Fewer people now leave hospital with a permanent colostomy than in the past. When a section of bowel is removed from the intestine the surgeon will aim to join the two ends of healthy tissue together. If this is not possible, a false opening (stoma) is made onto the outside of the abdominal wall to allow the passage of faeces (stools). The protruding piece of bowel is sewn to the surface skin forming a colostomy (large intestine) or ileostomy (small intestine).
Many stoma are created as temporary measures only, to give the intestine below the surgical site time to heal, and closed at a later date. A permanent colostomy is usually necessary only if the tumor was removed from the lower part of the rectum where extensive surgery is necessary to remove the cancer tumor completely.
The word stoma comes from a Greek word meaning ‘mouth’ or ‘opening’, ie colostomy means ‘opening in the colon’. The stoma looks like a small, puckered mouth-shaped opening. It is dark pink in color and is without feeling, despite it’s raw appearance. The siting of the opening depends largely on where the section of bowel is removed. Patients are encouraged to think beforehand how the position could affect their future activities, posture and clothing style. It is also important to be able to see it clearly to make bag changing easy. A stoma nurse always advises where to mark the site.
After food has been digested in the normal way, the waste matter (indigestible fibre and water) collects in the colon. When the waste material reaches the opening the stools are passed into a disposable bag attached to the skin with an adhesive rim. The bags are removed and emptied or destroyed as necessary. Whether a temporary or permanent stoma has been created, the procedure is the same. A range of bag designs is available in terms of size, fixing style, materials and emptying arrangements, and your stoma therapist will be able to help your relative find what will suit them best.
At first the waste matter is ejected randomly as it arrives at the stoma, but colostomy owners usually find that a regular pattern develops in much the same way as before. Stools that are passed through a stoma may be less formed than motions that would normally stay longer in the bowel, especially if the stoma is situated high up in the colon, but users need not be concerned, colostomy bags are strong and well designed for their purpose.
It takes a while to feel comfortable about dealing with a colostomy and adjusting to the changes in body appearance but every foreseeable aspect of living with a stoma is covered before leaving the ward. Permanent colostomy bag users soon enjoy a normal attitude towards life with almost total freedom of lifestyle, including sexual activity. Some people, who adopt the habit of flushing out their colostomy at a regular time each day, find they can reduce the times when they need to use a bag and after a while many people get to know which foods to avoid and which foods add bulk to the stool.