Oncological rehabilitation of patients with colon cancer. Features of the formation of colostomy in various pathologies of the intestine

So, colostomy: what is it? This artificial anus, which doctors call Anus Preter Naturalis, is an opening on the abdomen, usually on the left, formed during a colostomy, into which the end or loop of the colon or sigmoid colon is brought out and sutured. The output of the colostomy is necessary for the outflow of the contents of the large intestine, bypassing the natural path of the rectum, in the event that there is damage or an insurmountable obstruction of the output section.

According to its anatomical location, the large intestine almost closely adjoins the wall of the peritoneum. Outlining the place of withdrawal of the colostomy, the surgeon focuses on the nearest area, under which the lesion is also located.

A colostomy is formed slightly above the pathological area to prevent the penetration of feces there. A colostomy can be a temporary palliative or permanent preventive measure, depending on the pathology and the nature of the operation preceding it.

How to live with a colostomy?

To a non-medical person, a normal life with a colostomy can seem like hell. For some patients, the diagnosis of "Cancer" is not so terrible as the prospect of "living with a fecal sac" is terrible. In fact, this is not so, even with the setting of a permanent colostomy, you can lead a full-fledged active life. In the article about, we present the results of a survey of ostomy patients on how they assess the quality of their life? The survey showed that life with a colostomy is just as wonderful as without it, it all depends on the person!

How many years can you live with a colostomy?

Long, very long! I have a patient who has been living with a colostomy for over 35 years. By the way, not only cancer is an indication for stoma surgery.

Types of colostomy and indications for colostomy

Note that the gut is removed not only for cancer! Many other diseases lead to colostomy surgery. The need for such treatment - the removal of a colostomy always arises for two main reasons, these are:

1. If it is necessary to give time to rest and recover the rectum or the lower parts of the large intestine, for example, after severe inflammation or surgery. Then a temporary withdrawal is established, which will be removed by closing the colostomy at the end of the recovery period and complete healing of the tissues.
2. In the event that during the main operation a part of the large intestine (rectum, sigmoid or colon) was removed, then a colostomy is performed with the removal of a permanent colostomy.

According to where it is planned to form an artificial conclusion, the types of colostomy are classified.

Transverse colostomy

It is formed in the upper left part of the abdominal wall, since this part of the colon is less innervated. The imposition of a transverse stoma is done with such pathologies as:

• diverticulitis,
• Colon cancer.
• Injuries of the abdominal cavity with damage to the intestines,
• Congenital pathologies of the large intestine.

In the vast majority of cases, a transverse view of the colostomy is formed for a short time to eliminate the risk of complications after surgery. Further treatment is reduced to a reconstructive operation - removal of the stoma

Double-barrel colostomy (loop)

This type of colostomy is performed when it is necessary to temporarily disconnect the lower intestine from the digestive process, but leave open access to the affected area. A loop of the colon is brought into the hole, cut across and two holes are formed. One of them serves to remove feces, and the second to administer drugs. The closure of the temporary colostomy is carried out after the complete healing of the “turned off sections of the intestine”.

A double-barreled colostomy is formed with such diseases as:

• Crohn's disease,
• Nonspecific ulcerative colitis,
• total polyposis,
• Severe infection of the lower intestine.

Single-barreled colostomy (terminal)

This is in most cases a permanent colostomy, in which a completely cut end of the intestine is sutured to the abdominal wall. The technique of setting a single-barrel stoma is carried out after the complete removal of the lower intestine due to cancer.

Rectal cancer, sigmoid colon cancer, and other forms of colorectal cancer may be an indication for terminal colostomy, rarely familial.

Advantages and disadvantages

The most important and significant advantage, covering many minor shortcomings of the anus preter naturalis, is the possibility of a normal life for patients after radical surgery for cancer of the rectum or sigmoid colon.

Modern convenient colostomy bags, bandages and other devices make it possible to practically not experience any inconvenience even in the presence of a permanent colostomy.

Psychological factor

Depression? No place for depression! Life goes on!

Some ostomy patients even manage to make a business out of their position. As the saying goes, “you can’t forbid living beautifully!”. became a celebrity thanks to his positive attitude towards the stoma!

To avoid depression, before discharge, doctors tell you how to properly care for a colostomy; what the person might feel; and what nuances he needs to take into account.

