The colostomy is one of the forms that the ostomy technique can take. For medicine, the term «ostomy » defines a communication between a hollow internal organ and the outside. The ostomies can be from the digestive system or urinary tract.
In the specific case of the colostomy, it is an opening in the abdomen, which allows part of the large intestine to communicate with the outside. That point of contact is known as «stoma".
The colostomy divides the intestines artificially into two parts. The section that is located before the stoma is functional and maintains its relatively normal activities. The part that remains after the stoma no longer works, since the stool will come out of the opening.
Similarly, in addition to the last portion of the large intestine, also the rectum and anus are no longer functional for stool. However, it is possible that the mucosa continues to produce fluids that are expelled outside.
As the colostomy is located in the large intestine, nutrient absorption remains intact. Remember that this process belongs to the small intestine, located above and not affected by the technique. What is affected, then, is the production of fecal matter and its elimination.
Types of colostomy
The surgical technique that creates the colostomy in a patient can be framed in any of these three types:
A temporary colostomy, as the name implies, responds to pathologies or interventions that It is known to evolve better with a part of the large intestine at rest.
For example, when bowel surgery is performed, it should heal. So, to prevent the passage of fecal matter, sand creates a momentary stoma that will be closed later. When closing, the entire digestive system is left functioning normally.
In this case, the technique is performed with the goal of leaving the colostomy forever. It can be a colon cancer, For example, that diagnosed in an advanced stage does not allow for a solution other than the removal of a large section of large intestine. When it is anticipated that the traffic will be irreparable, then a permanent colostomy is placed.
These colostomies are named for their location. We have to know that the large intestine has three parts, and one of them is the transverse colon, located in the upper abdomen.
It is not usual to perform the colostomy in that section, but it may be necessary due to anatomical conditions. In that location it is also possible to plan a temporary technique or a permanent technique.
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The colostomy, then, produces the outflow of stool through the stoma outward. Stool is no longer expelled in the traditional way with its passage through the rectum and anus.
To receive the stool, which will come out involuntarily, there are colostomy bags. These are fixed to the stoma firmly YThey act as a deposit for what the functional large intestine expels regularly.
Although there are multiple models and designs of bags, they all coincide in having two fundamental parts: the adhesion system – which will fix the deposit to the skin and stoma -, and the collection system – which can be a simple bag or a mechanism With emptying.
The collection bags have many manufacturers, and hence also the price difference. There are cheap, expensive bags, with more or less resistant materials, girls, medium, large, transparent, colored, with lid or without lid.
Another point of differentiation of the bags is the system they offer for emptying. Here the patient's comfort, the availability of the models and the purchasing power of the person who finances the bags run for the decision. Basically, the emptying can be:
Bag replacement: The bag is used only once, and when it is filled, it is removed and another is placed.
Open Fund: The bag has a bottom lock that allows you to remove content and continue using it.
Washed: Some bags have a special adhesion system that allows them to be removed. They are made of washable material and, once clean, re-adhere completely.
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The fact of altering the normal excretory function of the intestine and having a stool bag attached to the body logically leads to certain complications. Some are more difficult than solving than others. The most commons are:
Dermatitis: Around the stoma, the skin is usually reddened due to the colostomy and the flow of stool. In general, with proper hygienic care and the use of certain creams formulated for this purpose, the adverse effect is manageable.
Stoma shrinkage: after surgery the stoma decreases its diameter. It is normal, but if it gets too small, it should be rechanged with a new intervention. This is because it can obstruct the exit of the stool.
Stoma movement: at the site of the colostomy, the intestines have changed their disposition and, therefore, can exert more pressure outward, causing a stoma hernia. Or it can happen the other way around, and the stoma retracts inward. Both situations require medical consultation to take measures that maintain the functioning of the colostomy.