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.

• 
  

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.

How To Empty and Clean An Ostomy Pouch

Let’s face it - everyone who has ever had to wear an ostomy pouch in the history of the world absolutely hates it when it is time to change the bag. Talk about bad smelling and gross looking output! Changing the ostomy pouch is probably the most frustrating part of having to wear an ostomy pouch, even more so than trying to hide it to prevent people from noticing that you have a stoma. To make things worse, it is actually quite difficult to get the hang of changing an ostomy pouch at first, so people who are new to the life of ostomy may struggle quite a bit at first.

It is honestly one of the most disgusting things that you can do. My girlfriend is a nursing student right now at the college we go to, and during one of her clinical rotations she had to change some overweight guys’ ostomy pouches and clean his stoma - she said it was probably one of the most disgusting things that she has ever done and it smelled awful. She said it took all of her strength to stay in the room and not gag while she changed the pouch and cleaned the stoma. That being said, there are some things about changing an ostomy pouch that make it a lot easier compared to what the novice methods contain, so I wanted to come on here and talk for a little bit about how to properly empty and clean an ostomy pouch.

So the first thing that you are going to have to do when you go to change the ostomy pouch is find a good place to do it. Obviously, (and I think most people know this, but I want to just make sure) you are going to need to find a private place to change out the pouch. Believe it or not, most normal people do not want to witness you removing your ostomy pouch and wathcing your stoma leak output everywhere onto the floor of the mall food court. That being said, being next to a toilet is the best place to be when you go to change your ostomy pouch.

You can either stand over the toilet or try to sit on it, whatever works best for you. However, it is worth mentioning that your stoma will likely leak output at some point while you are changing the ostomy pouch. Keep in mind also that it is going to smell absolutely awful to change out your ostomy pouch, so you may want to make sure that no one else is around so that you don’t make anyone lose their lunch or something like that. 

Most drainable ostomy pouches open up from the bottom of the pouch, so while you are leaning over the toilet you can just open that sucker up and let fly with all your contents from the past few hours or whatever. Keep in mind that the toilet water may splash up and onto your exposed abdomen while you are draining your ostomy pouch, so it might be a good idea to put some toilet paper down to prevent too much splashing. All this being said, this was probably one of the grosser articles that I have had to write and I wish that I didn’t have to know any of this information about ostomy.