| Colostomy | |
|---|---|
| Intervention | |
Line drawing showing a permanent colostomy for rectal cancer. |
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| ICD-9-CM | 46.1 |
| MeSH | D003125 |
A colostomy is a surgical procedure in which a stoma is formed by drawing the healthy end of the large intestine or colon through an incision in the anterior abdominal wall and suturing it into place. This opening, in conjunction with the attached stoma appliance, provides an alternative channel for feces to leave the body. It may be reversible or irreversible depending on the circumstances.
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There are many reasons for this procedure. Some common reasons are:
Placement of the stoma on the abdomen can occur at any location along the colon, but the most common placement is on the lower left side near the sigmoid where a majority of colon cancers occur. Other locations include the ascending, transverse, and descending sections of the colon.[1]
Types of colostomy:[2]
Colostomy surgery that is pre-planned usually has a higher rate of long-term success than surgery performed in an emergency situation.
People with colostomies who have ostomies of the sigmoid colon or descending colon may have the option of irrigation, which allows for the person to not wear a pouch, but rather just a gauze cap over the stoma, and to schedule irrigation for times that are convenient. To irrigate, a catheter is placed inside the stoma, and flushed with water, which allows the feces to come out of the body into an irrigation sleeve. Most colostomates irrigate once a day or every other day, though this depends on the person, their food intake, and their health.
Colostomies are not viewed positively due to the misconception that it is difficult to hide the pouch and the smell of feces, or to keep the pouch securely attached. However, modern colostomy pouches are well-designed, odor-proof, and allow stoma patients to continue normal activities. Latex-free tape is available for ensuring a secure attachment. People with colostomies must wear an ostomy pouching system to collect intestinal waste. Ordinarily the pouch must be emptied or changed several times a day depending on the frequency of activity; in general the further from the anus (i.e., the further 'up' the intestinal tract) the ostomy is located the greater the output and more frequent the need to empty or change the pouch.
The preferred option by the surgical community, wherever possible, is now an internal colo-anal pouch which eliminates the need for an external pouch. In place of an external appliance, an internal ileo-anal pouch is constructed using a portion of the patient's lower intestine, to act as a new rectum to replace the removed original.
A UK man named Ged Galvin has been given a remote-controlled bowel.[3]
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