Sometimes treating diseases of the digestive or urinary systems (such as Crohn's disease, ulcerative colitis, or bladder cancer), involves removing all or part of the small intestine, colon, rectum, or bladder. In these cases, there must be a new way for wastes to leave the body. The surgery to create the new opening in the abdomen is called ostomy. An ostomy connects either the small or the large intestine to the surface of the body. The opening is called a stoma.
There are many different types of ostomy. Some examples are ileostomy, colostomy, and urostomy.
Ileostomy: In an ileostomy, a surgeon removes the colon and rectum and attaches the bottom of the small intestine (ileum) to the stoma.
Colostomy: In a colostomy, a surgeon removes the rectum and attaches the colon to the stoma.
Urostomy: In a urostomy, a surgeon attaches ureters (the tubes that carry urine to the bladder) to either the small intestine or to the abdominal wall.
An ostomy may be temporary or permanent. A temporary ostomy may be required if the intestinal tract cannot be properly prepared for surgery because of blockage by disease or scar tissue. A temporary ostomy may also be created to allow a disease process or operative site to heal without irritation by the passage of stool. Temporary ostomies can usually be reversed with minimal or no loss of intestinal function.
A permanent ostomy may be required when disease, or its treatment, impairs normal intestinal function, or when the muscles that control the rectum do not work properly or require removal. The most common causes of these conditions are low rectal cancer and inflammatory bowel disease.
Once an ostomy has been created, a surgeon or an enterostomal therapist or "ET nurse" (a nurse who specializes in ostomy care) will teach the individual to apply and wear a pouch called an ostomy appliance. The pouch is made of a special form of plastic that is held to the body with an adhesive skin barrier. Many sizes and styles of ostomy pouches are available. The pouch is disposable and is emptied or changed as needed. The system is quite secure; accidents (bladder or bowel spilage) are not common, and the pouches are odor-free. The frequency of bowel movements will vary, depending on the type of ostomy, the diet, and bowel habits prior to surgery. If the ostomy is a colostomy, irrigation techniques may be learned that allow for increased control over the timing of bowel movements.
Individuals with ostomies can lead normal lives. Someone with an ostomy generally cannot be outwardly distinguished from those who do not. Public figures, prominent entertainers, and even professional athletes have ostomies that do not significantly limit their activities. All usual activities, including active sports, may be resumed once healing from surgery is complete.
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