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Ostomy, Colostomy, Ileostomy. These three words and the images
they convey produce dread in many people who know very little
about them.
An ostomy is a surgical procedure that creates an
opening on the abdominal wall for waste products to move out of
the body. It is performed when a medical condition is so severe
that an ostomy offers a better alternative. The quality of life
is usually much improved for patients with an ostomy, because
their previous medical condition was so debilitating.
To really understand an ostomy, it helps to know a little
about the body's anatomy. The gastrointestinal tract begins
with the esophagus (the tube connecting the mouth and stomach)
and continues through the stomach, small intestine, large
intestine (colon), rectum, and anus. Food is swallowed in the
esophagus, mixed and churned in the stomach, and digested and
absorbed in the small intestine. The waste leaves the small
intestine as liquid. The colon absorbs water from the liquid
material and stores the remainder as formed stool until it is
passed voluntarily out of the body through the rectum.
What Is an Ostomy? A Colostomy? An Ileostomy?
An ostomy is an artificial opening on the abdominal wall
through which waste material passes out of the body from the
bowel or urinary tract.
A colostomy indicates that the opening is from the colon. When
the colostomy is in the left colon, only a pad may be needed to
cover the opening. When the opening is in the right side of the
colon, some type of appliance or bag is required. There are
various types of colostomies. The physician and surgeon recommend
the appropriate one for each patient.
An ileostomy involves bringing the ileum (the last portion of
the small intestine) to the abdominal surface. When waste matter
reaches the ileum it is liquid, so an appliance is needed to
collect it. However, a type of ileostomy called a Koch's
pouch or continent ileostomy does not require an appliance. The
physician and surgeon discuss these choices with the patient.
Why Is an Ostomy Performed?
A number of conditions call for an ostomy as part of the
treatment and recovery. These include cancer of the colon and
rectum, trauma, malformations present from birth, obstruction of
the bowel, complications of diverticulosis, and Crohn's
disease. In each of these, an ostomy may be the best and safest
form of treatment. In certain conditions the ostomy may be
temporary and can be reversed at a later date. In the past,
surgery for ulcerative colitis required a colostomy. Now, a
rectal pouch can usually be created out of the small intestine.
Liquid stool is then passed through the rectum 3-6 times a
day.
The Psychology of an Ostomy
When the physician first mentions an ostomy, every patient,
without exception, has negative feelings. The younger the
patient, the harder it is to accept an ostomy. There is probably
no surgical procedure that produces more misunderstanding and
fear than an ostomy.
After the surgery, the patient needs time to heal, to learn
how to manage the ostomy, and to mentally adapt to these changes.
In time, the patient usually finds that life is only slightly
altered, if at all. Most would rather have the ostomy than their
previous medical conditions.
Appliances and Care
A covering or appliance is necessary for all ostomies.
Typically, a colostomy on the left abdomen may require only a
pad. A colostomy on the right side and an ileostomy need a small,
odor-proof bag that adheres to the body and cannot be seen
through clothing. All hospitals and many physicians' offices
have nurse specialists who are extremely knowledgeable about the
care of ostomies, and how to treat and prevent their problems.
Odor from an ostomy is seldom a problem. Again, assistance is
available.
How Does an Ostomy Affect Lifestyle?
Bathing - Tub or shower bathing is done much the same as
before the ostomy. If an appliance is used, bathing can be done
with or without it attached.
Clothing - Generally, the types of clothing worn before an
ostomy can be worn after surgery. Only minor changes may be
needed, such as larger pantyhose and panty girdles for women, or
a larger athletic supporter for men who exercise.
Exercise - There are few, if any, limitations on exercise and
sports. People with ostomies swim, water ski, play tennis and
football, jog, scuba dive, and participate in practically any
sport or activity.
Diet - Some minor changes may be required. The patient may
find that certain foods and liquids cause diarrhea and/or flatus
(gas). He or she then simply avoids these foods. There are many
other foods available which work fine with an ostomy. A little
experimenting may be necessary.
Sex - A strong, loving relationship always assures
satisfactory sexual relations. An ostomy certainly does not make
a person less masculine, or feminine. The patient's attitude
is very important in maintaining sexual performance. In some
cases, professional counseling is necessary, and the physician
can assist the patient in obtaining help.
Travel - The only steps needed for traveling are advance
planning and packing adequate ostomy supplies.
Social relationships - Each year about 100,000 people of all
ages have this surgery. So, chances are you have socialized with
people who have ostomies and you didn't know it. Today's
devices are secure, lightweight, and unnoticeable. Who and what
you tell about your surgery is up to you. Remember, this is an
alteration to a part of your body. You are the same person, and
there is no reason why your relationships with family and friends
should change.
Summary
Contrary to common fears, an ostomy almost always improves the
quality of life for the patient by correcting the previous
serious or debilitating condition. Tens of thousands of ostomy
patients attest to the fact that they lead active, stimulating
lives, with near normal diets, sex and travel habits.
Additional Help for Ostomy Patients
1. Most hospitals have enterostomal therapists. These
professionals provide support and assistance for problems that
occur with an ostomy.
2. The United Ostomy Association,
a self-help organization,
provides useful information. There may be a local chapter in your
area. Address: 36 Executive Park, Suite 120, Irvine, CA 92714.
Phone: (800) 826-0826 or (714) 660-8624.
3. Crohn's & Colitis Foundation of America, Inc., 386
Park Avenue South, 17th Floor, New York, NY 10016-8804, (800)
932,2423 or (212) 685-3440.
4. The Internet and World Wide Web - simply find a search
location and type in ostomy, colostomy, or ileostomy. A huge
amount of material is readily available.
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