Smell

Not so long ago, the biggest problem was to prevent the appearance of smell. Uncomfortable rubber pads constantly moved out, rubbed the skin, and let the discharge pass. Life with a colostomy really turned into a continuous torment.

But today, when colostomy bags with a magnetic lid, odor filters, special deodorants are available for free, not only the problem of unpleasant odor has disappeared, but also the problem of frequent changes of the colostomy bag and skin irritation.

Involuntary Factors

People with a colostomy should be aware and always remember that a stoma does not have sphincters and therefore involuntary emptying or flatulence can occur. To avoid this, you need to adjust the diet and try to control the bowels. And also you need to put on an elastic bandage when leaving the house, which will help to avoid unexpected sound effects and support the colostomy bag.

Constipation and colostomy

A common issue that worries patients with a colostomy is the possibility of constipation, which they suffered before surgery, or constipation after surgery. This factor is not to be feared. Since the output sections of the large intestine are excluded from the work, complete absorption of liquid from the chyme will not occur, therefore, the feces entering the colostomy bag will always be of a liquid consistency. Constipation usually does not happen. But if constipation still occurs during a colostomy, then an enema is given. How to do an enema with a colostomy is described and shown (video) in an article about.

A hernia with a stoma is another unpleasant moment. A hernia may also occur after reconstructive stoma closure surgery. To prevent the formation of a hernia, you should not lift more than 5 kg and it is recommended to wear an elastic bandage for at least 6 months after the operation.

Types of colostomy bags and accessories for them

Today, colostomy bags are represented by two main types, one-component and two-component.

A one-piece colostomy bag is attached with a sticky layer to the skin around the stoma opening, after filling it is removed, as it is disposable.

The two-component view of the colostomy bag, in addition to the adhesive plate, has ostomy bags connected by a flange. The advantage of this device is that it is possible, without peeling off the plates for several days, to change only the bags. According to the instructions, the adhesive plate should be changed only when there is a feeling of discomfort or with significant contamination.

Both types of colostomy bags have filters that keep out odors and air leaving the intestines.

On average, the change of colostomy bags is obtained in this mode:

• One-component - after 8 hours;
• Two-component - once, twice a week.

And for fashionistas and fashionistas, designer bags for colostomy have been developed. Some bags are just a work of art! And trendy bandages.

Colostomy care

While the patient is in the hospital, the colostomy is cared for by a specially trained nurse. She changes the filled ostomy bags, treats the skin with ointments and creams, and fastens clean bags. At the same time, she teaches the patient to perform all the manipulations, since after discharge he will have to do it himself.

Immediately after the colostomy, fecal formations are removed from the output, the adjacent skin areas are thoroughly washed and dried with napkins. Then the colostomy is closed with a sterile dressing for 4 hours. Only after the complete reconstruction of the colostomy and complete healing of the tissues has passed, the colostomy bag is attached.

The main treatment of the colostomy should be done in the morning. The bags are removed carefully, without creating tension on the skin. Then traces of feces are removed, the colostomy is washed with warm water, and treated with a special cleaning solution Klinser, which foams and cleanses the skin well. Clinser does not need to be washed off. No need to treat with alcohol-containing antiseptics! After complete drying of the skin, an adhesive ointment with nourishing properties is applied to better adhere the colostomy bag, and after that the colostomy bag itself is attached.

For high-quality processing of a colostomy, in addition to a colostomy bag, you must have:

• support bandage,
• Softening, nourishing ointments,
• Talc,
• detergent solution,
• Deodorant,
• Sterile wipes.

Features of nutrition in colostomy

The first weeks after a colostomy, a low-fiber diet is prescribed. This is necessary to avoid the formation of large volumes of feces, which can lead to constipation, since large stools cannot pass through the opening of the colostomy. Details in the article about.

In the future, it is necessary to follow a healthy balanced diet, consisting of fresh vegetables and fruits, semi-liquid cereal dishes, lean varieties of dietary meat, lean fish and soft-boiled eggs.

Be sure to include dried apricots, raisins and prunes in your daily diet. Exclude white bread and pastry, replacing it with baked goods made from wholemeal flour, preferably with the addition of bran.

Treatment of various bowel diseases may require special diets, taking into account the stoma. Features of the diet for bowel cancer and chemotherapy are determined by the oncologist. Western scientists tend to exclude or limit meat (animal protein) in the treatment and nutrition of patients with colorectal cancer.

