Stoma after surgery on the intestine
Bowel Disease: How to take care of stoma
Caring for an ostomy is a very important part of maintaining a quality of life.
A stoma is a one-time procedure in which a hole is created in the body through which feces go out. The term stoma is used to describe both the procedure itself and the hole that is made during the procedure.
This is done when the digestive system or urethra is unable to remove the processed foods from the body. By fixing the tip of the small or large intestine or the end of the ureter to the outer part of the body, the bowel movements can leave the body and accumulate in a specially installed system. The point at which the ureter or intestine leaves the surface of the abdominal wall is called the stoma.
You will need:
Clean the pocket as needed.
Replace the system every 4-7 days. It may also be necessary to measure the stoma (open part of the intestine) and cut the septum to a certain size. Usually, children and newborns need to be replaced every 2-3 days.
Take care of the skin and stoma, and also watch for the appearance of irritation on the skin.
You can also rinse the stoma to prevent infection during stool. Washing should be carried out with the approval of the doctor and under his clear guidance.
Colostomy is a procedure that allows you to control the process of bowel movements. Washing stimulates the intestine to work, because usually the washing is done at the same time daily or every other day.
During this procedure, a special tube and a conical tip (which is inserted into the intestine) are connected to the stoma, the wash solution enters the intestine and flushes the bowel movements.
People who do rinsing may need only a special septum, and may not use a colostomy tank. Washing should be carried out with the approval of the doctor and under his clear guidance.
In order to teach you how to care for ostonomy in hospitals there is a special staff.
In this section, only colostomy and ileostomy are treated.
Colostomy and ileostomy - surgical operations. When part of the intestine is affected by the disease or can not work properly, a hole is made in the abdominal cavity and a part of the large or small intestine is removed to the surface of the skin. The hole is called colostomy (in the large intestine), or ileostomy (in the small intestine), and the tip of the intestine is the stoma.
If you have colostomy or ileostomy, the excrements leave the body not through the anus, but through the stoma. Since there are no muscles around the stoma, you are not able to control when gases or feces come out of the body. A pocket that does not miss smells is attached to the stoma, all feces accumulate in it.
Stomu can do for a variety of reasons.
There are the following types of stoma:
In the case of colostomy, part of the large intestine or rectum is removed, and the remaining part of the large intestine is removed to the wall of the abdominal cavity. Colostomy can be done due to bowel cancer, inflammatory bowel disease, diverticulitis, Hirschsprung disease or when a person does not have an anus (closed anus).
Colostomy can be temporary or permanent and it is determined by the part of the body on which the operation will be performed.
Sigmoid or descending colostomy is the most common form of surgical intervention. The tip of the descending or sigmoid colostomy is brought to the surface of the abdominal cavity. It is usually located in the lower left part of the abdominal cavity. Stools emerge in the form of a stool.
The transverse colostomy is located in the middle or right side of the upper abdominal cavity. The discharge is in the form of a thick liquid or pasty. Loop colostomy can be used on the colon. There are two holes in the loop colostomy: One for stool and one for mucus.
Ascending colostomy is usually located in the lower right side of the abdominal cavity. The discharge is in the form of a thick liquid.
Ileostomy is when the ileum is the lowest part of the small intestine) is removed to the wall of the abdominal cavity to form an ostomy. Ileostomy can be used for ulcerative colitis or Crohn's disease, or when colon and colon develop many polyps (congenital family polyposis of the gastrointestinal tract). The discharge is in liquid form or in the form of a mushy consistency.
The section does not address the issue of care for urostomy.
Urostoma (urine diversion) is a procedure in which urine is sent to a special bag before it enters the bladder. In such a procedure, it becomes necessary when the bladder either does not function, or it must be removed.
Usually, urostomy can be caused by bladder cancer, spinal cord injury or a congenital defect, such as a spina bifida.
What is ostonomy?
Ostomy is a type of surgical intervention. When part of the intestine is affected by the disease or can not work properly, a hole is made in the abdominal cavity and a part of the thick or small intestine is removed to the surface of the skin. A hole is called an ostonomy, and the tip of the intestine is an ostomy. For colostomy or ileostomy treats the same way with the same products.
See the image of the colon.
If you have colostomy or ileostomy, the stools instead of the anus leave the body through the stoma, the end of the intestine, which is attached to the wall of the abdominal cavity.
The rectum is a muscle tube approximately 12.70 cm long. which is located at the end of the large intestine (colon). The rectum connects the colon to the anus, the opening through which the stool leaves the body.
