7 Reasons Why You May Need a Colostomy
A colostomy is a surgical procedure whereby a section of the colon is diverted and then attached to a stoma, which is a hole made in the abdominal wall. This opening, the colostomy stoma, enables a patient to expel faeces from the digestive tract, because the bowels and rectum has been surgically disabled.
The colostomy procedure is performed as a life-saving measure that may be linked to various illnesses or conditions.
Why Do You Need to Have a Colostomy?
There are many reasons why a patient may need to undergo colostomy surgery but the seven most common reasons why anyone may require this surgical procedure is if they have:
- Crohn’s disease
- Cancer of the bowels
- Obstruction of the bowels
- Trauma and/or injury
- An emergency situation
- Bowel incontinence
In diverticulitis, the diverticula, small pouches in the walls of the colon, get inflamed and then infected. The onset of this will give symptoms such as:
- Severe pain in the stomach
- Very high temperature
With severe or repeated diverticulitis disease, a patient's doctor may feel there is need to remove the affected section of the colon and reattached the remaining part of it. And because the colon will heal naturally, but needs some time, a patient may require a colostomy stoma as a temporary measure.
2. Crohn’s Disease
Crohn’s disease is a condition that causes inflammation of the digestive tract. Symptoms include:
- Abdominal pain
Patients with cases of Crohn’s disease can be treated without surgery, but if there is no response to treatment, colon surgery will have to be performed, by surgically removing a section of the bowel and performing a temporary colostomy procedure.
3. Cancer of the Bowels
Cancer of the bowels is one of the most common cancers in the developed world, with thousands of new cases occurring each year. They mostly develop within the rectum or the colon, and this condition is referred to as colorectal cancer.
A colostomy surgery is the most common form of treatment, where the affected portion of the bowel is surgically removed. With the removal of the diseased part, the remaining colon is then reattached, and a temporary colostomy stoma 'installed' to perform waste (faeces) elimination duties.
The temporary ostomy will be in use for times ranging from four months to a couple of years, depending on the physicians recommendations, and the patients condition. With reversible colostomy surgery, the colostomy and stoma will be removed, and the healed colon is reactivated.
However, with colorectal cancer, if the problem is within the rectum, and it has to be removed, it is likely that the patient will require a permanent colostomy. This form of colostomy procedure is irreversible.
4. Obstruction of the Bowels
An obstruction in the bowel is a serious condition and must be treated as a medical emergency.
This is because there is the risk of bowel rupture, which in turn will cause a serious infection and many times, internal bleeding.
The ways that the passage way of the bowel can become blocked include:
- Acute constipation
- Bowel cancer
- Scarring of the bowel the lining (due to infection or inflammation)
With severe bowel obstruction or rupture, it may become necessary to remove either a portion of the colon, in which case, a temporary colostomy will be performed.
However, if all of the colon is removed, the patient will require a permanent colostomy surgery.
5. Trauma and Injury
An experience of severe damage by a penetrating injury to the colon, for example, a gun shot wound, a knife stab, or a gruesome accident to the abdominal area, may require the colon to be removed.
Depending on the degree of injury, a temporary or permanent colostomy surgical procedure may be performed.
6. An Emergency Situation
Some patients, in hospital for surgery related to other conditions, may wake up to discover they have a colostomy stoma. This most likely occurred during that involves dissection close to the colon.
For example, a female patient with massive fibroids may be in hospital to have them removed. Their size in itself may have encouraged 'gumming' to nearby organs.
And in trying to remove these fibroids, the colon may have been cut (accidentally), or nicked. If after surgery, there is an indication of severe infection, there is the likelihood of seepage of faeces into the body system.
With this, a temporary colostomy may have to be done to save the patients life. The colostomy reversal may then be carried out after a number of months.
7. Bowel Incontinence
Bowel incontinence is a medical condition whereby patients are unable to control their bowel movements, thereby experiencing episodes of embarrassing soiling.
This condition is more common with the elderly. A colostomy surgery may be used as a 'last resort’ medical measure, if all other medical or surgical procedures prove unsuccessful.
What to Expect after Colostomy Surgery
After surgery, as it was in my case, you’ll feel heavy and tight around your abdomen and you’ll also feel a lot of pain, and feel extremely weak. You will be on intravenous pain relievers that will help the pain reduce to the barest minimum.
You will soon be aware of the colostomy bag attached to your abdomen and depending on your physical and mental condition; your doctor will carefully explain your current condition and tell you what to expect.
For the first few days, you won’t be able to stand on your own two feet and it’s virtually impossible to take a shower. You will be towel-washed by the nurses and you will have to contend with some discomfort.
At first, your stoma will not function and because you haven’t started to eat solid foods, you won’t pass out waste through the newly installed stoma. As a post-surgery patient, you will not be allowed to eat or drink anything until the stoma starts to function.
When your stoma starts to function varies from one patient to another but in my case, it took about a week. Peristalsis (involuntary constriction and relaxation of the muscles of the intestine) must be confirmed through auscultation (listening to sounds with a stethoscope) of the patient's stomach for intestinal movements.
As soon as intestinal movement is ascertained, you can start to ‘eat’ your first meal which will be clear liquids. It soon progresses to eating softer foods like broths.
A couple of days after colostomy surgery, once conditions are favourable, you will be encouraged to sit up in bed though you will have to be lifted up (you can't do this simple task on your own) to achieve this. Depending on your strength and willpower, you will be encouraged to try standing up unaided. Soon enough, you should be able to take a few steps, aided by a nurse.
It is very important to start this early process as it encourages early healing and a faster recovery.
How Has It Been Coping With A Colostomy?
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