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What Is a Colostomy?During a colostomy, part of the colon (large intestine) is removed or disconnected. If the large intestine was diseased, it may be removed. If it was injured, it may be disconnected for a short time while it heals, then reconnected after a certain period of time. During a colostomy, the colon is brought through the abdominal wall. This makes an opening, called a stoma, for stool and mucus to pass out of the body. You will have special appliances to cover the stoma to collect the stool and to eliminate odor. Types of colostomiesThe type of colostomy you have depends on what part of the colon is removed or disconnected. The most common types of colostomies are: Sigmoid colostomyHere is what to expect with a sigmoid colostomy:
Descending colostomyHere is what to expect with a descending colostomy:
Transverse colostomyHere is what to expect with a transverse colostomy:
Types of stomasThe stoma is created by bringing the colon through the abdominal wall and turning it back on itself, like a cuff. The stoma is pink and moist, like the inside of the mouth. It shrinks to its final size 6 or 8 weeks after surgery. The kind of stoma you have depends on your surgery. The most common types are: An end stoma. This is, most often done for a permanent colostomy. Stool and mucus pass from the same opening. If the anus is not removed, mucus passes from it as well, like you might see in the stool of a normal bowel movement . A loop stoma . This is most often done for a temporary colostomy. Stool passes from one side of the stoma. Mucus passes from the other. The anus is most often not removed, so mucus passes from it, too. Two stomas. This may be done for a temporary or permanent colostomy. Stool passes from one stoma. Mucus passes from the other. If the anus is not removed, mucus passes from it as well. StayWell last reviewed this educational content on 6/1/2019 © 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions. This information will help you care for your ileostomy or colostomy. An ostomy is an opening created during surgery. A piece of your intestine is brought to the outside of your abdomen (belly) so that bowel movements (stool) and gas can exit your body. The part of your intestine that’s on the outside of your body is called a stoma. Your stoma will look red and moist, like the inside of your mouth. Your stoma will be swollen right after surgery, but the size will decrease in 6 to 8 weeks. You usually don’t feel pain or pressure within your stoma. Your stoma does not have the nerve endings and cannot feel sensations of heat or cold. Having an ostomy is a big change for most people. We have written this resource with the help of people who have an ostomy. We hope it will help prevent problems and give you tips that can make your daily life easier. Your wound, ostomy, continence (WOC) nurse will go over most of this information with you. Back to topTypes of OstomiesAn ostomy can be made out of the small intestine or colon (large intestine). When a piece of the small intestine is used to create an ostomy, it’s called an ileostomy. When a piece of the colon is used to create an ostomy, it’s called a colostomy. The consistency of your bowel movements from your ostomy will depend on the part of your intestine that’s used to create the ostomy. Your bowel movements may be liquid, soft, or solid. The most common types of ostomies are: Ileostomy
Ascending colostomy
Descending colostomy
Sigmoid colostomy
Loop ostomy
In some surgeries, a second opening is created on the abdomen called a mucous fistula. It drains left over stool (poop) or a mucus-like fluid and leads to the rectum. If you have a mucous fistula, your WOC nurse will teach you how to care for it while you’re in the hospital. Usually, a small pouch (bag) or dressing is placed over the mucous fistula. The pouch may need to be emptied throughout the day. Once the drainage decreases, the mucus fistula can be covered with gauze and tape, band aid, or a special mucus fistula bandage. Back to topLearning to Care for Your OstomyYour WOC nurse and nursing staff will teach you how to care for your stoma and ostomy while you’re in the hospital. When you’re discharged from the hospital, you’ll be given the basic supplies you need to care for your ostomy. During your post-operative appointment, a WOC nurse will re-evaluate your ostomy supplies and will show you how to order them. There’s a list of medical suppliers at the end of this resource. Your case