With a number of intestinal diseases, the passage feces and their exit naturally turns out to be impossible. Then doctors resort to colostomy.

Colostomy - what is it and how to live with it?

Colostomy is a kind of artificial anus which doctors do in the abdominal wall. A hole is made on the peritoneum, and the end of the intestine (usually the colon) is sewn into it. Fecal masses, passing through the intestines, reach the opening and fall into the bag attached to it.

Usually, such an operation is performed when it becomes necessary to bypass the rectal part in postoperative period, with traumatic injuries or tumors, inflammation, etc.

Photo of rectal colostomy

If the lower intestinal region cannot be restored, then a permanent colostomy is performed. Healthy people it is easy to control the processes of intestinal emptying. This is ensured by the uninterrupted activity of the sphincters.

In patients with colostomy, feces exit through an artificially formed anus in the form of semi-shaped or shaped masses, without disrupting intestinal activity.

Indications for colostomy

A colostomy can be temporary or permanent. Children are usually given a temporary stoma.

In general, the indications for colostomy are as follows:

1. Anorectal incontinence;
2. Blockage of the intestinal lumen;
3. colonic walls such as gunshot or mechanical wounds;
4. Severe cases of colon pathologies such as ischemic colitis, cancer or peritonitis, and ulcerative colitis, abscesses of the intestinal wall with perforation, etc.;
5. Recurrent cases of cancerous processes in and, or;
6. The presence of severe forms of post-radiation proctitis, especially often after cancer of the cervical canal;
7. In the presence of internal to the vagina or bladder;
8. As a preoperative preparation for the prevention of suture divergence and suppuration;
9. With anomalies of a congenital nature such as Hirschsprung's pathology, meconial obstruction of newborns or atresia of the anus canal, etc. (if it is not possible to carry out radical intervention);
10. With rectosigmoid resection, if after the operation the sutures are untenable.

Types of stoma

According to the localization, colostomy is classified into several types: transverse, ascending, and descending.

• Transverse colostomy.

Transversostomy is formed in the upper abdomen, in the transverse colon-intestinal region.

To avoid nerve damage, the transverse stoma is positioned closer to the left splenic flexure.

A transverse colostomy is shown in case of intestinal blockage or oncopathologies, traumatic injuries and diverticulitis, congenital colonic anomalies.

Usually, these colostomas are placed temporarily for the duration of treatment. On an ongoing basis, transverse stomas are necessary when removing the underlying intestinal tract.

Transverse stomas are divided into two types: single-barreled and double-barreled.

1. Single-barreled or the end stoma is a longitudinal section of the large intestine, so only one hole is brought to the surface. This technique is usually performed permanently and is used for radical ectomy of the descending colon.
2. Double-barreled colostomy involves the removal of the intestinal loop with a transverse incision on it in such a way that 2 intestinal openings are displayed on the peritoneum. Through one passage, feces are excreted, and through the other, drugs are usually injected.

The lower intestine may continue to produce mucus, which will escape through the incision or the anus, which is normal. Such transverse ostomy is usually done for a certain time.

• Ascending colostomy or ascendostomy.

Such a stoma is located on the ascending colonic segment, so it is localized on the right side of the peritoneum. This area is located in the early intestinal part, therefore, the excreted contents will be alkaline, liquid and rich in residual digestive enzymes.

Therefore, the colostomy bag needs to be cleaned as often as possible, and the patient is advised to drink more to avoid dehydration, since thirst is characteristic of ascendostomy. An ascending colostomy is usually a temporary therapeutic measure.

• The descending and sigmoid colostomy method (descendo and sigmoid).

These varieties are colostomy placed on the left side of the peritoneum in its lower part, in fact, at the end of the colonic section. Therefore, masses come out of it in terms of physicochemical properties similar to ordinary feces.

A distinctive feature of such colostomy is the patient's ability to regulate bowel movements. This is due to the fact that in these parts of the intestine there are nerve endings that allow you to control the process of excretion of feces. Such localization with colostomy allows them to be installed for a long time and even for a permanent period.

Advantages and disadvantages

The procedure is often of vital importance, providing the patient with a normal life after radical surgical intervention for sigmoid or rectal cancer.

This fact is the main undeniable advantage of an artificially created anus.

In addition, modern bandages, colostomy bags and other devices allow you to live comfortably even with a constant colostomy.

