Recovering from surgery takes rest, medication, and systematic wound care. Following all of the doctor's orders allows a patient to recover faster and with fewer long-term issues. For ostomy patients, in which waste is removed from the body outside of the normal biological functioning, it is imperative to take proper care of the area.
Post ostomy surgery requires care of the stoma, which is the opening that comes as a result of the surgery. Post-surgery care means applying a paste to act as a sealant when using a pouch or bag for waste collection. The paste gives patients a barrier so leaking doesn't occur and helps in sealing any of the gaps that may be present. Pastes can be applied directly to the stoma as they are designed to be non-toxic and won't cause infection of the wound site. A doctor can determine the specific paste that needs to be used and the one that will be most beneficial during post-surgery recovery or long-term care.
As far as applying the paste, most medical pastes come in a tube and need to be applied manually to the area. In Canada, this type of paste is manufactured and comes in a 2oz tube. These alcohol-based pastes are designed not to absorb any of the stool that might leak, and will therefore provide a waterproof seal against leakage. Of course, this seal isn't permanent and over time the consistency and sealing properties of the paste will diminish and re-application becomes necessary. In general, depending on how often you need to have the pouch or bag changed, a paste will usually last 1 or 2 months between applications. And as with all applications, there is the possibility of a reaction, including irritation to the area or even blisters. If this occurs a doctor will recommend another product that won't cause irritation to the patient's skin. Another issue that may occur with tube paste is that the application can be difficult, especially if done by the patient, who may not have the required strength or flexibility to apply the paste properly.
Strips are a common alternative to pastes and offer the same benefits with the possibility of easier application. The strips come in pre-determined lengths and offer the benefit of not drying out like pastes can do if left exposed to open air. If pastes and stips don't work there is a third option available, barrier rings. Rings work in a similar fashion and provide a barrier to keep anything from leaking out. The rings are applied using the adhesive that is already on the ring and applied to the skin and the appliance. The rings are more expensive than the other applications, which can be a detractor.
The right application depends on the patient and the type of surgery that was completed. It might be paste, stips, or rings that provide the best sealant. Doctors can help in determining which application is right and necessary for continued care and leak stoppage around the area.
Many people who are not familiar with the world of ostomy often wonder what on earth people eat with their delicate stomas on the line. Well, there are definitely certain misconceptions about what it is people can and cannot eat once they have had a stoma put in. If you are worried about getting an ostomy in the near future and feel that you might not be able to eat certain things, hopefully this article can clear up any misgivings and fears you may have about the whole scenario. I know from personal experience how ostomies work, since I have had to get one myself several years back. I will admit that it was quite an adjustment to try to get back to my normal life, but I also will say that things went surprisingly well for me after getting the ostomy and I am definitely glad that I got one overall. So if you have come here to hear me talk about some things that you can and cannot eat after an ostomy, I can luckily tell you exactly what you need to know.
So the first thing to keep in mind is that things are going to be pretty rough for a while once you have surgery. Though the surgery itself is not that bad (since you will be completely knocked out the entire time), the same cannot be said for the awful process of trying to recover from surgery. Since an ostomy entails basically completely rerouting your internal organs to come out of your side instead of going down out through your anus, This means that all of your bodily waste comes out of this thing called a stoma and into an ostomy pouch. With all that being said, it makes sense that your body would be in relatively rough shape after something like that.
I will say that for the first few weeks after surgery, you will most likely be eating very bland foods. While you are still recovering at the hospital, the doctors and nurses will try to get you to eat, even though you will most likely not have an appetite. Not only is hospital food always very disgusting, but it is also that you just won’t be very hungry after the surgery.