manager in the hospital will also arrange for a visiting nurse to come to your home after you’re discharged from the hospital. They will reinforce the information on how to care for your stoma and adjust to being home. If you have any questions or problems once you’re home, call your healthcare provider to contact your WOC nurse. Pouching (bag) systemsAfter your surgery, you’ll wear a pouching (bag) system over your ostomy. All pouching systems are waterproof and odor-proof. The pouching system is made up of a skin barrier (wafer) and a collection pouch. There are many different sizes and styles of pouching systems. Most pouching systems are either a 1-piece system in which the pouch is attached to the skin barrier, or a 2-piece system in which the pouch can be taken off of the skin barrier. With both types, the pouch attaches to your abdomen by the skin barrier and is fitted over and around your stoma to collect your stool and gas. The skin barrier protects the skin around your stoma from possible stool leakage. Your WOC nurse will help you find the best pouching (bag) system for your stoma. As the size of your stoma changes, you may need to change your pouching system. Some people find it helpful to buy a fitted waterproof mattress cover or waterproof bed pads to place over the mattress and bed sheets to use after surgery at home. This protects the bed in case the pouch accidentally leaks during the night. Emptying your pouch (bag)Empty your pouch (bag) when it’s ⅓ to ½ full. The pouch shouldn’t become overly full. A full pouch will be more difficult to empty and could cause leakage. Your WOC nurse and the staff nurse will teach you how to empty your pouch. Liquid stool empties easily out from the bottom of the pouch (bag). Pasty or thick stool may not drop to the bottom of the pouch as easily. You may squeeze the stool out from the pouch or add water to make it more liquid, and then empty the stool into the toilet. When emptying your pouch, do not squeeze all the air out of the pouch because the sides will stick together, and this could slow stool from dropping to the bottom. There are lubricants to help keep this from happening. This is more of an issue if your stool is thicker. If your stool is thinner, you can use a thickening product in the pouch to help thicken them. Your WOC nurse will help you determine which product you should use. Changing your pouching (bag) systemYour WOC nurse will teach you how to change your pouching (bag) system. Generally, you should change your pouching system every 3 to 5 days. If you have leakage, change it immediately. This is to protect the skin around your stoma from getting irritated from stool leakage. If you have any leakage or irritation that has lasted for a few days, call your healthcare provider’s office to get in touch with your WOC nurse. Back to topLifestyle IssuesBody image and depressionAfter people learn that they have cancer, they often view their bodies in a different way. Surgery, chemotherapy, and radiation therapy can change the way a body looks and works. This may be especially true when someone has a new ostomy. Some people feel disgust. This is normal given the shame in many cultures of talking about bowel movements. Other people feel sadness at the loss or change in their bodies. They view their ostomy with negative thoughts and feelings. However, others view their ostomy more positively and see it as an answer to difficult symptoms, such as bowel incontinence (trouble controlling your bowel movements), or as the path to better health. You may have both positive and negative feelings. As you adjust to living with an ostomy and get used to how it looks and works, you’ll feel better about your body. It may help you cope better if you:
NutritionYour healthcare provider will give you dietary guidelines to follow after your surgery. You’ll also meet with a dietitian while you’re in the hospital to review these guidelines. Below are some recommended guidelines if you have an ileostomy:
If you have an ileostomy, don’t take any kind of laxative. It can cause severe dehydration and other problems. MedicationIf you have an ileostomy, your body may not be able to completely absorb some medications. This happens because your bowel is shortened and some medications are absorbed slowly or in a lower portion of the intestines. This happens most often with:
Ask your healthcare provider if you’re taking these types of medications. If you see a tablet in your pouch (bag) that isn’t absorbed, call your healthcare provider. Don’t crush pills unless your healthcare provider or pharmacist says you can do so. Taking crushed pills change the absorption of the medication and can cause problems with digestion. ExerciseTalk with your healthcare provider about what exercise is right for you. For most people, walking and light stretching are good exercises to do while recovering from surgery. You should avoid lifting or pushing anything heavier than 10 pounds for 6 to 8 weeks after your surgery. This includes housework such as vacuuming or mowing the lawn. If this will be a problem for you, talk with your healthcare provider. Don’t do sit-ups, pushups, or any strenuous exercise for 2 to 3 months after your surgery. This will help prevent a hernia (bulging of an organ or tissue) through your incision or around your ostomy. Speak with your WOC nurse after your surgery and during your postop visit to learn more about how to prevent a hernia around your stoma. Odor controlPouching (bag) systems are designed to be odor proof. Unless you’re leaking bowel movements underneath the wafer, there should be no odor while the pouching system is attached. However, if odor is a problem for you, there are deodorants that you can put into the pouch to help. Some examples are drops, charcoal tablets, or lubricating gel. You may need to experiment to find one that works best for you. There are also deodorants you can take orally (by mouth) to decrease your bowel movement’s odor. Check with your healthcare provider before using any of these. Many pouches have a built-in charcoal filter. This vents the gas and filters it at the same time to prevent odor. There are also filters that can be bought separately and attached to the pouch, or you can apply a small plastic vent on each pouch. This vent allows gas to be released without opening the pouch. Some people find it useful to empty the pouch at bedtime. This is done because gas could continue to build overnight and fill the pouch. SexualitySexuality is a part of relationships and life. After ostomy surgery it’s common to feel insecure or concerned about your sexuality with a new stoma. Most people with new ostomies experience changes in how they feel about their bodies and worry about sexual activities. Talk with your healthcare provider about difficulties or fears that you may have. Sexual activityTalk with your healthcare provider about when it’s safe to resume sexual activity. Generally, this is after your incision is healed, about 2 months after your surgery. As long as excessive pressure isn’t placed on your stoma, there should be no harm done to it. Do not use your stoma as a sexual orifice (opening). For many people, returning to a normal sex life will come naturally. This happens as your concerns decrease and your feelings about your body become more positive. Try to stay intimate with your partner as much as possible. Use kind words, meaningful touch, and hugs. Check to see if your pouching (bag) system fits well and if there’s any odor. Some people prefer to cover their pouching system with a cloth band or wrap, shirt, or lingerie during sexual activity. You can buy ready-made covers from many ostomy supply companies. You may also plan your sexual activity for times when you’re less likely to have a bowel movement. Some people with a permanent colostomy, irrigate (give themselves an enema through the stoma) to try to control their bowel movements. For more information about irrigation, see the section titled “Frequently Asked Questions About Ostomy Care”. Talk with your healthcare provider if surgery or radiation therapy caused changes that make it hard to have sex. Examples are erectile dysfunction (difficulty getting or keeping an erection) or vaginal dryness, pain, or tightness. If these problems don’t get better, you can talk with a sexual health specialist. MSK has a Sexual Health Program to help people address the impact of their disease and treatment on sexuality. You can contact our Sexual Health Programs at the numbers listed below or have your healthcare provider’s office place a referral. Female Sexual Medicine and Women’s Health Program: 646-888-5076 Male Sexual and Reproductive Medicine Program: 646-888-6024 The United Ostomy Associations of America, Inc. (www.ostomy.org or 800-826-0826) has information on sex for people with ostomies. Other good sources of information are the following resources published by the American Cancer Society. You can get these resources by calling 800-ACS-2345 (800-227-2345) or by going to the links below.
