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Overview

 


A colostomy is a surgical procedure that involves connecting a part of the colon onto the anterior abdominal wall, leaving the patient with an opening on the abdomen called a stoma. In a colostomy, the stoma is formed from the end of the large intestine, which is drawn out through the incision and sutured to the skin. After a colostomy, faeces leave the patient's body through the abdomen.

A colostomy may be performed for many reasons. A colostomy may be needed to divert the contents of the intestine in case of an inflammatory disease of the bowel. If the muscles that control bowel movements (sphincter muscles) are removed during surgery, you will be unable to control your bowels. In such a case, a colostomy becomes necessary so that the bowel contents can pass into a colostomy bag.

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Sometimes, a colostomy may be necessary to relieve a bowel obstruction, or there may be inherited bowel problems, such as a bowel defect which is present at birth, or may be performed following an injury to the abdomen. A colostomy is performed by making a small cut through the wall of the abdomen to one side of the main incision (where the section of bowel has been removed).The upper cut end of the bowel is brought out through this opening, known as a stoma, and the edges are stitched to the margins of the opening. The lower cut end may be closed internally or may also be brought out.

The bowel contents pass out through the colostomy and are collected in a waterproof bag which is worn over the stoma. The bag is made of a special waterproof material, known as hydrocolloid, which is adhesive and sticks to the area without the need for adhesive tape. A colostomy may be permanent or temporary, depending on the reasons for its use. colonoscopy.


The Operation


You will have a general anaesthetic, and will be asleep for the whole operation. A cut is made around the colostomy to free the bowel from the skin and the body wall. The opening in the bowel is then joined up again inside the tummy, or sealed off, so that the waste will drain the normal way to the back passage.

The wound where the colostomy once was, is then closed off. Sometimes the main wound in your tummy has to be reopened to join the bowel up properly. The wound is stitched up again at the end of the operation. You should plan to leave hospital 7 days after the operation. If you have had the main wound reopened, plan for 10 days in hospital.


Possible Complications


Complications are unusual but are rapidly recognised and dealt with by the nursing and surgical staff. If you think that all is not well, please ask the nurses or doctors. Chest infections may arise, particularly in smokers. Do not smoke. Occasionally the bowel is slow to start working again. This requires patience. Your food and water intake will continue through your vein tubing. Sometimes there is some discharge from the drain by the wound.

This stops given time. Wound infection is sometimes seen. This settles down with antibiotics in a week of two. Aches and twinges may be felt in the wound for up to 6 months. Occasionally there are numb patches in the skin around the wound which get better after 2 to 3 months. Very occasionally the bowel cannot be joined up again. This will be discussed with you. Sometimes there is a weakness where the colostomy has been closed. A rejoin operation may be needed later.




























































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