Physiotherapy

An obligatory component of treatment - specially selected exercises performed under the guidance of an experienced trainer, contribute to the restoration of bowel function and the rapid healing of postoperative wounds. In addition, classes in the pool are useful. Since all colostomy bags are waterproof, swimming is not prohibited.

Job

After complete healing of the tissues, you can return to your usual life and work. In the event that professional activity requires physical exertion, it is necessary to wear a bandage. In any case, "anus preter naturalis" will not affect your professional qualities in any way, and there is no reason to refuse your favorite work.

Dr. Svetlana Srivastava

Dear friends! The medical information on our website is for informational purposes only! Please note that self-medication is dangerous for your health! Sincerely, Site Editor

Not everyone knows what it is - a colostomy and how to live with it. These issues are quite relevant for patients who are concerned about the consequences of pathological processes associated with the emptying of the large intestine.

In simple terms, a colostomy is an artificial anus formed on the abdomen to remove stool. They resort to this in a situation where there is damage to the large intestine or there is an obstacle to emptying it.

A colostomy is an opening in the anterior abdominal wall, created by surgery. It takes over the function of the anal exit when defecation is not possible in a natural way.

During the operation, a round incision is formed above the damaged area of ​​the organ, through which the colon or sigmoid colon is removed. It is sewn to the edges of the hole formed.

The elevation above the skin, formed as a result of the operation, smoothes out as the edema decreases. The hole narrows.

Feces from the excreted intestine are excreted into the colostomy bag - a special bag that is installed directly in the area where the intestine is removed.

The operation to form a colostomy provides the possibility of removing feces without affecting the digestive process.

In what cases is the operation performed

An indication for the formation of an artificial anus is the presence of intestinal diseases, when its natural emptying becomes impossible. Often such an operation is the only way to save the patient's life.

The reasons for requiring surgery are as follows:

1. Weakening of the muscles of the anus, accompanied by.
2. Neoplasms in the anus, resulting in its blockage and obstruction.
3. Injury to the walls of the colon.
4. Intestinal diseases - perforation of the walls due to abscesses, ischemic or ulcerative colitis, peritonitis.
5. The need to remove a colostomy is mandatory after bowel surgery or rectal cancer.
6. Fistulas on the inner walls of the organ.
7. Intestinal operations.
8. Congenital anomalies leading to intestinal obstruction in newborns.

Often, a colostomy is performed as a preventive measure before major operations in order to prevent complications in the form of pus on postoperative sutures.

Classification

Depending on the reason that caused the need to remove the rectum, surgeons distinguish two situations:

1. The indication for the removal of a permanent colostomy is the inability to restore the functions of the lower part of the large intestine. This is due to a violation of the activity of the sphincter due to various diseases of the colon, especially if malignant tumor processes take place in it (that is, in oncology).
2. A temporary colostomy should be closed after 6-12 months. This is again performed with the help of surgical intervention, as a result of which the natural emptying of the intestine is restored.

Temporary placement is performed most often in newborns.

Varieties by type of localization

Based on the place where the operation is performed, there are three types of colostomy.

transverse

Such a conclusion is made in the upper zone of the peritoneum. In this case, the transverse section of the colon is brought into the hole.

Indications for operations of this type: congenital pathologies of the large intestine, trauma to this organ, its obstruction or oncological diseases.

There are two types of transverse colostomy:

1. Single-barreled. They are performed in the form of a longitudinal dissection on the intestine. At the same time, one of its ends is removed and sutured.
2. Double-barreled. The cross section of the intestinal loop is performed in such a way that two exits are fixed on the abdomen. This makes it possible to remove feces through one of them, the second is used to administer the necessary drugs.

In the presence of a formed double-barreled colostomy, mucus from the lower intestine can be released both from the established mouth and through the natural anus. Deductions of this type are made for temporary use.

Rising

It is performed in the right side of the abdomen in the upper part of the colon. The excreted feces will be insufficiently formed, liquid with a large number of incompletely digested food fragments.

This causes frequent processing of the reservoir for the accumulation of waste products.

descending

Such a conclusion of the intestine (usually the colon) is formed in the left lower region of the peritoneum.

The peculiarity of this operation is the preservation of the nerve endings of the intestine. This makes it possible to control the defecation process.

Such colostomies are formed as permanent.

Types of surgery

Operations to remove the colon to the outside are carried out in exceptional cases. Before this, the most optimal variant of the type, type and location of the stoma is specified.