Showering, bathing, and swimmingYou can shower with your pouching (bag) system on or off. However, if you have an ileostomy, you may want to keep the pouch on during the shower due to possible drainage of bowel movements while showering. You can also use waterproof tape or strips around the edges of the wafer to keep it from getting wet. When you take a bath or swim, keep your pouching system on. Most people can wear the same swimsuit they wore before their surgery. However, it may not be possible to wear hip-high swimsuits or two-piece swimsuits. WorkYou can go back to work as soon as you feel ready and your healthcare provider approves. Unless you tell them, people won’t know that you have an ostomy. It’s highly unlikely that the pouching system will be visible. You’ll probably be able to wear most of the same clothes you wore before your surgery. TravelBring extra pouching (bag) systems with you wherever you go, even if it’s only a short trip or a healthcare provider’s appointment. If you’re going to be away from home for several hours, think about where you’re going and mentally prepare yourself. Some people feel anxiety the first few times they travel. If you feel anxious, you may be able to lower your stress by thinking ahead. First, think about where the bathroom is located and what you may need. Second, get the supplies you plan to take with you. Place 2 of every item in a travel bag. This way, if you have an emergency or are away from home longer than you expect, you’ll be prepared. Remember to bring:
When you’re traveling by air:
Call Your Healthcare Provider if You:
Frequently Asked Questions About Ostomy CareWhat is irrigation and will I be able to do it?A colostomy irrigation is a type of enema that helps control when you have bowel movements. This means you wouldn’t have any bowel movements between the irrigations. Irrigating may also reduce gas. Some people who irrigate their stoma are able to wear a stoma cap over their stoma instead of using a pouching system. Irrigation is done every day or every other day. People who have a sigmoid colostomy may be able to irrigate. Most people who have had an abdominal perineal resection have a sigmoid colostomy. People with an ileostomy should never irrigate because it can cause dehydration. You also can’t irrigate:
Ask your healthcare provider or WOC nurse for more information about irrigation. What color should my stoma be?Your stoma should be a deep pink or red color at all times. While it’s working to move bowel movements out of your body, you may notice a slight change in its color. This should only be for a few seconds to a minute. If your stoma looks dark red, grey, brown, or black, call your healthcare provider immediately. Is it normal for my stoma to bleed when I touch it or change my pouching (bag) system?Your stoma has many blood vessels, so it may bleed easily with touch or irrigation. It’s common to have a small amount of blood on the tissue when cleaning your stoma. The bleeding should stop on its own within a few minutes. If you’re on a blood thinner or aspirin, you may bleed more easily and for a longer period of time. If you bleed a lot or if the bleeding doesn’t stop after 5 to 10 minutes, apply pressure to the area and call your healthcare provider. If you notice blood in your bowel movements or coming from the inside of your stoma, call your healthcare provider immediately. The area around my stoma seems to bulge. Is this normal?If you have a change in the curve around your stoma, tell your healthcare provider or WOC nurse. You may have a stomal hernia (parastomal hernia). This happens because the abdominal wall muscle may be weak and the intestines bulge through the weak area. Your healthcare provider or WOC nurse will examine you to see if you have a stomal hernia. People with a stomal hernia don’t initially feel any symptoms. Surgery isn’t needed unless you have a complication, including a blockage or twisting of the herniated bowel. If you have any of the following symptoms, call your healthcare provider:
If you have a stomal hernia, your WOC nurse can measure you for a custom-made hernia support belt. These belts don’t cure the hernia, but they can try to prevent it from getting bigger by giving it support. A light panty girdle or biking shorts with a hole cut out for your pouch may also work well as an alternative to the custom-fitted hernia belt. How do I wear a belt over my stoma?Try to wear the belt above or below your stoma. If the belt is worn directly over your stoma, it can cause:
While you’re wearing the belt, position your pouch downward or to the side. You can also fold it, depending on your preference. What do I do if I have leakage of bowel movements under my wafer?If you’re having leakage, tell your WOC nurse. You may need a different pouching (bag) system that fits better to avoid this problem. Is there anything I should do to prepare for tests, such as scans with contrast dye?Always take an extra set of supplies when going to the healthcare provider for tests because you may have to remove your pouching system. If you live 1 hour or longer away from the hospital, be ready to change or empty your bag during the trip home. The contrast dye may empty into your pouch in 1 or 2 hours, but it can take longer. Do I need to wear gloves when I change my pouching (bag) system?This is a personal choice. There is no risk of infection from changing your pouching (bag) system. However, some people prefer to wear gloves because some bowel movements could come in contact with your fingers. If I have an ileostomy, is it normal to still pass bowel movements or mucous from my rectum?Depending on the type of surgery you had, you may pass left over bowel movements or mucous from your rectum. This should decrease over time, but it may be useful to wear a pad and apply a zinc ointment product (such as Desitin®) around your anus to prevent irritation. What should I do if I am admitted to the hospital?If you’re admitted to the hospital, you may want to bring 1 or 2 extra sets of supplies with you, just in case they stock a different product or they have run out of the product you use. Back to topVideo ResourcesThis video will teach you how to change your ostomy appliance.