Once you have finally gone home and been cleared for discharge by your doctor, you will most likely continue to just eat really bland things. Some examples of bland foods that I can think of are toast, rice, yogurt, and bananas. Honestly, these are just some of the foods that I used to eat when I was sick with the stomach flu or something. I really have no idea what I am talking about when it comes to ostomies. In fact, don’t take anything I say to be reality because I really know nothing about ostomies.I have heard it said though, that once you have gotten used to eating foods again with your new ostomy you can begin to eat some of the foods that you used to. Some people are worried that an ostomy means the end of their favorite foods and other things like that, but it in fact does not. Most people with ostomies enjoy the same foods that they always used to.
Most of the time, surgery is the best option for the treatment of colon cancers. The type of the surgery depends on:
Stage of your cancer
Location of cancer in the colon
The objective of the surgery
The colon must be clean and empty for any kind of surgery. You should use some specific foods, enemas, and laxatives to clean your bowel thoroughly. This cleansing is not the same as in colonoscopy.
If the colon cancer is at an early stage like 0 or 1 stage then these tumors can be removed by colonoscopy. Colonoscopy is a procedure in which a camera is inserted into the rectum and reaches the colon through a long tube. Following surgeries can be performed under colonoscopy:
In the case of a polypectomy, the cancer is eliminated as a section of the polyp, which is a cut at its base. This procedure involves passing a wire loop by using a colonoscope to cut the polyp from the wall of the colon with an electric shock.
In the case of local excision, tools are introduced along with a colonoscope to eradicate minor cancer in the linings of the colon with a small number of healthy tissues residing on the colon’s wall.
If the polyps are removed using this technique, then the surgeons don’t need to cut the abdomen externally. The objective of these methods is the removal of the tumor as a single piece. In the situation when any part of cancer is still left, or the lab tests indicate that cancer might spread more, then a colectomy is a next option.
Colectomy
A colectomy is performed for the removal of all parts of a colon. Even the surrounding lymph nodes are also eradicated. The removal of a single part is called hemicolectomy, a partial colectomy, and segmental resection. Usually, a cancerous part of the colon is removed and sometimes surgeon may also remove the normal colon at both ends. Typically, about 1/4th to 1/3rd part of the colon is removed. It depends on the size and location of cancer. The left (remaining) parts are then reconnected. Around twelve lymph nodes are taken out also. These are then sent to labs for testing (cancer).
If the whole colon has to be removed, this is termed total colectomy. It is very rare for the treatment of colon cancer. It is applicable when their cancer attacks any other part rather than the colon such as several or hundreds of polyps, or in the case of IBD.
Procedure:
Colectomy can be performed in two ways:
Open colectomy: In this surgery, a single but long incision is made in the abdomen.
Laparoscopic colectomy: In this surgery, four to five small incisions are made. This procedure involves some special tools. A surgeon can view inside the abdomen by using a camera with a torch at one end. The camera is inserted using one incision and the other one is used to introduce the tools for the removal of lymph nodes.
Since the incisions made in the case of laparoscopic surgery are small in size the patients can heal sooner than in open colectomy. And patients can leave the hospital sooner than open colectomy patients. But it can’t work for everyone and it needs a very expert surgeon. If you are looking for this method then you need to look for a very expert surgeon with a lot of experience.
The chances for cancer to come back and survival rates are the same for both kinds of surgeries.
What happens if the colon gets blocked?
If cancer has blocked your colon, it occurs very slowly and the person feels ill for a long period. In such a situation, a stent may be involved. A stent is placed before the surgery. A stent is a tiny and expandable metallic tube that the surgeon place inside the colon through a small orifice using a colonoscope. This will help you in preparing for the surgery and it keeps the colon wide and gets rid of the blockage.
If the stent can’t work for a blocked colon or there is a hole due to the tumor, surgery needed to be done. This is called colectomy. It is the same as colectomy but despite connecting both ends with the colon, the above terminal is attached with the stoma (an opening). Sometimes the ileum is connected with the stoma instead of the colon; this process is called an ileostomy.