Given the individual characteristics of the individual patient, various methods of surgical intervention are used. Among them:

1. overlay. This operation is performed under general anesthesia. Previously, in the area where the colostomy will be located, a round-shaped skin area and the same amount of subcutaneous adipose tissue are cut out. Then the intestine, stretched outward in the form of a loop, is incised and sewn to the abdominal muscles, the edges are connected to the skin.
2. Colostomy closure. In order to close the artificial anal outlet after a certain time, another operation is required - a colostomy. It is carried out not earlier than 2 months and not later than six months after its imposition. In addition, such an important factor as the favorable condition of the lower zone of the large intestine and the natural anus is taken into account. To close the colostomy, the suture sites are separated, the ends of the intestine are sutured and set into the peritoneum. The hole is then sutured. The main complication after closing the mouth is a recurrence of intestinal obstruction.
3. Colostomy reconstruction. A surgical operation associated with changing the hole is performed in the presence of a temporary colostomy.

This procedure does not give a 100% guarantee that the closure of the stoma will lead to the complete formation of the natural functioning of the defecation processes. This is explained by the fact that the reconstructive operation does not compensate for the removed segment of the intestine. This affects the activity of the entire large intestine.

A similar operation is performed in the period from 2 months to a year after the establishment of a colostomy. Most often, permanent shaping of the anus is recommended.

Pros and cons of the operation

We must not forget that impaired intestinal patency is associated with a high risk of death for patients. The operation gives a chance for a continuation of life.

An indisputable fact that is part of the positive side of the artificial exit is to ensure the full process of the formation and removal of feces from the intestines.

Flaws

The biggest drawback is the psychological state of depressed patients. The depressed state is eliminated during conversations with patients after the operation.

Even in the hospital, they are taught the rules for caring for the hole, they are warned about possible sensations and ways to eliminate discomfort.

Most of all, patients are afraid of the possibility of the presence of a bad smell. But this can be easily avoided by using special devices equipped with reliable devices with filters that do not let in odors, as well as deodorants.

Possible Complications

There is a possibility of negative consequences with any operation. Among the most common such manifestations should be noted:

1. Discharge at the mouth of mucus, resembling the consistency of egg white. Its formation in the intestine promotes the movement of feces through it. The appearance of pus and blood in it indicates the presence of infection or damage to the tissues of the colon.
2. Blocking the formed anus. This situation occurs with insufficiently formed stools, frequent bowel movements with poorly digested food fragments. This provokes swelling of the colostomy, increased gas formation, nausea and vomiting.
3. The hernia is paracolostomy. In this case, the intestine goes beyond the hole, a convex formation is probed under the skin in this area.
4. Stricture, stenosis (narrowing) of the mouth of the stoma. A pronounced narrowing is accompanied by pain, makes it difficult to empty the intestines and in some cases completely excludes its possibility. If constipation occurs, which are not eliminated with the help of laxative food, they resort to the method of irrigation - the use of an enema.
5. A rare manifestation of complications is weight loss by the patient after surgery. This may be a consequence of psychological experiences, due to which the patient loses his appetite. A more complex reason for this phenomenon is the recurrence of a remote tumor in the intestine or metastases.

In addition to these complications, you should be aware that excessive physical stress, as well as weight gain, lead to the fact that the stoma can overgrow, turn black, and increase in size.

In such situations, it is necessary to see a doctor who will give appropriate recommendations to eliminate the complication that has arisen.

How to avoid bad consequences

To prevent the formation of a hernia, the following preventive measures are taken:

• use of a bandage;
• exclusion of physical activity;
• weight gain prevention.

Such preventive measures do not always manage to eliminate the hernia. In this case, its surgical removal is carried out, which does not exclude relapse.

To prevent narrowing of the lumen of the colostomy, its bougienage (expansion) is recommended. In most cases, it is carried out by the patient independently. But before using this method, you need to take a training course.

Is a diet necessary?

There are no strict nutritional requirements after surgery. But you should follow some rules:

• it is advisable to exclude from the menu (especially at first) foods that provoke diarrhea or constipation - freshly baked white bread, rice dishes, strong tea, black coffee, fruits and vegetables containing a lot of coarse fiber;
• limit the use of eggs, cabbage, beans, peas, onions and garlic to prevent the appearance of a heavy smell;
• spicy spices, alcoholic beverages are prohibited.

