colostomy : Purpose, Procedure, Benefits and Side Effects

A colostomy is a surgical procedure in which a part of the large intestine (colon) is removed or bypassed and an opening (stoma) is made through the abdomen wall. Stool passes through the stoma into an attached pouch or bag, which collects the waste material.

• End sigmoid colostomy: This type of colostomy is used when the left side of the colon needs to be accessed. This type of stoma is located on the lower left side of the abdominal wall and allows stool to be passed through an opening in the skin into a collection bag.
• Ascending colostomy: An ascending colostomy involves placing an ostomy on the right side of the abdomen, where stool passes directly from the ascending colon that empties directly into a bag attached outside the body.
• Transverse colostomy: A transverse colostomy is created on either the right or the left side of the abdomen, where stool passes directly from a portion of transverse colon into a pouch attached externally to collect faeces
• Double-barreled colostomy: A double-barreled or “Loop” Colostomy involves creating two stomachs on each side of your abdominal wall. The loop acts like an intestinal bypass, allowing one part of your large intestine to temporarily rest while allowing normal elimination in another part without having to have a temporary colostomy take over all elimination duties for several weeks

• Improved quality of life: Patients with colostomy can enjoy a better quality of life as a result of the improved health and functioning.
• Reduced risk of infection: Colostomy can reduce the risk of infection in patients as compared to other forms of surgery.
• Improved control over stool: Colostomy provides patients with greater control over their stool, making it easier to manage bowel movements and reduce incontinence.
• Greater independence: With a colostomy, individuals have greater independence from needing to be close to a restroom at all times, which often improves their mobility and quality of life.
• Improved recovery time: Patients typically recover faster from colostomy than from other forms of surgery, allowing them to return to their regular activities sooner.

• To treat intestinal diseases or injuries such as bowel obstruction, diverticulitis, Crohn's disease, ulcerative colitis, and cancers of the intestine or rectum.
• To allow healing of the rectum and/or colon after surgery.
• To bypass an obstruction in the intestines.
• To stop bleeding in the intestines that cannot be controlled by other treatments.
• To give rest to an intestine that is too inflamed to function properly.

The main risks associated with colostomy (ostomy reversal) are:-

• Leakage of stoma: which can cause skin irritation and infections. Risk of having difficulty passing stool due to incorrect reconnection of the intestine or adhesions that may develop, which could require another surgery to correct.
• Anastomotic dehiscence: the rupture of the surgical connection between the two ends of the intestines can occur if there is too much tension on the reconnected section, resulting in leakage into the abdomen.
• Bowel obstruction caused by scar tissue or fibrous bands forming around the reconnected area, leading to difficulty passing stool or possibly requiring another procedure to correct it as well as lasting damage to your intestinal wall and surrounding organs.
• Possibility of herniation: when a section of bowel goes through an already narrowed opening it can cause further damage or infection in your intestines and other organs surrounding it.

• Talk to your Health Care Provider: Discuss any questions or concerns you may have, and make sure you understand the details of what will happen during the procedure and during your recovery period.
• Get Educated: Read up on colostomies, including any materials provided by your healthcare provider, books or online resources that provide more detailed information.
• Talk with a Colostomy Nurse: Many hospitals or medical offices have nurses who specialise in helping patients with preparing for their colostomies ahead of time. They can offer valuable advice about lifestyle changes that may need to be made for successful post-operative healing and recovery.
• Set up Home Preparations: Ready your home for visiting family and friends willing to help with daily activities (such as laundry and cooking). This will enable you to spend the most time possible out of bed when returning from the hospital or clinic where you had your surgery done.
• Eat Well Ahead of Time: Certain medications are designed to prepare patients ahead of time in order to reduce inflammation before colostomy procedures; eating well (including plenty of fruits and vegetables) prior to having this surgery emphasises those efforts further by aiding in overall body health at the same time!

• The patient is given a general anaesthetic.
• The surgeon will make an incision in the abdomen and locate the affected part of the colon that needs to be removed.
• The surgeon will then cut away the diseased part of the colon and prepare a new end for the remaining part of the colon that is healthy.
• The surgeon will then create an opening in the abdominal wall, called a stoma, where the end of the remaining colon can be brought through to empty into a colostomy bag outside of the body.
• The surgeon will then close up any remaining incisions in the abdomen and attach a drainage bag to collect waste from the stoma.
• Finally, once all stitches are secure and healing is underway, patients can start to adjust to life with a colostomy bag.

• Your doctor will explain the procedure and answer any questions you may have.
• You may need to stop taking certain medications before the procedure, such as anticoagulants or NSAIDs.
• You will likely be asked to empty your bladder before the procedure so the doctor can easily access your midsection.
• Wear comfortable, loose clothing to the hospital or doctor’s office for the procedure.
• Depending on arrangements, you may need to stay overnight at a hospital for monitoring afterwards and have someone take care of you at home afterward if necessary.