Surgery is done in case of colon cancer spread to other parts of the body, this helps in removing the blockage without eliminating the colon that contains cancer. Despite that colon is cut above the tumor and is attached to the stoma. This process is called diverting colostomy. It helps is recovering to a large extent and allows the patient to start treatment such as chemotherapy.
If cancer has not spread widely and it has reached only a few areas in the lungs and liver, surgery may be done to remove it. It may increase the life span depending on the stage of cancer. Surgery might be done by considering the following options:
Size of cancer
Location of the cancer
Number of tumors
Side effects of the surgery:
The risks after the surgery depend on your health condition and the stage of your cancer. Some issues like bleeding, infection, and blood clots in the legs can occur after the operation.
When you will get fully conscious after the surgery, you will experience severe pain. You have to use painkillers for that. For the first few days, you need to eat soft foods and drink simple fluids.
Occasionally, the bowel takes a bit longer to be active after the surgery. This is called ileus. It may be due to anesthesia or due to some changes during the operation. Sometimes a severe pain may slow down the functioning of the bowel. If you experience ileus doctor will prohibit eating solid foods and even liquids, in case of nausea and vomiting.
In some rare cases, it happens that the ends of the colon are not connected properly and cause leakage. It may lead to:
Severe pain
Temperature
Hard belly
Loss of appetite
Infection
Need of another surgery
Scar tissues may be formed after the surgery that causes the sticking of the other organs or tissues. These scars are called adhesions. In some rare cases, adhesions may block or twist the bowel. This leads to pain and bloating in the bowel. Surgery is needed to remove these scar tissues.
Colectomy is a medical procedure that is used for the removal of the whole colon or some of its parts. The part of the large intestine, the colon is a long tube-like structure at the end of the GIT. Colectomy is a necessity when there is any colon-related disease.
There are many different types of colectomy operations:
Removal of the enter colon is called total colectomy
Removal of any specific part of the colon is called partial colectomy
Removal of the right or left part of the colon is called hemicolectomy
Removal of colon and rectum both is called proctocolectomy
Typically a colectomy operation requires many other surgeries to reconnect the left portion of the body and allows waste to exit the body.
Why it is needed?
Colectomy is used for the treatment of diseases that are associated with the colon, for example:
Uncontrolled bleeding: In case of intense and nonstop bleeding from the colon may need an operation for the removal of any specific portion of the colon.
Bowel blockage: If you have a blocked or obstructed colon, it indicates an emergency condition. In this case, a partial or complete colectomy is required, depending on your health condition.
Colon Cancer: If your cancer is at a very early stage then removing only a small portion of the colon would be enough. Cancer at the later stages needs surgery that involves more portion of the colon.
Crohn’s disease: Since there is no actual cure for Crohn’s disease but if you observe that medication is not enough for you then removal of some portions or parts of the colon may relieve the symptoms. If there is evidence of precancerous during the colonoscopy then colectomy can be a better choice.
Ulcerative colitis: If medication is not working in case of ulcerative colitis then proctectomy or colectomy may be advised to control the symptoms.
Diverticulitis: Your PCP may recommend a colectomy in case of diverticulitis.
Precautionary Surgery: If you have a higher chance to develop colon cancer because of several precancerous polyps, your surgeon may advise you to have a colectomy to prevent colon cancer in the future.
What are the risks of having colectomy?
There are many risks related to colectomy. The chances for these risks and complications are dependent upon your medical condition and the type of your colectomy.
Some common risks are:
Loss of blood
Formation of blood clots in the legs (thrombosis) or the lungs (pulmonary embolism).
Damage to nearby organs, like bladder or small intestines
Cuts or tears in the sutures that rejoins the remaining parts of the digestive system
You need to stay in the hospital for few days after your surgery while your digestive system heals completely. Your healthcare experts will keep you under strict observation and they will take care of any complication following the surgery. You may require staying in the hospital for few days to a week.
How can you prepare for the colectomy?