About the quality of life

The ability to properly maintain the normal state of the colostomy makes it possible not to change the usual way of life, to be active and experience the joy of communication in society.

The main thing is not to become isolated, which often happens when patients are issued with a disability. Gloomy thoughts about their inferiority and inferiority not only spoil the mood, but also make them think about suicide.

All problems after the operation are solved quite simply..

This is facilitated by the presence of special devices that facilitate the care of the colostomy, which are perfectly fixed on the skin.

They prevent the penetration of odors, are not visible under clothing, do not interfere with movements. With their help, life with a colostomy is not difficult.

Types of stool storage

There are several types of colostomy bags available:

• one-component - with a plastic bag;
• two-component - with bags attached to a self-adhesive plate with special flanges;
• closed and open tanks (closed ones have filters that neutralize odors, open ones are equipped with a clamp and a hole for removing feces);
• special - for patients with a retracted mouth.

The advantages of a two-component colostomy bag are that the plate sticks for 2-3 days with the daily replacement of bags. Whereas single-component ones are subject to mandatory replacement at intervals of 6-9 hours.

Care rules

Immediately after the operation, the patient is taught how to care for the colostomy.

The first step in this procedure is the processing of the mouth. It provides:

• removal of faeces;
• thorough washing of the hole and the skin;
• drying with sterile wipes;
• applying Lassar paste (or Stomageziv ointment) to the skin near the mouth and applying vaseline-impregnated gauze to it;
• applying a sterile napkin to the hole and applying a bandage.

The dressing is changed regularly after four hours.

Second phase

Mastering the methods of imposing a colostomy bag. This procedure is performed after the final healing of the stoma. The home care algorithm consists in the daily replacement of the device in the following sequence:

1. Wash the colostomy as described above.
2. Measure its size and increase the diameter of the hole on the colostomy bag to the same size.
3. Apply a colostomy bag, aligning its opening with the mouth, fix the device with a slight movement, preventing the formation of wrinkles.

The procedure for replacing the tank is carried out in the morning or evening.

How to avoid skin irritation

The use of Coloplast paste, which soothes the irritated dermis and facilitates the fixation of the device, will help prevent the likelihood of inflammation.

For cleansing, the surface of the skin is treated with Klinser paste, which helps to remove feces, mucus, and glue. Being an excellent antiseptic, it does not lead to dry skin..

The use of a special protective film prevents inflammatory processes on the skin.

It should be remembered that life continues after the removal of the colostomy. But in order to prevent complications, it is necessary to strictly follow the recommendations of specialists.

Proper nutrition, careful care of the hole and compliance with the rules for using tanks ensure a comfortable life for many years.

The patient stays in the clinic for several days. Several different devices can be attached to it, they are removed after the patient recovers:

1. A dropper that provides fluid to the body.
2. A catheter to remove urine.
3. Oxygen mask or nasal oxygen cannulas to facilitate breathing.

A colostomy bag, a special sealed bag, is attached to the stoma. It is usually larger than the standard ones. Later it is replaced with smaller ones, before being discharged.

During the hospitalization process, a nurse at the Assuta clinic will teach you how to care for your stoma, how to keep your skin clean and avoid irritation, advise on the process of emptying and changing bags. The bags are waterproof so you can swim with them.

3-10 days after the colostomy surgery, the patient will be able to leave the hospital.

During this period, it is important to avoid tedious activities that will give a load to the abdominal cavity. The medical staff of the Assuta clinic will inform you how to return to such activities.

In the first few weeks after a colostomy, there may be excessive flatulence and unpredictable discharge. However, the condition will improve when the intestines recover from surgery.

To get a consultation

Colostomy closure

If the stoma is temporary, surgery will be needed to close it. It is performed only when the patient's health has been restored, he has recovered from the consequences of the formation of a colostomy. It is usually performed, as a rule, 12 weeks after the initial intervention.

However, the recovery process may be longer if further treatment is required, such as chemotherapy. In this case, there is no exact limit, some people can live with a colostomy for several years before it is closed.

Sometimes surgery to close a colostomy is not recommended. For example, if the muscles that control the anus (sphincter muscles) have been damaged. Then the elimination of the stoma will cause intestinal incontinence.

The operation to close a loop colostomy is relatively simple. The surgeon makes an incision around the stoma. The upper part of the large intestine is connected to the rest of it.

