Colostomy

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.

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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.