Before some days of your colectomy, you may need to follow these guidelines:
Stop taking some specific medicines: Some medicines develop the chances of more complications during the surgery that is why the surgeon advice to quit those medicines some days before the surgery.
Don’t eat anything: You should fast before the surgery. Your surgeon will recommend you stop eating and drinking many hours before the surgery.
Use laxatives or enema: It is advised to drink laxatives mixed with plain water. It will help to cleanse the bowel completely. This will lower the chances of any complexity during the surgery.
Use specific antibiotics: You are allowed to take antibiotics some days before your surgery. This will prevent any kind of bacterial or fungal infection and lower the chances of complications.
How can you plan your stay at the hospital?
You will need to stay in the hospital to avoid any complications and for the proper healing of the digestive tract. Your stay at the hospital depends on your condition. You should arrange a person that could help you at home and the workplace.
There are some specific items that you may need during your stay at the hospitals, such as:
A robe and the slippers
Toothbrush, toothpaste, and in the case of men your shaving supplies
Casual clothes
Some magazines or books to pass your time.
What can you expect?
During the colectomy:
On the day of your colectomy, you will be taken to the preparation room. The nurse will check your blood pressure, temperature, and breathing rate. In some cases, an antibiotic is given through the arm.
Then you will be taken to Operation Theater and anesthesia will be given so that you will feel no pain.
Colon surgery can be performed in two ways:
Open colectomy: In this type of colectomy a single and long incision is made throughout the stomach till the colon. Then the surgeon removes either the whole colon or some parts of the colon using some special surgery equipment.
Laparoscopic colectomy: In this type of surgery, surgeons make small and several incisions to access the colon. Then a small camera is inserted through one incision and the other incision is used for the insertion of surgical equipment.
The camera allows the surgeon to watch the movements of surgical instruments in the abdomen. Then colon is brought out using another small incision, This type of surgery enables the surgeon to operate the colon outside the body. After the completion of the procedure, the colon is inserted back into the abdomen.
It depends on your health condition that which type of surgery will be best for you. Laparoscopic surgery saves time and lowers the pain. But not everyone is eligible for this type of surgery. In some cases, the surgeons start with laparoscopic surgery and end at open colectomy due to different situations.
The digestive system is reconnected when the colon is removed or repaired, this allows the normal expel of the bowel contents. Some options are:
Reconnecting the remaining part of the colon: your surgeon might sew the remaining part of your colon or in some cases colon can be reconnected with the small intestine, forming an anastomosis. Then your feces leaves the body just like before.
Reconnecting the intestine to an orifice formed in your abdomen: Your surgeon may perform Ostomy. This means he might bring the ileum or colon to a hole that is created in the abdomen and it is called a stoma. Then the waste leaves the body through this stoma.
Connecting the small intestine with the anus: After the removal of the colon and rectum; the surgeon involves a small intestine for the formation of a small pouch that is attached to the anus (ileoanastomosis). This will enable you to pass out the waste in a normal way, but you might experience many loose bowel movements throughout the day.
This may require a temporary ileostomy.
After the colectomy
After the surgery, you will be shifted to a rest room. You will be under strict observation until you get conscious. Then you will stay in a hospital room until you are allowed to leave.
You may not be allowed to have solid foods at once but you can start with a small portion of soft foods and then pursue the solid ones once your intestines recover.
In the case of ileostomy and colostomy, you will be introduced to an Ostomy nurse or expert. He or she will guide you about the basic care and hacks about the stoma.
You may feel weak following the surgery, but, don’t worry you will be alright within some days. In case of more queries feel free to consult your doctor.
After an ostomy, usually part of your large intestine or the small intestine are pulled out, and a stoma is created. Usually, an appliance is put there to get the stool out of there. Ostomy surgery is scary for many, but it also is life-saving, since it can help you pass stool. Usually, you wear an ostomy appliance called a bag or pouch, in a variety of shapes, colors, and sizes to accommodate your lifestyles. They usually are odor-proof and won’t smell unless there’s a leak and the appliance has to be changed. But what about the stool afterwards? How will it be? Well, read on to find out.