This video will teach you how to empty your velcro end closure pouch.
This video will teach you how to care for irritated skin around your stoma. Back to top Support GroupsYou may find it helpful to join our ostomy group for patients with different types of ostomies. This is a live, confidential, online support group in which people can share their experiences and provide practical and emotional support for one another. Discussions are guided by a social worker and nurse. The group is open to everyone, including non-MSK patients. The group is held monthly on the 3rd Thursday of the month from 4:00 p.m. to 5:00 p.m. Visit www.mskcc.org/event/ostomy-support-group to learn more or register. On the United Ostomy Associations of America (UOAA) website, you can search for UOAA-affiliated online and in-person support groups for people with ostomies. To find a group, go to www.ostomy.org/supportgroups.html. Local hospitals may also offer ostomy support groups. Back to topOrdering SuppliesSpeak with your WOC nurse about ordering supplies. They are familiar with the latest products on the market. You can also call companies to ask for samples of their products. Mail order medical supply companiesListed below are some mail order medical supply companies. Most of the supply companies accept Medicare and other types of insurance. Call the company directly to ask if they take your insurance. If they don’t accept your insurance, call your insurance company to get a list of suppliers that do. These companies will mail the supplies to you every month. After you reach out to the company for your supplies, they will work with your healthcare provider’s office to get an order for the supplies. The supply companies are familiar with the insurance companies’ coverage and can let you know the amount of supplies covered by your insurance company, and if you have a co-pay. Byram
Healthcare CCS Medical Edgepark Medical
Supplies Landauer Metropolitan You can also buy ostomy supplies at local pharmacies and medical supply stores. However, the prices may be higher due to a low volume of supplies or because they may not take your insurance. Ostomy product manufacturersListed below are companies that make ostomy products such as skin barriers, pouches, and other ostomy accessories (such as pastes, powder, and rings). Many of these companies also have a WOC nurse on staff to answer questions. Feel free to call and ask for samples of products. Coloplast
Corporation ConvaTec Professional Services Cymed Hollister, Inc. Marlen Manufacturing & Development
Company Nu-Hope Laboratories, Inc. MSK Support ServicesResources for Life After Cancer (RLAC) Program Social Work Department Sexual Health Programs ResourcesBooks100 Questions & Answers about Colorectal Cancer The Ostomy Book: Living Comfortably with Colostomies,
Ileostomies, and Urostomies The Complete Financial, Legal, and Practical Guide for Living With Cancer, HIV, and Other Life-Challenging Conditions Positive Options for Living with Your Ostomy: Self-Help and Treatment The Human Side of Cancer: Living With Hope, Coping With Uncertainty OrganizationsCancercare Caregiver Action Network Colon Cancer Alliance
(CCA) Crohn’s and Colitis Foundation of
America C3Life.com Red Door Community International Ostomy Association (IOA) National Ovarian Cancer
Coalition (NOCC) NCI’s Cancer Information Service Ovarian Cancer National Alliance (OCNA) United Ostomy Associations of America, Inc. (UOAA) Women’s Cancer Network Wound, Ostomy, Continence Nurses
Society What is an end sigmoid colostomy?During an end colostomy, the end of the colon is brought through the abdominal wall, where it may be turned under, like a cuff. The edges of the colon are then stitched to the skin of the abdominal wall to form an opening called a stoma. Stool drains from the stoma into a bag or pouch attached to the abdomen.
Which test should the nurse expect to be ordered for a client suspected of having diverticulosis?Abdominal and Pelvic CT: A CT scan is the best test to diagnose diverticulitis.
Which of the following tests is normally administered to a client suspected of having diverticulosis?Colonoscopy. Doctors may recommend a colonoscopy to confirm a diagnosis of diverticular disease and rule out other conditions, such as cancer link.
Which of the following types of diets is implicated in the development of diverticulosis quizlet?The low-fiber diet is thought to predispose a person to diverticulosis, owing to a slower fecal transit time and smaller stool weight.
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