Internal and external anal sphincters are ring-shaped muscles at the anus opening. The sphincters keep the anus closed, as a result of which the stool accumulates in the rectum. Gradually, the pressure of the walls of the rectum causes the external sphincter of the anus to relax. Conscious control of the external anal sphincter allows the stool to leave the body through the anus.
Since there are no muscles around the stoma, you are not able to control when gases or feces come out of the body. The pocket that passes odors surrounds the stoma, all feces accumulate in it. The package is attached to the skin with the help of special adhesives. A similar system can consist of one or more parts.
If the system consists of several parts, then the pocket and the special partition are fixed separately. In the pocket will be installed a special fastener, which is attached to the partition. Usually it is a snap ring, resembling a ring, mounted on food containers. The septum is placed around the stoma and attached to the skin.
If the system consists of one part, then the pocket and the special partition are one.
See the image of a special pocket used for colostomy.
Colostomy with colorectal cancer
Colostomy- this unnatural anus, which is formed during surgery for extirpation of the rectum. An open end of the sigmoid or colon is displayed on the abdominal wall in the left part. This is necessary for the evacuation of stool, which is impossible after the operation.
In what cases is colostomy necessary?
Colostomy is performed in all operations for colon cancer. This is necessary in several cases:
- If a complete removal of the rectum part is made together with the sphincter. Then the removal of stool in another way is impossible.
- If the sphincter department is preserved, but depending on the situation during the operation, a decision was made to impose a temporary colostomy. Subsequently, plastic surgery of the rectum and suture stoma.
How to care for stoma?
With colostomy, i.e. deducing a portion of the large intestine on the abdominal wall, the shape and type of feces will differ little from the usual, the frequency of the stool is usually 2-3 times a day. At the first time after the operation, when a person is still in hospital conditions, care for the stoma is performed by medical personnel. This process consists in the timely removal of stools, treatment of the wound with disinfectant solutions, the imposition of a gauze dressing. Subsequently, a doctor or nurse will train his patient or a member of his family to take care of himself.
After the healing of the wound occurs, it will be possible to use the kalos. Kalopriemnikami called special bags for collecting stool. Care for the colostomy is mainly performed during the change of the calico. At each replacement it is necessary:
- Preliminary to make a hole in the kolohopriemnik, corresponding to the size and shape of the stoma.
- Remove the filled calorimeter: depending on the type, it can be removed completely or partially.
- Rinse the skin around the stoma with ordinary water, clean it from contamination. To clean the stoma, there are also purifiers that help to perform care without water, disinfect, and prevent dryness of the skin (for example, "Cleancer".) After cleaning, dry the skin with a towel or a soft towel, if it is is necessary.
- If necessary, use protective creams, films to protect the skin from excessive moisture, as well as to repair damage (Cream Barrier, protective film, protective powder).
- To create a flat surface, to improve the fit of the kalospriemnika apply a special paste (Comfil in a tube or strips, Stomagic).
- Using the instruction, fix the new kologopriemnik.
What are the kalopriemniki?
First, these devices can be disposable and reusable. At present, disposable absorbent pouches are more common: it is more hygienic. Depending on the type of intestinal stoma, they are also open (drained) or closed.
Drained up kalopriemniki used with frequent stools (usually 3-4 times a day), they are more suitable for patients with ileostomy (ie, excreted in the small intestine). They do not need to be changed every time, but you can empty them without taking them off. For people with an ostomy from the large intestine, closed calico-receivers come up, which need to be changed every time they are filled.
In turn, closed kalopriememniki are:
- Single-component - they change completely, they are whole. They are attached to the stoma using an adhesive backing.
- Two-component - they consist of a properly closed bag and a plate on which the bag is fastened. When daily care is necessary to change only the bag itself, and the plate remains in place. This protects the skin from unnecessary damage. The plate itself is replaced no more often than 2 times in 7 days. It can be on an adhesive basis or with an additional belt.
Complications of colostomy
Even with proper and timely care, complications can develop. If you have pain, itching, rashes, you need to see a doctor.
Some complications develop in the period immediately after the operation. Then the sick person is still under the supervision of a doctor, so all these complications will be noticed and treated. These include:
- Abscess - suppuration of tissues near the colostomy
- Necrosis - necrosis of the intestine on the anterior intestinal wall
- Westing-the gut through the orifice returns back to the abdominal cavity with a strong tension of the mesentery or because of incorrect management of the postoperative period
- Equation - the divergence of the wound and the prolapse of the intestinal loops from the abdominal cavity. This condition requires urgent surgical care.