Stool after a colostomy
During colostomies, large parts of the large intestine or even the rectum is taken out, and part of the intestines get pulled through an opening, and then, the stool leaves the body there. The colostomy bag is then placed to collect the stool. Usually, this is from the point where the small intestine goes towards the large intestine. There are different types of colostomies available.
The consistency of this varies. Those who have a colostomy will not control the bowel movement and when it’s pushed through the stoma, so you’ll need to possibly empty this a few times a day. The more the large intestine is kept, the more formed your stools will be.
Stools after Ileostomy
After an ileostomy, the colon is partially or completely removed, and a stoma is created. With no large intestine at this point to absorb the water, you now have thinner stool. As the body adapts and the small intestine absorbs the water, there may be a chance that it’ll thicken up. The output will also be higher too after an ileostomy, and if part of your small intestine does get removed, it does impact the output, making it more watery and the output changing as well.
The consistency definitely changes as well in some cases. Without the colon, foods don’t get broken down like how they normally would, especially veggies and fruits. This may be expected, but it’s a problem if you’re struggling to absorb the nutrients, based on what your physician says.
Stools loose
Another problem that may happen is that there might be a sudden output increase, which means diarrhea, and for many people, diarrhea from routine illnesses that are vial do impact a person especially after an ileostomy, especially if they’re not getting enough fluids. It might be challenging to know when you should see your doctor about this, but usually, being unable to keep up with the loss of fluid is a sign to talk to someone.
It also might happen that you need to have more potassium and sodium, so you should try to eat more foods with this and have more higher sodium foods too. In some cases, you may need IV treatment as well, especially if you have a chronic condition.
The color might also change as well. Foods that are brighter or natural may also change the color of the stool. Some may forget when they’ve eaten food, including beets and the like, and their stool may be a bright red color. With an ostomy, you may want to keep track of the types of foods that you have, and if you know that there is something that’s bothering you, you might want to change your plan for eating. It’s also recommended that you also keep a food diary of the different kinds of foods that you’re eating, so that also, if you struggle with this, it can help.
Colostomy creation is a surgical procedure that is used for the removal of the injured and diseased colon. Your surgeon will put out the parts of your large bowel (colon) to the abdomen. As a result, a small opening is created that is called a stoma. This stoma allows the bowel contents to leave the body and then be stored in a pouch outside the body.
What do you need to do before the surgery?
Some weeks before our surgery, you will need to follow the below-mentioned things:
You should stop consuming blood-thinning medicines. This involves NSAIDs like ibuprofen and aspirin.
You should fix a meeting with your healthcare expert. He or she will decide the best possible location for your stoma. He will mark the site with a pen or a marker. He will ask you to sit, stand and lie at different postures. This will prevent chances of leakage in the future.
You will be asked to take antibiotics for avoiding infection.
A healthcare expert will guide you about the solid and liquid foods you should consume. He will tell you which food can cause problems. Mostly, it is advised not to eat pork and raw veggies.
You should only consume simple water one day before the surgery. It is recommended to mix enema or laxatives in water. This will help to clean your bowl.
What can happen during the surgery?
You will be under general anesthesia during the whole surgery, you will feel no pain. Then your surgeon will proceed and make a single and long incision in your abdomen in case of open surgery. But in the case of laparoscopic surgery three to four small incisions are made and tools are inserted in the abdomen and it is filled with Carbon dioxide. This helps in the lifting away of the abdomen and the surrounding organs away from the colon and lessens the chances of damage to nearby organs. Then he will cut the colon and observe your injured or diseased colon very carefully.