End colostomy closure surgery is a more invasive surgery because the doctor needs more access to the abdomen. Therefore, the risk of complications will be higher, the recovery period will be longer.

Most patients feel well enough to leave the clinic 3-10 days after such surgery. It will take some time to restore normal bowel function. Some people have diarrhea, but it goes away with time. There are pains in the anus. The use of protective creams such as sudocrem is suggested.

The operation to close the colostomy is less extensive compared to its creation. However, it will take several weeks to recover and return to normal life.

Potential complications of a colostomy

After creating a stoma, there is a possibility of some complications. Let's consider some of them.

Allocations

After a colostomy that did not involve the rectum or anus, there may be discharge of mucus from the rectum. It is produced by the intestinal mucosa and acts as a lubricant to help the stool pass. Its consistency varies from clear "egg white" to sticky and gooey. If there is blood or pus, it is a sign of infection or tissue damage.

One option for managing this symptom is the use of glycerin suppositories. The capsules dissolve, making the mucus watery, making it easier to get rid of.

Sometimes the mucus causes irritation around the anus, and protective creams can help here.

Paracolostomy hernia

A hernia is a condition in which an organ protrudes from the cavity it normally occupies, such as muscle or surrounding tissue due to weakness. In this particular case, there is a protrusion of the intestine through the muscle tissue of the abdominal cavity, near the site of the colostomy, a noticeable bulge forms under the skin. People with an ostomy have an increased risk of this complication because the abdominal muscles were weakened during the operation.

As effective ways to prevent hernia, are considered:

1. Wearing a support belt or underwear.
2. Maintain a healthy weight, as being overweight or obese puts extra stress on the abdominal muscles.
3. Avoid heavy lifting.

Most hernias are managed conservatively, but sometimes surgery is required after colostomy surgery. However, there is a possibility that the hernia will then reappear.

Colostomy blockage

This complication occurs due to food sticking. Possible signs of blockage:

1. Decreased stool volume or watery stools.
2. Flatulence.
3. Swollen stoma.
4. Nausea and/or vomiting.

If there is a suspicion of the occurrence of this complication after colostomy surgery, one should:

1. For the time being, avoid solid foods.
2. Drink plenty of fluids.
3. Massage the abdomen and the area around the stoma.
4. Lie on your back, pull your knees to your chest and roll over from side to side for a few minutes.
5. Take a hot bath (15 - 20 minutes), which will help relax the abdominal muscles.

However, if there is no improvement, you should immediately contact your doctor, as there is a risk of colon rupture.

You can reduce the chance of this complication of a colostomy by chewing your food slowly and thoroughly, without eating too much at a time.

Foods that promote blockage should be avoided, such as corn, celery, popcorn, nuts, cabbage, coconut macaroons, grapefruit, raisins, dried fruits, apple peels.

Other complications of colostomy after surgery

There are a number of other complications that can occur after a colostomy is formed:

1. Skin problems when there is inflammation and irritation on the skin around the stoma. Doctors in Assuta will give recommendations on how to solve it.
2. Fistula (fistula) - a fistula develops next to the colostomy, a pathological small canal.
3. Stoma retraction - retraction of the colostomy into the abdominal wall. The reason can be both a sharp loss and an increase in weight. As a result, intestinal contents can leak and cause skin irritation. Various types of colostomy bags can alleviate this problem, although in some cases further surgery is required.
4. Stoma prolapse - prolapse of the intestinal mucosa due to a wide stoma. Other contributing factors may be intestinal flatulence, increased intra-abdominal pressure, wearing a belt bag. If the prolapse is small, the use of a different bag may improve the situation, although later surgery may be required. It is also recommended not to lift weights, use a bandage.
5. Leakage of digestive waste from the colon onto the skin or into the abdomen. With external problems, the use of various colostomy bags and techniques can help, with internal problems, further surgery will be required.
6. Ischemia of the stoma due to a decrease in blood flow to it. There will be a need for an additional operation.
7. Stenosis or narrowing of the stoma. In most cases, it appears six to eight weeks after the colostomy. An operative approach that widens the mouth can be used. The procedure of "finger bougienage", a special massage, will bring benefits.

The high level of professionalism of doctors in the Assuta clinic, modern medical capabilities will ensure the best treatment result with minimal complications.

Sign up for treatment

Digestion is one of the most important processes performed by such a system of the human body as the gastrointestinal tract.

Violation of the functioning of one of its constituent parts is reflected in the work of the whole organism.