Complications in the late period after the operation develop when the person who has undergone colostomy is already at home. Therefore, you need to be careful about the condition of the stoma and, in case of appearance of suspicious symptoms, contact a specialist. The following complications can develop at home:
- Loss of the intestine: a small prolapse can be corrected independently, a strong fallout threatens the infringement and necrosis of the part of the intestine. It is better to consult a doctor about what to do in this situation.
- Constriction of the opening of the intestine is due to the formation of the scar and in neglected cases can lead to difficulty in removing the stool and even complete intestinal obstruction. In the process of recovery, the hole gradually changes its size, and this is a normal process, if it does not cause any inconvenience. You need to know about this, in order to measure the size of the stoma about once every 4 weeks before using the kalospriemnika.
- Hernia can interfere with the installation of the kalospriemnika. Treatment consists in its incision, strengthening of the abdominal wall and in the most complicated cases - reconstruction of the colostomy.
In addition, with colostomy, there may be various skin complications - redness, maceration (the skin becomes wet, wrinkled). In order to prevent these processes, you need to use special protective creams that prevent strong moisturizing of the skin.
Remember! Self-medication can cause irreparable consequences for your health! At the first symptoms of the disease, we recommend that you immediately consult a specialist!
Surgery to remove intestinal stoma
The main goal of such an operation is to return the patient to the habitual and active way of life, after the surgical intervention and the formation of the intestinal stoma.
The operation to close the stoma is the following, a recovery stage in the treatment of various pathologies of internal organs, in which the movement of the food mass through the intestine was disrupted.
Stoma is formed solely for life indications and it gives an opportunity to save the life of the patient. What will be the stoma-temporary or permanent depends on this underlying disease, the age of the patient, the concomitant diseases. A temporary stoma is formed to relieve the acute condition when it is difficult to achieve good bowel preparation for the operation (for example, if intestinal perforation is disturbed due to a tumor or adhesions). Also, a temporary stoma is formed to limit the passage of intestinal contents through the gut, so that the site of surgical intervention is not injured by the feces. Often, after the formation of temporary stoma, the functioning of the intestine returns to its previous level.
If necessary, the stoma remains constant. For a constant stoma, you will learn how to take care of yourself, you will need constant use of care products stoma-one-component or two-component kalopriemniki, skin care products around stoma cleansers, protective cream, film, pastes, powders, filters. And also, special belts for wearing a kalospriemnika.
Operations to restore the integrity of the intestinal tract (reconstructive and reconstructive surgery on the large or small intestine) are referred to as rather complex and traumatic. Operations are preceded by a complex of medical and diagnostic measures, conducting a full range of necessary studies, various preparatory procedures, biochemical methods, ultrasound, colonoscopy, irrigography (fluoroscopic examination large intestine).
In the reconstructive-reconstructive operation, various methods are used which depend on the length of the stump of the disconnected intestine, as well as the severity of the inflammatory process in the small pelvis.
Closure of the stoma, depends on the patient's condition. In case of complications after the formation of the stoma or inflammation of the peritoneum, the closure is carried out not earlier than three months, from the moment of the first operation. If complications were not observed, it is possible to close the stoma earlier. The optimal time to close the colostomy is from two to four months. Use of antiadhesive drugs will help to speed up the healing of the stoma.
After the operation, it is necessary to restore the patency of the intestine. You can use special medicines, a hydromassage of the part of the intestine that does not work, a diet is necessary, and the diet is adhered to. For several months it is not recommended to eat fruits and vegetables. Baked and boiled fruits and vegetables can be consumed 3-4 months after the removal of the colostomy. Raw fruit and vegetables-not earlier than in six months. Be sure to visit the doctor and limit the force.
Why is it better to do the operation with Us?
The Department of the Coloproctology Clinic of the Moscow Clinical Scientific Center has the most advanced modern equipment for providing high-tech assistance, including the robotic system Da Vinci.
All the doctors of the department passed internships in leading clinics in America and Europe and have extensive experience in performing the most complicated and even unique operations. The employees of the department have one of the largest experience of carrying out similar operations in Moscow.
ENTRY FOR RECEPTION8(926)265-58-85 8 (495) 304-30-39; 8 (495) 305-34-50 CONTRACTUAL DEPARTMENT8 (495) 304-30-40
Sources: http://www.eurolab.ua/child/3113/25118, http://gemor.su/soputstvoyushie/rak/kolostoma-pri-rake-pryamoj-kishki, http://xn80aqkgbepix.xnp1ai/index.php/operatsii-po-zakrytiyu-stom
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