Colostomy

Definition:
A colostomy is a surgical procedure where an artificial opening is made in the abdominal wall through which the colon is brought out. This procedure is done in certain colon diseases.
The reason for this is to remove the faeces through the colostomy opening; it is collected in a colostomy bag.
Colostomy can be either:
Permanent: In certain colon disease.
Temporary: until colon heals from certain procedures.
Reasons for colostomy;
The colon is the large intestine which is connected to small intestine, its basic function is to absorb water and certain fatty acids and then turn the remaining undigested food into faeces. During certain conditions which affects the colon it is necessary for the colon to rest in such condition to divert the materials away from colon colostomy is performed.
The conditions that affect colon are inflammatory disease of the bowel, colon cancer, bowel obstruction, bowel infarction, injury to abdomen, neurological problems affecting the muscles of colon which results in loss of muscular movements of the colon, rectal cancer, bowel defect since birth and tumours of the lower part of digestive tract.
How is it done,
In any of the above said condition which requires removal of a piece of colon, colostomy is performed. During the operation where the piece of colon is removed the upper cut end of the colon is brought out to the surface through the skin, by a small incision in the skin of abdomen. The uppercut end is levelled and stitched to the skin of the abdomen.
The lower cut end of the colon is usually stitched inside or in rare cases is brought out through another incision through the stomach skin.
The openings are called as stoma. Through these stoma the faces comes out and is collected through a special water proof bag, usually made up of hydro colloid. The bag sticks to the opening of the stoma without any requirement of the adhesive tape, and the bag needs to be cleaned twice daily.
In temporary colostomy the cut end of the colons are joined usually after 8-12 weeks , with the recent advancement in the field of surgery it is easier to rejoin the colostomies even after loss of a segment of colon.
The cut wound in the skin of the abdomen is closed which is usually leave a small scar, use of linear and circular staples are common now a days in order to rejoin the cut end of colons.
Post operation recovery:
As in any operation, pain is the common symptom felt immediately after post op. Pain killers will be prescribed usually IV to reduce the pain. Usually pt will be fed intravenously for 3-4 days till normal bowel movement resumes.
Certain steps that are followed;
To wash the hands before changing the bag
To clean the skin around the stoma with betadine in order to prevent skin infection.
Specific diet should be followed in order to avoid indigestion or hardened stools.
If there is pain, or bleeding through the stoma a doctor should be consulted immediately