Almost 100,000 individuals undergo Ostomy every year, in the US. Colostomy, ileostomy, and urostomy are done to help the patients to pass out urine and feces. Ostomies can be permanent or temporary. These can be continent or incontinent. Usually, in the case of incontinent Ostomies, the patient needs to use an Ostomy pouching system. In this article, the main focus of interest will be incontinent Ostomies.
Basic information about Ostomy
In this procedure, a small portion of your small or large intestine is brought to the abdominal surface. A small opening is created, as a result, known as a stoma. The part of the bowel which will be involved in the stoma formation depends on the condition of the patient and the type of the Ostomy.
- The conditions which need an Ostomy are:
- Cancer in the rectum or colon
- Trauma or injury to the rectum or bowel like a stab wound or bullet wound
- Bowel obstruction
- Cancer in bladder
There are three most commonly occurring types of Ostomy:
An Ostomy in which a part of the small bowel, ileum is involved in stoma formation is known as an ileostomy. The patients with ileostomies need to wear an Ostomy pouch every time and everywhere to collect the feces which are highly acidic due to enzymes. If these bowel contents come in contact with the peristomal skin or the nearby tissues it can cause their destruction or infection.
In the case of colostomy, any part of the transverse, sigmoid, ascending, or descending colon may involve in stoma formation. Some patients with colostomy such as the patients with descending or sigmoid colostomy may use a method to schedule out their bowel movement. This method is termed irrigation. This enables them to predict the bowel movement and they can spend some time without the pouch. Also, these patients can wear a stoma cap over the stoma to prevent any leakage. This cap can absorb the mucus and helps the patient to keep their clothes tidy and dry.
A urostomy is also termed as an ileal conduit, consist of one opening. In urostomy, the surgeon involves a part of the ileum and attaches ureters with it and it is then brought to the abdominal surface. The part of the ileum acts as a conduit and there is nonstop drainage of urine, that’s why a pouching system is required.
A healthy stoma appears to be pink to dark red. It looks moist and bright. There are no nerves at the stoma that’s why you should feel no pain. At first, it is a bit swollen and large but it will shrink back to the normal size in almost six weeks.
The stoma may be prolapsed or it may lie flat with the skin. If you observe any weird changes in the stoma you must consult with your doctor as soon as possible. A traditional method to reduce the stoma size is to put some sugar on the stoma or holding a cold compress over the stoma.
Your surgeon will discuss the location of the stoma before the Ostomy. The location of the stoma is decided after carefully considering all the possible complications. It also depends on the type of Ostomy. In some conditions, there is more than one stoma such as in total pelvic exoneration.
During the first few hours, it is okay if there is some blood along with the feces. With time when the patients are allowed to take solid foods or fluids, the output starts to increase in amount and change in color. There can be foul-smelling but it can be controlled by cutting off some food items and using deodorant pouching systems.
The formation of the feces also depends on the type of the Ostomy and the diet of the patient.
To avoid blocking the small ureters which help in kidney drainage tiny stents are located during the procedure. These are very soft and easy-going and remain inside the body for several days.
Peristomal skin issues
- 55 out of 100 Ostomy patients complain about skin problems after the operation. This mostly happens when there is leakage or the ostomy pouch does not fit properly with the skin. The bowel contents come in contact with the skin. And cause soreness or breaking down of the skin, around the stoma. It can also cause severe skin infections.
- Some people pull off the pouching system very roughly this can also cause skin damage or the stoma may start bleeding.
- Always avoid using soaps or chemical or alcoholic products while cleaning the stoma
There are different types and sizes of pouching systems available in the market.
There is an opened or closed bottom for fecal collecting pouches. An open-end pouch allows patients to empty the pouch and reuse it again. While the closed-end pouch is needed to be changed every time it is filled.
There is s spout in the case of urine pouching systems. There is no spout in the fecal pouching system. Spout acts just like a valve. You can open the spout when you need to empty or drain the pouch and afterward close it.
There are two main types of pouching systems:
- One-piece pouching system: has no separation between the wafer and the pouch
- The two-piece pouching system has a separation between the pouch and the skin barrier or the wafer.
Some people fear that they can’t face other people around them. They fear going to public places, and to go back to their work after the ostomy. They think that everybody would know that they are wearing an ostomy pouch. It feels awkward. But there is nothing to be worried about. The individual must think that it’s a blessing that he or she is alive. Ostomy is a lifesaving procedure.
You can easily hide your ostomy. You can choose with whom you want to share it. You can do all the activities just like other normal people.
You can find help on the internet from the support groups or you can talk with the people having an ostomy. You must look yourself in the mirror and encourage looking at your stoma. It will take some time but you will accept this change once you start to think positively.