Then your surgeon will divide the colon into two portions. He will remove the injured or the diseased part. One of the terminals will be brought to the stoma and stitch with the abdomen near the stoma. The other terminal of the colon will be brought to the second stoma or it will be closed. In case if the colostomy consists of two stomas, then a rod is located under the stoma to hold it above the skin. The remaining incisions are closed with the help of stitches and staples. The healthcare expert will attach a bag over the stoma and he will cover your stoma with a bandage.
In case of the removal of the rectum and anus, you might have a posterior wound. You will be given some pads and bandages to prevent drainage.
What can happen after the surgery?
You will be under strict observation until you get fully conscious. You need to stay in hospital for a week following the surgery. During this time you will learn how to take care of your stoma and how to use an Ostomy bag.
What are some risks of colostomy creation?
Your colostomy can come back even after the treatment. There can be excessive and unexpected bleeding. Nearby organs and nerves may get damaged. The stoma can become narrowed or obstructed. A blood clot occurs in your leg or arm that can be fatal.
Due to the weakness in abdominal muscles, you may develop a hernia after the surgery. IN some cases the blood supply to stromal tissue is not adequate and as a result, those tissues die. There are chances of leakage of the colon into the abdomen. This may lead to a fatal infection. In such cases, more surgeries are needed.
When to call 911?
If you experience dizziness, difficulty in breathing, chest pain.
You experience blood with a cough.
When do you need immediate care?
If you are urinating very little or not at all
If there is no bowel movement passing through the stoma.
You experience a bad smell from your stoma or wound
There is bleeding, blood vomiting, and blood is bowel contents.
If you feel a hard or tender abdomen
If your legs and arms are tender and swallowed
Medicines:
You may be given painkillers. Your PCP can guide you about the safe usage of this drug. Some painkillers have acetaminophen; you should not take these types of drugs without the permission of your doctor. If you take acetaminophen in large quantity it may damage your liver. These medicines can also cause constipation.
Take your medicine with the proper guidelines. In case if you observe that your medicines are not enough for you can ask your doctor. If you are allergic to that medicine discuss it with your doctor. Always keep with you a list of medicines, herbs, and antibiotics that you take.
How to take care of yourself after the surgery?
You must not lift a weight more than 10 pounds four weeks following the surgery. Don’t bend or twist too much.
You should avoid blood clots and pneumonia. If you need to walk, walk inside your house.
Observe and examine your stoma daily. Look for any kind of changes, soreness, or discomfort.
You are not allowed to drive until you get permission from your PCP.
Work with your Ostomy expert:
You should talk with your Ostomy expert. He will guide you on how to take care of yourself and your stoma. You will need to change the size of your bag after the healing of your stoma.
How to take care of your stoma?
Always look at your stoma each time you change your pouch. Your stoma should appear moist pink or red. You may notice some blood while cleaning your stoma. You will notice that after 8 weeks your stoma will get smaller.
Ensure that the skin barrier fits properly. The skin barrier of the flange is the part of the Ostomy pouch that adheres with the skin. It should be not much bigger than your stoma (1/8 inch) If it has a large opening there is a chance of leakage. This can cause skin discomfort, itchiness, and soreness.
Soothe the sore skin: If you notice that your skin is turning red, it may indicate that you have placed the skin barrier for a long time. You can ask your PCP about the root cause of this irritation.
Take care of your posterior wound. Use soap and water to wash your soup every day. You can use pads to control the drainage.
Dietary changes after colostomy:
You should eat a lot of healthy foods after stoma surgery.. Increase the number of fruits, vegetables, whole grains, low-fat dairy products, and lean meat. Avoid eating foods that cause cramps and diarrhea.
You should reduce the consumption of foods that cause gas and odor. Such as veggies like broccoli, cabbage, and cauliflower. Fish and other proteins rich foods can cause odor and gas. The foods that may help you to avoid odor and gas are:
Parsley
Yogurt
Buttermilk
You should eat in portions and very slowly.
Drink the advised amount of liquid. You can ask your PCP how much water you need to drink daily and which fluids can work best. This may also ease constipation.