There are certainly drawbacks to the technique. Perhaps the main one is the psychological factor, which is often the cause of the patient's deep depression. But doctors have learned to deal with this too - they conduct explanatory work with patients, talk about proper care behind the stoma, clarify important nuances, talk about feelings, etc.

For many, the smell may seem like another drawback. But the problem is quite solvable, because modern colostomy bags are equipped with magnetic covers, anti-odor filters, there are also specialized deodorants on sale. Therefore, today such accessories can solve the problem of skin irritation and frequent replacement of the colostomy bag.

Types of colostomy bags

Kalopriyemniki are one- and two-piece. Two-piece ones are equipped with ostomy bags and a self-adhesive plate, connected with a special flange. But such colostomy bags are inconvenient in that they can provoke skin irritation. Therefore, during their operation, it is allowed to replace the plate every 2-4 days, and the bag - daily.

If there is a feeling of itching and discomfort, it is recommended to immediately peel off the plate. The undoubted advantage is that the colostomy bag is equipped with a special filter that removes gases and odors.

Unlike the two-component, the one-component colostomy bag must be changed every 7-8 hours. Two-component ones involve replacing only the bag, and the plate is changed only once every 3-4 days.

The drainage bag must be emptied when it is 1/3 full; for this, they bend over the toilet a little and open the drainage hole, after which the fecal bag must be washed and dried. Before reusing the bag, check the drain hole to ensure that it is closed.

How do i care for my stoma at home?

Colostomy requires very careful care, which starts from the first day after surgery. First, the patient is taught by a nurse who changes the colostomy bags and flushes the stoma. In the future, the patient already independently changes the fecal sacs and processes the opening of the stoma.

The whole process takes place in several algorithms:

1. First, the feces are eliminated;
2. Then the outlet is washed with boiled warm water, the skin around it is thoroughly washed, after which it is dried with gauze napkins;
3. The skin surface is treated with Lassar paste or Stomageziv ointment, after which gauze soaked in petroleum jelly is applied around the stoma, and the top is covered with a sterile bandage and cotton wool. From above, cover the treatment site with a gauze bandage, which is changed every 4 hours.
4. When the stoma is healed and fully formed, colostomy bags can be used. The final formation and healing is indicated by the mouth that does not protrude above the skin and the absence of an inflammatory infiltrate. Only with such a clinical picture is the use of a colostomy bag allowed.
5. It is recommended to change fecal sacs in the evenings or in the morning. First, carefully remove the used faeces receiver, then remove the remaining faeces and wash the stoma. Then the mouth and the skin around are treated with ointment or paste, and then the colostomy bag is again fixed.

Usually, Coloplast paste is used to glue the receiver, which contains a small amount of alcohol. The product does not irritate even the skin damaged by injuries and inflammation, and also improves the fixation of the device.

Some patients, before gluing the colostomy bag, treat the skin with a special protective film that protects the skin from inflammation and irritation.

Nutrition

There is no special specialized diet for colostomy patients, therefore, no significant changes in the patient's diet are expected after the operation.

With a colostomy, the only thing to consider is the effect of each product on the digestive processes.

• Gas-generating foods, which include eggs and beer, soda and cabbage, mushrooms and legumes, onions and chocolate, are understandably recommended to be limited.
• Foods such as garlic and eggs, spices and fish, onions and cheese noticeably increase the smell of intestinal gases.
• Lettuce and yogurt, lingonberries and spinach, parsley, etc. have the opposite effect.

A lot of unpleasant situations can be avoided by the right combination of products. In addition, it is recommended to chew food with particular care, eat more often and a little bit.

To prevent unwanted gas evacuation, you can press down lightly on the stoma. Colostomy patients should also monitor the consumption of laxative and fixative foods to avoid such nuisances as diarrhea or constipation.

Types of operations

The location of the colostomy is determined by the doctor, taking into account the specific clinical picture each patient.

The presence of scars or scars can significantly complicate the installation of a stoma on the intestine, since it is imperative to take into account the state of adipose tissue and muscle layer, which, when folds form, can displace the colostomy over time.

Patients may require surgery to place or close a colostomy, as well as surgical intervention for reconstructive purposes. Each of the interventions has its own individual characteristics, requiring a different approach to the patient.

Overlay

The colostomy procedure is performed under general anesthesia in sterile operating conditions.

