COLOSTOMY

By Gowsia rasheed
 Introduction

• A colostomy is a surgical procedure in which a portion

of the colon (large intestine) is brought to the surface of
the abdomen to create an opening called a stoma. This
stoma allows for the elimination of waste from the
body when a person's normal bowel function is
compromised, often due to medical conditions such as
colorectal cancer, inflammatory bowel disease, or other
digestive disorders. Waste material passes through the
stoma into a disposable pouch or bag that the person
wears on the outside of their abdomen. Colostomies
can be temporary or permanent, depending on the
individual's medical condition and treatment plan.
Indications
• Colostomies are typically performed for various
medical indications, and the decision to perform a
colostomy is based on the patient's specific
condition and treatment needs. Some common
indications for a colostomy include:
• Colorectal Cancer: Colostomies are often necessary
in the treatment of colorectal cancer to divert the
flow of feces away from the affected area of the
colon or rectum.
• Inflammatory Bowel Disease (IBD): Patients with
severe Crohn's disease or ulcerative colitis may
require a colostomy when other treatments are
ineffective in managing their symptoms.
• Diverticulitis: In cases of severe diverticulitis, a
colostomy may be performed to allow the inflamed
or infected colon to heal.
• Trauma or Injury: Severe abdominal injuries or
trauma can sometimes necessitate a colostomy to
manage bowel function during the healing process.
• Bowel Obstruction: When a blockage or obstruction
in the colon is too challenging to treat
conventionally, a colostomy can help relieve the
pressure and allow for decompression.
• Birth Defects: Some individuals are born with
congenital conditions that require a colostomy to
manage their bowel function from an early age.
• Fecal Incontinence: In rare cases, a colostomy may be
recommended to manage severe fecal incontinence
when other treatments are ineffective.
TYPES
• There are several types of colostomies, which are
named based on the location where the colon is
brought to the surface of the abdomen. The
specific type of colostomy is determined by the
patient's medical condition and the surgical
procedure. Here are the main types of colostomies:
• Sigmoid Colostomy: This is the most common type
of colostomy. It is created by bringing the sigmoid
colon to the abdominal surface. It's typically
located in the lower left abdomen. People with
sigmoid colostomies may have formed or semi-
formed stool, making it easier to manage.
• Descending Colostomy: This type involves bringing
the descending colon to the abdominal wall. It is
usually located on the left side of the abdomen,
and the stool may be semi-formed to liquid in
consistency.
• Transverse Colostomy: In a transverse colostomy, a
portion of the transverse colon is brought to the
abdominal surface. This type is often performed
when the lower part of the colon or rectum needs
to be bypassed. Stool consistency can vary.
• Loop Colostomy: A loop colostomy is created by
bringing a loop of the colon to the abdominal
surface. It's often a temporary colostomy and can
be performed when there is a need to divert stool
temporarily while allowing the lower bowel to heal.
• Double-barrel Colostomy: In this type of colostomy,
two stomas are created on the abdomen. One
stoma is connected to the functioning part of the
colon (usually the proximal end), and the other
stoma is connected to the non-functioning or
bypassed part. It's often temporary and can be
reversed in the future.
• End Colostomy: An end colostomy is created when
the end of the colon is brought to the abdominal
surface. It is typically permanent and is often
performed when there is a need to remove or
bypass the lower part of the colon or rectum.
• The choice of colostomy type depends on the
patient's specific medical condition, the location of
the problem within the colon, and the expected
duration of the colostomy. The type of colostomy
can also affect the consistency of stool output and
the management requirements. Patients and their
healthcare providers work together to determine
the most appropriate type of colostomy for their
situation.
PROCEDURE
• The procedure for creating a colostomy involves a
surgical operation performed by a qualified
surgeon. Here are the general steps involved in the
colostomy procedure:

• Anesthesia: The patient is put under general

anesthesia to ensure they are unconscious and do
not feel any pain during the surgery.
• Incision: The surgeon makes an incision in the
abdominal wall to access the colon.
• Isolation of the Colon: The affected part of the
colon is isolated. Depending on the type of
colostomy, a specific section of the colon (sigmoid,
descending, transverse, etc.) is chosen for the
stoma.
• Creation of the Stoma: A small portion of the colon
is brought through the abdominal wall and sutured
to the skin to create the stoma. The stoma is an
opening on the abdomen through which waste
material will pass.
• Stoma Care: The surgeon or a specialized stoma
nurse will ensure that the stoma is functioning
properly and teach the patient how to care for it.
This includes cleaning, protecting the skin around
the stoma, and attaching a pouching system to
collect waste.
• Closure of the Incision: The incision in the
abdominal wall is closed with sutures or staples.
• The specific details of the procedure may vary
depending on the patient's medical condition and
the type of colostomy being performed (temporary
or permanent). After the surgery, patients will
receive instructions on how to manage and care for
their colostomy, including how to change the
pouching system and monitor the stoma's
health.It's essential for patients to work closely
with their healthcare team, including a stoma nurse
or enterostomal therapist, to ensure a successful
and comfortable adjustment to life with a
colostomy.
• They will provide guidance on diet, lifestyle, and
stoma care to promote a better quality of life.
COMPLICATIONS
• Infection: Infection of the surgical wound or the
stoma can occur. Proper hygiene and stoma care
are essential to reduce this risk.
• Stoma Prolapse: Sometimes, the stoma can
protrude further from the abdomen than usual,
which may cause discomfort and difficulty in
managing the pouching system.
• Stoma Retraction: In some cases, the stoma can
retract or pull back into the abdominal wall, making
it more challenging to attach the pouching system.
• Skin Irritation: Skin around the stoma can become
irritated due to stool or urine leakage. Proper fitting
and maintenance of the pouching system can help
prevent this.
• Stoma Obstruction: Sometimes, the stoma can
become partially or completely blocked, preventing
the passage of stool. This can be due to adhesions,
food blockages, or other factors.
• Dehydration and Electrolyte Imbalance: Excessive
fluid loss can occur, leading to dehydration and
electrolyte imbalances if not managed properly.
• Psychological and Emotional Impact: Adjusting to life
with a colostomy can be emotionally challenging. Many
individuals may experience feelings of self-
consciousness, anxiety, or depression.
• Pouching System Issues: Problems with the pouching
system, such as leaks or pouch detachment, can be
inconvenient and affect a person's daily life.
• Hernia: Some people may develop a hernia near the
stoma site, which can cause discomfort or complications.
• Stenosis: Stenosis is the narrowing of the stoma, which
can restrict the passage of stool.
THANK YOU