In some cases, getting rid of intestinal diseases requires drastic measures, especially if the negative changes are irreversible.

One of these procedures is the creation of a colostomy (artificial anus), which is used when the normal functioning of the lower part of the intestine is impossible of a temporary or permanent nature.

Colostomy - what is it and how to live for people who have gone through this method of surgical exposure? And also, colostomy - what is it, and what are the types of operations?

The concept of colostomy

What is an intestinal stoma? The surgical term "stoma" implies an artificially created inlet or outlet opening connecting the surface of the skin with one or another hollow organ, for the possibility of direct interaction with it.

What is a colostomy? A variation of this formation, connecting the colon and the surface of the abdomen, is called a colostomy.

A hole is surgically made on the abdomen, into which a section of the intestine (most often the colon) is sewn.

A colostomy is a type of surgical intervention, during which such an education as a stoma is obtained.

Later, a special bag, called a colostomy bag, is placed at the exit, where the fecal masses fall, reaching this artificially created outlet.

Its creation is necessary for pathological formations (for example, tumors, intense inflammation), which prevents the passage of feces, for a subsequent natural exit.

In some cases, a colostomy is a necessary temporary measure for surgical procedures in the lower abdomen or for normal recovery after them.

The colon is closely adjacent to the inner wall of the abdominal cavity, so the choice of the location of the surgical formation depends on the localization of the affected area.

The outlet must always be above the dangerous segment.

The type of pathology or other circumstances that caused the use of this technique also affect the next choice: temporary or permanent changes will be made. For example, if it is impossible to restore the lower intestines, the effect of surgery will be a permanent measure.

And it's not scary. Over time, a person learns to control the activity of the “renewed” digestive system, and independently regulate the processes of emptying.

A colostomy is a way to freely remove feces from the intestines without disturbing its activity, if the digestive system cannot do it on its own.

Indications for use

What are the indications for the formation of a colostomy:

1. Anorectal incontinence.
2. Malignant neoplasms in the lower intestines, covering the intestinal lumen with their growth (for example, rectal cancer).
3. Injuries to the walls of the lower part of the gastrointestinal tract, resulting from gunshot wounds or other mechanical effects.
4. Complicated cases of diseases such as ischemic or, peritonitis or malignant degeneration of inflammatory cells, ulcerative colitis of a nonspecific type, polyposis, abscess of the intestinal walls, complicated by their perforation.
5. Relapses of oncological pathologies in the tissues of the bladder, uterus, canal connecting the uterus to the vagina (cervical), or rectum.
6. Complicated consequences of radiation therapy, after treatment for cancer of the uterus or cervical canal.
7. The formation of fistulas leading from the rectal walls to the bladder or vagina.
8. Exclusion of postoperative complications such as open sutures or their inflammation, that is, as a preventive measure for the recovery period.
9. Congenital pathologies of the lower part of the intestine, which impede or exclude the process of normal emptying. For example, Hirschsprung's disease, anal atresia, meconian obstruction (most often diagnosed in newborns).
10. Resection of a part of the rectum or sigmoid colon, in which it is not possible to sew the remaining sections.

Classification

Depending on the localization of the new "anus", the following types of colostomy can be distinguished:

• transverse (transversostomy);
• ascending (accendostoma);
• descending (descendostoma and sigmostoma);
• parietal.

transverse

Such an intestinal stoma is located in the upper abdomen, opposite the transverse colon. To avoid damage to the nerve endings in this area, a transverse stomy is formed closer to the spleen, namely to its left side.

The main indications for this type of surgery are:

• blockage of the intestines;
• oncological pathologies;
• damage to the intestinal walls resulting from mechanical injuries;
• anomalies of the large intestine, having a genetic origin (congenital).

Most often, this type of stoma is temporary. They are removed after the necessary treatment.

The permanent setting of such a formation is due to the resection of the following sections of the gastrointestinal tract.

The transverse stoma has two types of execution: single-barrel colostomy (terminal) and double-barrel:

1. In the first case, the incision on the intestine itself is made in the longitudinal plane and a single hole remains on the surface. Most often, this type of exposure involves the permanent imposition of a colostomy. The reason is the removal of the rest of the colon.
2. In the second case, the intestine is dissected transversely and two holes are removed at once, performing different functions: up the intestine - the removal of feces, below - for the introduction of medications. Moreover, mucus produced by the intestinal walls can exit through the “lower” stoma, but this is part of the norm. A double-barreled colostomy is temporary, used for the duration of the treatment of other parts of the intestine or manipulations with the organs of the lower abdominal cavity.