• First, the surgeon cuts off a rounded section of subcutaneous tissue and skin where the stoma is supposed to be located.
• In the second stage of the operation, the muscles are separated in the direction of the fibers. To avoid compression on the intestine, the hole is made large enough. In addition, the likelihood that the patient will gain excess weight is taken into account in advance if the stoma is imposed for a long time.
• Then the intestine is taken out in a loop and the necessary incision is made on it.
• The intestine is sutured to the muscle tissue of the peritoneum, and its edges are attached to the skin.

Unfortunately, it has not yet been possible to invent drainage means for the ostomy mouth, since the immune system includes protective functions and actively resists foreign materials, provoking degeneration and inflammation of tissues.

Only surgical suturing of the intestinal edge to the skin heals favorably, although it would be much easier to use special tubes coming out of the intestinal lumen and brought out.

Closing

Surgery to close an intestinal stoma is called a colostomy.

A temporary colostomy is usually closed 2-6 months after application. This operation is the elimination of an artificially created anus.

A prerequisite for the closure of the operation is the absence of obstructions in the lower parts of the intestine to the anus.

Approximately one centimeter from the edge of the stoma, the surgeon dissects the tissue, slowly separating the elements. Then the intestine is taken out and the edge with the hole is excised. Then both ends of the intestine are sutured and returned to the peritoneum. Then, using contrasting, the seam is checked for tightness, after which layer-by-layer wound stitching is carried out.

Reconstructive surgery

Typically, such interventions are prescribed for patients with temporary colostomy, imposed during the treatment of the underlying intestinal tract. Many patients believe that after ostomy closure, intestinal functions are fully restored, which is not entirely true.

For Dasha, with the complete success of the restorative surgical intervention, the absence of a certain area in the intestine cannot but affect its further functionality.

The most optimal time to close the stroma is the first 3-12 months after surgery. This is the only way to count on the successful healing of intestinal tissues without consequences for the body. In fact, reconstructive surgery is the closure of the stoma or colocolostomy, the description of which is presented above.

Diet after surgery

After reconstructive surgery or closure of the stoma, a strict diet must be followed so that the digestive process can recover quickly.

The diet is reduced to the exclusion of foods like:

• Hot herbs or spices like curries, chili peppers, etc.
• Excessive amounts of soda, kvass or beer;
• Gas-forming products such as beans, garlic or cabbage, etc.;
• Fatty dishes;
• Foods that irritate the intestinal tissues, such as currants or raspberries, grapes or citrus fruits.

If necessary, the doctor prescribes individual restrictive dietary prescriptions for the patient.

Complications

Colostomy is a serious surgical procedure that can cause many complications.

• Specific discharge. This mucus is produced by intestinal tissues as a lubricant to facilitate the passage of feces. Normally, the consistency of the discharge may be sticky or egg-white. If there are purulent or bloody impurities in the mucus, then this may indicate the development of an infectious process or damage to the intestinal tissues.
• Blocked stoma mouth. Usually, this phenomenon becomes a consequence of the adhesion of food particles and is accompanied by watery stools, swelling of the stoma, flatulence, or nausea and vomiting symptoms. If there is a suspicion of the development of such a complication, it is recommended to exclude solid food, periodically massage the abdominal area near the mouth of the stoma, increase the amount of fluid consumed, and take hot baths more often, which helps to relax the abdominal muscles.
• Paracolostomy hernia. A similar complication involves protrusion of the intestines through the muscles of the peritoneum, and a clear subcutaneous bulge is observed near the orifice of the stoma. Special support bandages, weight control and refusal to lift and carry weights will help to avoid. Hernias are usually repaired conservative methods but sometimes you can't do without. Unfortunately, there is always the possibility of re-formation of the hernial process.

Also, with a colostomy, other complications may develop, such as fistulas, prolapse or retraction of the stoma, stenosis or ischemia of the colostomy, leakage of digestive waste into abdominal cavity or on the skin surface, strictures or evaginations, and necrosis, purulent processes, etc.

To avoid such troubles, you can, most importantly, strictly follow medical recommendations, especially the diet and hygiene requirements for the care of a colostomy.

The video tells you how to care for a colostomy:

If a person has a need to form an intestinal stoma, he needs to know how his life and habits will now change. There are diseases in which stoma is the only way to save the patient's life. For what diseases is such an operation needed, what types of surgical intervention are there and what kind of complications arise if the recommendations of the attending physician are not followed?

The intestinal tract is an operation measure necessary for the removal of feces outside the anus.

What it is?