• Clean the patient's abdomen and groyne area and administer a sedative to relax the patient.
• An incision is made, usually in the lower right side of the abdomen, and further incisions are made to expose the colon.
• The damaged or diseased section of the colon is removed and then the end of the healthy colon is pulled out of the body creating a stoma.
• Necessary blood vessels are sealed off using surgical clips or sutures before the stoma is reconnected to the healthy part of the colon left in the body.
• A drain tube may be placed before closing incision to release any fluid that accumulates at site before reattaching two parts of colon and completing procedure.
• The abdominal area is then closed with sutures or staples and the surrounding skin is covered with sterile dressing or adhesive pad for protection from bacteria or dirt entering into wound site during healing period
• Patient's vital signs are monitored for drop in heart rate or breathing difficulty due to procedure induced stressors .
• Post procedure instructions such as emptying ostomy bag, proper dressing change as well as avoiding infection risk factors should be reviewed with patient upon leaving hospital

• Clean the area around the stoma with a mild soap and warm water.
• Apply stoma paste to protect skin from excretions.
• Secure the pouch around the stoma using adhesive strips, making sure there are no air leaks in order to avoid embarrassing odours or Skin Maceration
• Change pouch every -5 days or as soon as necessary depending on rate of drainage and seal integrity
• Rinse and disinfect ostomy appliance before disposing of correctly in an appropriate container
• Monitor the skin regularly for irritation, infection, or erosion.
• Examine your stool and/or output for signs of infection, blood in stool/output, changes in colour/consistency
• See your doctor regularly to have your stoma evaluated and receive other necessary care

The cost of colostomy in India can vary depending on several factors, including the type of surgery required, the hospital you choose to have the surgery done at, and other medical costs. However, generally speaking, the cost of a colostomy operation in India can range from anywhere between Rs. 0,000 and Rs. 1,00,000.

• After a colostomy, it is important to take some time to adjust and learn how best to care for your stoma.
• The primary goal of postoperative care is to ensure that the stoma remains healthy and functioning properly. Here are some important steps you can take to care for your stoma:
• Follow your doctor’s instructions for postoperative care, including any medications that may have been prescribed.
• Use a special pouch or bag over the stoma when bathing or swimming in order to keep water away from the opening of the wound; this will help prevent infection.
• Clean the area around your stoma with a mild soap and water solution several times a day in order to prevent skin irritation and maintain healthy skin around the area of your body where the colostomy was done.
• Make sure you are checking your pouch regularly - empty it when needed and change it according to your doctor’s instructions - also make sure you are not overfilling it so that it can remain functional properly; this will help avoid blockages in your digestive tract from building up fluids or solids near Othethe Stone Area.
• Eat a balanced diet which includes foods high in fibre and drink plenty of fluids in order to help control stool consistency as well as maintain adequate hydration levels in order for proper digestion; if necessary - consult with a nutritionist if needed to tailor diet towards specific needs related post-colostomy operation has caused by lifestyle changes may need altered dieting plan specially designed for such cases .
• Monitor any signs of infection such as redness, swelling, fever, pain, or drainage near the incision site; notify your primary care provider immediately if any of these symptoms occur so they can determine an appropriate course of treatment .
• Stay active when able by slowly increasing exercise at home or through physical therapy sessions as recommended by doctor - having regular physical activity can not only improve overall health but also helps speed up recovery process after undergoing colostomy procedure .

Many people with a colostomy can enjoy a wide variety of foods, including healthy grains and legumes, fruits and vegetables, lean meats and fish, dairy products, nuts and seeds.

Eating high-fibre foods such as whole-grain breads, bran cereals and oatmeal is important for those who have had colostomy surgery to help maintain regularity.

Drinking plenty of fluids — particularly water — also helps maintain bowel function. While some individuals may need to limit certain types of food in their diet due to factors such as blockages or sensitivities to particular ingredients, this is not always the case.

No, colostomy is not generally painful. However, it may cause some discomfort due to the surgical procedure used to create the stoma. Talking to your doctor about what you can do to manage any postoperative pain is advisable.

The length of time it takes to recover from a colostomy depends on several factors, including the type of procedure that was done and the underlying health condition.

Generally, patients can expect to be released from the hospital after about two weeks and return to normal activities within about four to six weeks of their procedure.However, this could be longer depending on individual circumstances.

• The possible side effects of colostomy include:
• Abdominal discomfort, cramping, and bloating caused by gas buildup
• Diarrhoea or constipation are also seen.
• Skin irritation or infection around the stoma (the opening in your abdomen where the colostomy bag is attached)
• Excess water loss (dehydration) from liquid stool that is not being reabsorbed by the colon
• Difficulty controlling bowel movements and wearability issues caused by the colostomy bag
• Low vitamin D and calcium levels as a result of limited absorption of these nutrients when passing through the small intestine.

• Change bags and/or liners 1- times per week or according to the doctor's instructions.
• Keep the skin around the stoma clean, dry and free from infection by washing gently with mild soap and water daily.
• Have regular follow-up appointments with your medical team to check for any problems related to your colostomy.
• Monitor your stoma output (amount of drainage) regularly and notify your healthcare team if there is a sudden change in output or colour of output
• Make sure you are receiving enough nutrition and fluids, as these can impact the volume of output from your stoma
• Make sure to follow any additional instructions provided by your healthcare team

Colostomy can be a life-saving procedure that allows patients to experience improved comfort, mobility and quality of life. It also helps to reduce or eliminate digestive symptoms associated with certain medical conditions. While there is a risk of serious complications, with proper care and follow up these risks can be minimised.

Ultimately, for those who are considering a colostomy, it is important to consult with your doctor about the risks and benefits of this procedure in order to make an informed decision about how best to treat your condition.