What is an Ostomy?
Overview
Ostomy surgery causes a change in the way stool and urine exit the body. Bodily waste is re-routed from the colon, small intestine or bladder due to a malfunction in the urinary or digestive system. The malfunction is caused by injury, disease or congenital defect.
A stoma is the surgical opening located on the abdomen wall that allows stool to pass. One will not be able to tell whether the stoma is fecal or urinary as it cannot be determined with the naked eye. Most stomas are pink/red in color, moist, and warm. The shape of the stoma will vary depending on location and is typically an oval or round.
Colostomy
A colostomy is a surgically created opening that re-routes the end of the colon (large intestine) to the abdominal wall. The size of the opening and its location will depend on which part of the colon is used to make the stomy.
Ileostomy
A ileostomy is a surgically created opening that re-routes the lowest part of the small intestine (ileum) to the abdominal wall. This procedure takes place when a patient needs to have their large intestine removed and re-connection the the anus is not possible.
Urostomy
A Urostomy is a surgically created opening that re-routes urine from a non-functioning bladder. The bladder is typically bypassed or removed. The ureters are connected to a section of the small intestine called a conduit. The conduit is brought to the abdominal wall.
Types of Ostomy Construction
The three most common ways ostomies are constructed are known as the double barrel, loop ostomy, and end ostomy. The double barrel ostomy is created from two end stomas and has the openings close in proximity. One opening will yield stool while the other will yield mucous. The loop ostomy is formed when a loop of the intestine is brought through the abdominal wall and opened to reveal two ends. An end ostomy is when a single bowel is brought through the abdominal wall and stitched to the surface.
Ostomy Output
Ostomies will function differently based on the location they are brought to the surface. For example, a stoma using the ilium for an ileostomy will yield stool that is semi-liquid to liquid. The sigmoid colon on the other hand will yield solid feces. A general rule is the longer the stool can stay in the GI track, the more solid it will be.
The different locations are the ilium (Ileostomy) the cecum (Cecostomy), the ascending colon (Ascending Colostomy), the transverse colon, (Transverse Colostomy), the descending colon (Descending Colostomy), and the sigmoid colon (Sigmoidostomy)
Ascending Colostomy- The ascending colostomy is located on the right side of the abdomen. Since only a short portion of the colon is active, the discharge is very liquid in form and contains many digestive enzymes. This type of stoma is rarely used since an ileostomy is a better stoma when the discharge is liquid.
Transverse Colostomy- The transverse colon is located on the top of the abdomen and the stoma will be located either in the middle or towards the right side of the body. The two types of colostomies performed on the transverse colon are the loop transverse colostomy and the double-barrel transverse colostomy. This type of colostomy will allow stool to leave the body before it reaches the descending colon.
Descending Colostomy – The descending colon is located on the left side of the abdomen and is more preferable than the ascending and transverse colon. Most often, the output is firm and can be controlled.
Sigmoid Colostomy- The sigmoid colon is located a few inches below the descending colon and before the rectum. This is the most common and ideal type of colostomy as a long part of the colon is active and thus will yield a solid stool on a more regular schedule.
Temporary Versus Permanent Ostomy
The need for permanent ostomy surgery usually occurs when a patient has lost functioning of the colon and most commonly, the rectum. A temporary stoma is typically for those who have had complications in their lower colon and time is needed for healing. A stoma is surgically created and once the lower colon is healed, a person will resume bowel function through the anus. The most common type of temporary stoma is a transverse loop ostomy.
Types of Ileostomies
Ileostomy- The Ilium is the third and final part of the small intestine and communicated with the cecum. An ileostomy is when the ilium is brought the surface is often the large intestine is removed entirely. An ileostomy will yield a liquid stool as there is no active colon to absorb the moisture.
Ileoanal Reservoir or J-Pouch- A J-Pouch is a surgery that connects a pouch created from the small intestine in the shape of a J to the anus.
Continent Ileostomy (Kock Pouch) – a Kock Pouch is a reservoir created out of the terminal ileum with a valve mechanism at the abdominal wall. The reservoir acts as a controlled storage tank and the patient will empty the reservoir via catheterization on an average of three times a day.
Quick Facts
There are approximately 725,000 to 1,000,000 persons living with a stoma in the United States
More Information coming soon