A rectal stoma is an artificial opening that is created in the rectum, as a result of which fecal matter is removed from the organ, since emptying naturally is difficult due to a serious illness. The stoma is formed temporarily, or a person will have to be with such a hole all his life. If there are no complications and concomitant pathologies do not develop, a person can work and lead a full-fledged social life. However, if such surgery is caused by serious illness, then the patient may become disabled and then he will need the help of loved ones.

Indications

An indication for the formation of an artificial opening is a congenital anomaly in the structure of the intestine, when problems arise with its natural emptying. Thanks to the artificial opening, it is possible to solve the problem of emptying and restore the normal functioning of the intestines. But there are diseases in which the organ is subject to complete or partial removal, while it is possible to remove nearby organs (in oncology with the development of metastases). Here is a list of diseases in which an artificial hole is formed:

• oncological damage to the intestines and neighboring organs;
• mechanical damage;
• and nonspecific;
• problems with fecal incontinence;
• organ damage with poisons and chemicals;
• other pathologies that disrupt the work of the digestive system.

What are the types of intestinal stoma?

1. Depending on the place of imposition, there are such stomas as:
   • Colostomy, when the large intestine is affected, resulting in the need to remove the stoma. With a colostomy, the unloading of the large intestine occurs at least 2-3 times a day, and full-fledged feces are formed.
   • An ileostomy is formed when pathological processes occur in the small intestine and there is a need to remove the small intestine. With an ileostomy, the patient has a broken stool, diarrhea is constantly worried, which leads to dehydration of the body and a deterioration in health. An ileostomy is formed in the ileum, and the stoma is brought out on the right side of the abdominal cavity.
2. Depending on the shape, artificial holes are:
   • flat;
   • retracted;
   • convex.
3. Depending on the length of the rehabilitation period:
   • Temporary is formed in cases when it is impossible to empty the intestines before the intervention is carried out (the formation of adhesions, a tumor that blocks the entire lumen). After the intervention is carried out, the intestine regains its functions and the need for a stoma disappears.
   • The permanent is formed permanently and cannot be removed. This is caused by irreversible pathological processes when the organ is damaged and cannot be restored.
4. Depending on the number of trunks being formed:
   • single-barrel, when one barrel is formed.
   • double-barreled in which two trunks are made, which are close to each other, but bring them into one stoma.

Colostomy for cancer

If a patient has cancer that completely blocks the intestinal lumen, an operation to form an artificial opening is indicated. With cancer, the tumor is completely removed and if necessary, then part of the intestine is also removed, in which case the stoma will perform its functions. The peculiarities of caring for the hole are the same as for a regular stoma, however, if the patient is weak or completely bedridden, then the hygiene procedures are performed by relatives or hospital staff.

How can they change?

The shape and size of the artificial hole changes over time. After it is formed, edema forms at the site of the opening, which bleeds and hurts until the wound heals. After 5-7 days, the edema disappears, the stoma decreases in size, and a healthy pink tint is formed. In 2-2.5 months, the stoma becomes fully formed. It decreases and increases in size, this is due to the fact that there is a contraction or expansion of the intestinal walls. The size of the stoma should always be monitored. In the first 2-3 months, the size should be monitored every day, and after that, during the year, once a month. If everything is normal and there are no complications, then the stoma is checked every 6 months.

Human lifestyle

Nutrition and diet for ostomy

If the patient has an ileostomy, then the nutrition is based on the use of sparing food, which is steamed or boiled. The diet excludes the use of smoked meats and fatty meats, fast foods, hot spices and seasonings, vegetable and butter oils in large quantities, juice, raw fruits and vegetables. Do not eat sour foods (tomatoes, sour fruits), cabbage, potatoes of any kind, beans. During diet food you need to exclude carbonated drinks, food that contains coarse ingredients, nuts. Drink plenty of fluids, as there is a risk of dehydration.

With an artificial hole, the diet is based on the principles proper nutrition drinking enough water, as constipation and problems with emptying may occur from time to time. A person can determine for himself which products are suitable for him, and which ones must be completely abandoned. When forming this type of artificial hole, the patient needs to give up bad habits, learn to chew food thoroughly, eat in small portions, every 2-2.5 hours.

A stoma is an artificial opening of a hollow organ.

In surgery, this is an artificially created opening of a hollow organ, which is displayed on the anterior abdominal wall. It is applied surgically, the name of the stoma is determined by the organs on which the stoma is applied. For example, in case of violation of the patency of the larynx, a tracheostomy is superimposed, in case of obstruction of the esophagus - a gastrostomy.

