - A tube that can be inserted into a body cavity, duct or vessel

Colon - Large intestine which absorbs water and electrolytes and stores digestive wastes until they are eliminated from the body. It is about 5 feet long.

Continent Diversion - A pouch is created inside the body to store stool or urine, instead of creating an ostomy which would require wearing a pouching system on the abdomen.

Crohn's (granulomatous) colitis - Affects the colon only. Symptoms include diarrhea, rectal bleeding, and disease around the anus (abscess, fistulas, ulcers). Skin lesions and joint pains are more common in this form of Crohn's than in others.

Crohn's disease - A chronic (ongoing) disorder that causes inflammation of the digestive or gastrointestinal (GI) tract. Although it can involve any area of the GI tract from the mouth to the anus, it most commonly affects the small intestine and/or colon.

Dehydration - The loss of water, body fluids and salts essential for normal body function

Diverticulitis - Inflammation or outpouching of sacs arising from the bowel wall

Electrolytes - Compounds (salt, potassium, etc.) which maintain the body's chemical balance

Enterostomal Therapy Nurse - A nurse who specializes in the care and teaching of ostomy patients

Familial Polyposis - A rare disease which runs in families. The colon and rectum contain many polyps. It has a strong tendency to malignancy.

Feces - Stool, bowel waste or excrement

Fistula - An abnormal channel that connects two organs or connects an organ to the skin

Gastroenteritis - Inflammation of the stomach and bowel

Hirschsprung's Disease - A birth defect in which the nerves in the bowel wall are missing from the anal region up the bowel for a variable distance. These nerves normally assist the movement of stool through the bowels. As a result, the bowel suffers massive enlargement above the area of missing nerves.

Ileitis - Inflammation of the small bowel

Ileoanal - Joining the small bowel to the sphincter at the anus

Ileum - Lower part of the small intestine which ends at the beginning of the large intestine (cecum) in the lower right part of abdomen. It is about 12 feet long.

Irrigation - Flushing of large bowel through colostomy opening (stoma)

Mucosa - Mucus-secreting lining of hollow organs such as the intestines

Ostomate - Person who has had an ostomy surgery

Polyps - A usually non-malignant growth or tumor protruding from the mucous lining of an organ, such as the colon. Left untreated, polyps have an increased risk of becoming cancerous.

Rectum - Lower part of the intestinal tract about 15 cm (6 inches) long, ending in the anus

Stoma - Surgical opening in the abdomen to allow for disposal of body wastes

Stenosis - Narrowing of a passageway

Ulcerative Colitis - A chronic (ongoing) disease of the colon (large intestine). The disease is marked by inflammation and ulceration of the colon mucosa, or innermost lining. Tiny open sores, or ulcers, form on the surface of the lining, where they bleed and produce pus and mucus. Because the inflammation makes the colon empty frequently, symptoms typically include diarrhea (sometimes bloody) and often crampy abdominal pain.

Ureters - Ducts which carry urine from the kidneys to the bladder

Wafer - A molded faceplate of an ostomy pouching system. It adheres to the skin around the stoma.