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Colostomy Surgery Procedure Definition
Colostomy is a surgically created opening (stoma) through the abdominal wall through which the COLON passes fecal matter, typically accompanying surgery to remove a diseased segment of the colon.
Though there are numerous medical reasons for colostomy, among the most common are COLORECTAL CANCER, traumatic injury, and severe INFLAMMATORY BOWEL DISEASE (IBD). A colostomy may be temporary when a period of nonactivity will help the colon recover from INFECTION or inflammatory damage or during the stages of reconstructive surgery. A colostomy is likely to be permanent when the surgeon must remove large segments of bowel.
The OPERATION is a major surgery done under general anesthetic. Typically the person enters the hospital the night before the scheduled OPERATION to complete the preparations for surgery, which usually include LAXATIVES and enemas to thoroughly cleanse the colon. The length of the operation depends on the extent of the procedures. The surgeon attempts to locate the colostomy in the lower abdomen when possible, though may place a temporary colostomy in the upper abdomen to rest the lower segments of the colon.
Most people remain in the hospital for five to seven days, during which time an ostomy-care specialist provides education and instruction about colostomy care. HEALING after surgery takes about six to eight weeks. Diligent WOUND CARE during this period is essential to reduce the risk for infection and irritation and to help the stoma heal properly.
A small plastic bag, sealed against the SKIN with adhesive around the opening (stoma), collects fecal matter that exits the colon through the colostomy. It is important to empty or change the colostomy bag frequently and regularly and to cleanse the skin around the stoma with each changing to minimize irritation from the adhesive and from fecal matter. Frequent bag changes also reduce odor, as do deodorizing tablets that go into the ostomy bag. Over time, most people find that certain foods (such as meats and many processed foods) are more likely than others to cause odor or irritation and can avoid eating them to further reduce odor.
Concerns about how having a colostomy will change appearance and daily living activities are natural and common. A colostomy significantly alters the body’s structure and excretory function, which many people find challenging. An ostomycare specialist can provide information and suggestions to smooth the adjustment. Most people find they are able to return to their regular activities when the stoma fully heals. The colostomy should not interfere with clothing, exercise, lifting and carrying, and most other daily activities.
The effect of colostomy on sexuality is a major concern for most people. A risk of surgery on the colon is damage to the nerves that supply the perineal area, which can result in altered sensations in men and women and ERECTILE DYSFUNCTION in men. Some people feel self-conscious or embarrassed about having a colostomy. However, many people who have colostomies can return to regular sexual activity as soon as they feel the desire to do so. A special cap can cover the stoma during sex. Having SEXUAL INTERCOURSE or ORGASM does not cause any harm to the colostomy or adversely affect the underlying condition in most circumstances. It is important for partners to discuss their concerns and feelings openly and honestly so they can maintain intimacy within their relationships.