Types of stoma

• Colostomy- when a part of the large intestine is taken out through an opening in the abdominal wall, with diseases such as cancer, with severe trauma, removal. It can be temporary or permanent. There is no control over the excretion of feces from your side; a replaceable colostomy bag is used to accumulate the feces.
• Ileostomy- removal of a part small intestine... Ileostomy is applied for ulcerative colitis, Crohn's disease, when removed together with the rectum and anus. An ileostomy can also be temporary or permanent. Control over the excretion of faeces also occurs with the help of colostomy bags and additional protective O-rings.
• Urostomy- applied if necessary to remove the bladder. Urine is diverted through the stoma and collected in a urine bag.

Why is it necessary to place a stoma?

Stoma placement is carried out only for health reasons, such a stoma placement saves the patient and makes it possible to live and do everyday activities. For example, in colon cancer, stoma operations are performed to drain intestinal contents due to obstruction of the colon and tumor blockage. The stoma can be temporary or permanent.

Doctors, medical staff, your family and friends will help you learn to self-care, learn new hygiene skills and use aids (for example, colostomy bags), you will be able to return to your daily lifestyle, to work, even playing sports.

Features of stoma care

After stoma surgery, a recovery period of about 3 months is required. The stoma may look swollen and bleed. During the recovery period, the size and shape may change.

A regular hygienic ostomy toilet is required. No special devices, sterile conditions or dressings are required. After the recovery period, do not be afraid to touch it, the stoma can be touched and processed without gloves. The stoma is washed with warm, running water, it is possible with baby soap, while taking a shower, the colostomy bag is temporarily removed. Then blot with a soft towel. It is not recommended to shave the hair around the stoma; it is better to cut it with scissors. The skin around the stoma can be lubricated with baby cream (but not the stoma itself), before putting on the colostomy bag, the cream must be washed off.

As for changing the colostomy bag, you can do it yourself, preferably in front of a mirror, in any position that is convenient for you. Choose a colostomy bag (one-piece or two-piece) that suits your type of stoma, surrounding skin, frequency of bowel movements and stool shape

The stoma itself cannot hurt, pain or burning sensation appears due to irritation of the skin around or due to the increased work of the intestine. It is advisable to visit a specialist at least once every six months, as well as, at the slightest suspicion, when changing the stoma, leaving under the skin or eversion.

The stoma diet is gentle, not harsh. But with the absence of fatty, spicy, gas-promoting and diarrhea food. The food should be varied, chewed well enough, and sufficient water is needed.

Wear clothes that are not tight and do not put pressure on the stoma. Swimming is allowed (using a mini colostomy bag), light sports, aerobics, cycling, tennis. You can travel with a colostomy bag change kit.

Ostomy patients can continue to have a sex life, women (if the uterus and ovaries are not affected) can become pregnant and give birth (by Caesarean section).

In case of urgent problems, you can also consult a doctor at the local polyclinic - surgeon, coloproctologist, oncologist.

Stoma is not a disease, but support and assistance to your body. Considering all the features, you will be able to return to work and your daily life.

An intestinal stoma is an artificial opening that is often referred to as an unnatural anus because the bowel is emptied through an artificial opening and not through the anus. In some cases, this is a temporary measure: after a few months, an operation is performed to close the stoma, and in some cases, the patient, unfortunately, is provided with life with the stoma.

An intestinal stoma is made in the wall of the abdominal cavity: a special hole is made on the peritoneum, into which the end of the large intestine is sewn. A special bag is attached to the hole: the feces, passing through the intestines, reach a specially created hole and enter the attached bag.

Intestinal stoma can form in both adults and children. In babies, this type of surgery is in most cases temporary.

Indications for the operation

A permanent bowel stoma occurs only when the lower bowel cannot be restored.

Intestinal stomas are performed in the following cases:

• traumatic damage to the intestine due to mechanical damage;
• tumor-like formations in the intestine;
• anorectal incontinence;
• recurrent cases cancer not only in the intestines, but also in the bladder, uterus;
• complications after radiation therapy cervical canal;
• the presence of internal fistulas towards the vagina or bladder;
• atresia of the anus canal;
• congenital developmental pathologies gastrointestinal tract;
• severe forms of the course of proctological pathologies;
• rectosigmoid resection;
• sharp;
• preoperative preparation for the prevention of suppuration or seam dehiscence.

Such a hole of any type makes significant changes in a person's life: it is not possible to work in all areas, and it becomes somewhat difficult to visit public places and entertainment events. The way of life is changing, including the procedure for carrying out bowel movements, hygiene procedures.

Types of stoma

The hole can overlap both the small and large intestines.

If we talk about the form that is superimposed on small intestine, there are the following types:

• ileostomy;
• duodenostomy;
• jejunostoma.

With regard to the large intestine, the following types of stomas are distinguished:

• colostomy;
• transverse stoma;
• cecostomy;
• sigmoidostomy.

This type of operation can be performed in relation to other body systems - tracheostomy, bladder stoma.

By its structure, a colostomy can be:

• single-barreled - a longitudinal incision of the large intestine is carried out, only one hole is brought to the surface, it is used if the stoma is lifelong;
• double-barreled - the intestinal loop is withdrawn in such a way that there are two holes on the surface: fecal matter is removed through one hole, and drugs are injected through the other.

Colostomy and ileostomy are most commonly performed. This is due to their convenient location on the abdominal wall for performing hygienic procedures. The choice of the location of the artificial hole will depend on the type of pathological process.

By type, intestinal fistula can be temporary and permanent. A temporary one is applied in cases when the small or large intestine needs to be isolated from the passage of feces for the duration of treatment. At the end of the therapeutic measures, the stoma is closed.

A permanent type of artificial opening is formed when the lower intestine with the anal sphincter is removed. The operation can be both urgent and planned, depending on the type and severity of the pathological process. In the postoperative period, patients are prescribed a special bandage for the stoma, which improves the waste of feces.

Types of colostomy bags

Ostomy bags can be of two types:

1. One-component. The adhesive plate and the bag itself are integral. These types of bags can be drained or non-drained. In the first case, the bag must be emptied when it is filled by 1/3 with feces, and in the second case, it must be changed after each bowel movement.
2. Two-component. They consist of two parts - a plate with a flange and a bag. These ostomy bags are equipped with a special membrane filter that prevents gases and masses from entering the outside.

The plate for the colostomy bag is attached for at least 48 hours, while the first type of bags is not more than a day.

Stoma care involves not only the timely change of colostomy bags, but also other hygienic procedures. Otherwise, serious complications may develop.

Care rules

Stoma care involves performing several hygiene procedures regularly and in a timely manner. In the presence of an artificial opening, a person does not feel the urge to empty the intestines, therefore, the release of masses occurs involuntarily. Therefore, the patient needs to carefully monitor hygiene.

In the first days after the operation, the wound is cleaned and the colostomy bags are replaced, as a rule, by a nurse. Further, the procedures will need to be performed by the patient independently.

Until the hole is completely healed, the care procedure involves the following activities:

• gently remove feces;
• boiled water wash the hole, the skin around it and dry the surface with gauze or a sanitary napkin;
• the skin around the hole is treated with a special ointment - the doctor prescribes means to care for the stoma;
• a gauze soaked in petroleum jelly is applied around the stoma, a sterile bandage is covered, which must be changed every 4 hours.

Colostomy bags can be used only when the hole is finally formed and healed. Only a doctor can determine this.

The skin around the hole should be dry so that maceration and other unpleasant factors do not occur, which can subsequently lead to inflammation or infection. Instead of soap and water for cleansing the skin, it is better to use "Klinzer". Abucel is used - a paste for stoma that protects the skin around the artificial opening.

Replacement of the colostomy bag should be carried out as follows:

• it is not recommended to do this immediately after a meal - it is better to change the bag in the morning before breakfast and in the evening, before bedtime;
• the protruding intestine and the surrounding skin must be treated with sanitary napkins;
• the colostomy bag is being attached - so that the flange is better attached to the skin, it is recommended to use Coloplast paste.

When attaching the bag, you need to ensure that there are no gaps. There will be no leakage and no unpleasant odor coming out.

Nutrition

Eating during a stoma will not be special. A diet is prescribed only if it is due to the underlying pathological process.

The only thing to consider when eating with an artificial opening for emptying the intestines is the effect of a particular food on the output of feces:

• it is recommended to limit the amount of foods in the diet that provoke gas formation - mushrooms, carbonated drinks, legumes, onions, eggs, beer;
• limit the amount of foods that increase the smell of feces - fish, onions, cheese, spices, garlic, chicken eggs.

You need to eat often, but in small portions. Laxatives should be used with caution.

Possible complications

If the patient does not properly care for the hole, extremely unfavorable pathological processes may develop. Complications of a stoma can be expressed in the following:

• leakage of digestive waste into the abdominal cavity;
• stoma;
• tissue necrosis;
• development of inflammatory, infectious, purulent processes;
• blockage of the mouth of the stoma - a complication occurs due to the adhesion of food particles: the stool will be watery, the stoma swells, nausea and vomiting occur;
• specific discharge - normally white, protein-like chicken eggs, but if there are blood impurities in the mucus, the discharge becomes purulent: you should consult a doctor, as this indicates the development of complications.

Taking care of the artificial intestinal outlet and preventing complications from developing is not as difficult as it might seem at first glance. The main thing is to carry out hygiene procedures in a timely manner and not get hung up on the problem.

Stoma - This is an opening of the intestine, surgically formed after removing all or part of the intestine, or the bladder, brought out to the anterior abdominal wall, designed to drain intestinal contents or urine. The stoma does not have a closure apparatus, therefore ostomy patients do not feel the urge and cannot control the emptying process ... The stoma is also devoid of painful nerve endings, so pain is not felt. The resulting pain, burning or itching may be associated with irritation of the skin around the stoma or with increased peristalsis (work) of the intestine.

The need for a stoma occurs when the bowel or bladder is unable to function. This may be due to a birth defect, illness or injury.

Stoma may be permanent or temporary. A permanent stoma cannot be eliminated in the course of further treatment of the patient due to the absence of irreversible damage to the intestinal obturator apparatus, or if it is impossible to quickly restore the continuity of the intestinal tract and for other reasons.

Stomas can be single-barreled(i.e., through the opening on the anterior abdominal wall, one colon is removed) and double-barreled. Moreover, the latter are divided into loopback(i.e. two barrels are in close proximity to each other and brought out into one hole) and separate double-barreled stomas, when there are two openings on the anterior abdominal wall, i.e. two trunks located at some distance from each other.

In this case, when using ostomy care products, the colostomy bags should not overlap (even if the distance between the stomas is very small). With such stomas, one trunk is active, through which the bowel is emptied. A colostomy bag is glued to the active trunk. Another shaft may be needed for mucus removal or medical procedures. It can be covered with a mini cap (closed bag of minimum capacity) or a gauze cloth.

Types of intestinal stomas

Intestinal stoma often called an unnatural anus, since bowel movements are not carried out through the natural anus, but through an opening formed on the anterior abdominal wall.

Depending on the section of the intestine brought out to the anterior abdominal wall, the following types of intestinal stomas are distinguished: colostomy(when removing the colon) and ileostomy(when removing the small intestine).

Colostomy

According to the place of imposition, several types of colostomy are distinguished: cecostomy, ascendostomy, transverse stoma, descendostomy, sigmostomy.

With a colostomy, bowel emptying occurs mainly 2 - 3 times a day, the stool is shaped (with a sigmostoma) or semi-formed (with other types of stomas).

Ileostomy

With an ileostomy, bowel movements occur very often, almost constantly, the stool is liquid and acrid. A common problem with ileostomy, diarrhea, which can lead to dehydration and loss of electrolytes,

minerals and vitamins. Therefore, it is very important to consume a lot of fluids.

Urostomy

The urostomy is formed when it is necessary to remove the bladder. Urine diversion is performed through a dedicated section of the intestine, to the upper end of which the ureters are sutured, and the lower end is output to the anterior abdominal wall. Discharge of urine is constant and uncontrolled. With an urostomy, there is a constant outflow of urine through the stoma.

Ostomy care products

The choice of ostomy care products depends on the type of stoma, its location, the appearance of the stool, the characteristics of the skin around the stoma, as well as the patient's preferences.

There are two types of modern glue-based ostomy care products: one-component and two-component colostomy bags and uroreceptors.

One-piece colostomy bags and uro-bags are an ostomy bag with a built-in adhesive plate (i.e. a bag with an adhesive backing). They may be undrained (closed), drained (open) or urostomy.

Two-component colostomy bags and uro-collecting bags are a set consisting of separate ones from each other glue plate and ostomy bags and have a special device for attaching the bag to the plate - flange.

D For patients with a retracted stoma, special convexplates. They have a rigid flange and "ears" for attaching a belt. This plate is often recommended to be worn with a belt for a more secure fit.