Rising

With this operation, the colostomy is installed on the ascending section of the colon, located on the right side of the peritoneum. This section of the intestine belongs to the initial sections of its thick part, which is reflected in the excreted masses.

It is characterized by a liquid consistency, alkaline composition and the presence of a large amount of residual digestive fermentation.

With this in mind, a patient with an ascendostomy should be more carefully monitored for hygienic care around the surgical formation - the colostomy bag requires more frequent cleaning.

The intestines do not have time to absorb the right amount of fluid. Therefore, you should strictly monitor the water balance, in order to avoid dehydration.

Ascendostoma, in most cases, is installed temporarily.

descending

This method of surgical exposure is divided into two subtypes: the descending stoma of the colon (descendostoma) and the sigmoid technique (sigmostoma).

Both of these varieties are localized on the lower left side of the abdomen, that is, in the final section of the sigmoid colon. They are characterized by the fact that the fecal masses coming out through it practically do not differ from ordinary feces either in consistency or in composition.

It is this type of stoma that is distinguished by the ability to regulate and control the processes of bowel movement. This is possible due to the nerve endings located in this part of the intestine, and which in the normal state perform the same functions.

Therefore, if the patient's condition allows, they try to install a permanent stoma precisely on this part of the large intestine.

parietal

This type of intervention is rarely used. A parietal colostomy is characterized by the formation of a stoma that drains the intestinal contents not in full, but in part. It is used to reduce pressure in the intestines, that is, to decompress it.

Advantages and disadvantages

The main thing about the advantages of such operations can be said: most often they are due to vital necessity.

Statistically, the largest percentage of colostomies are performed in patients with malignant tumors in the lumen of the rectum or sigmoid colon.

The advantages include the ability to ensure the normal healing process of the underlying sections of the intestine after surgical treatment or during operations on the organs of the genitourinary system.

Bandages and colostomy bags produced today use all the latest advances in technology, which is reflected in their comfort and functionality. Therefore, even with a permanent colostomy today you can live and enjoy all the delights of life.

If we talk about the minuses, the first of them refers to the psychological component of the issue. Natural shyness and other factors (difficulty in processing and maintenance) can lead the patient into a state of deep depression. Life with a colostomy seems unbearable to them.

The exact recommendations of the attending physicians and the help of a psychologist, which is available in any modern medical institution, help to cope with this problem.

Often the main disadvantage is the presence of a corresponding unpleasant odor. But this problem has long ceased to be such.

All colostomy bags produced today have air filters that do not allow the "aroma" to pass through, magnetic lids that tightly close the container. In addition, you can buy special deodorants designed just for these cases.

Colastomy treatment

Any stoma needs careful special care, from the first days of installation.

And the first days this is done by medical personnel, until the moment when the person leaves the hospital.

In the future, all the manipulations that he is necessarily taught, the patient performs independently. And the degree of adherence to the recommendations when caring for a colostomy will determine the likelihood of complications.

The principle of operation when processing a fresh colostomy result is as follows:

1. Remove the accumulated fecal masses (it is still forbidden to use a colostomy bag during this period).
2. Rinse the edges of the hole and the skin around it with boiled water at room temperature, then remove the remaining moisture by blotting it with gauze.
3. Treat clean skin with the recommended agent (Stomageziv ointment, Lassar paste). Next, close the skin with a bandage or gauze, previously soaked with petroleum jelly, and then close the hole and adjacent areas of the skin with cotton wool and a bandage (exclusively sterile). The last step will be the application of a gauze bandage - it must be changed at least 6 times a day. A colostomy after surgery requires strict adherence to these hygiene rules.

The use of the colostomy bag is possible only after the end of the healing process and the final formation of the stoma. Signs of this will be the appearance of the mouth, rising above the surrounding skin and the complete absence of ichor.

On pharmacy shelves, you can purchase a specialized film that is applied before installing the colostomy bag and avoids the appearance of an inflammatory process or irritation on the skin.

Stool bags used to collect feces are usually changed in the morning or evening, depending on the type of device used.

The procedure for treating the skin after removing the colostomy bag is simple:

1. Remove the stool bag.
2. Remove fecal matter and clean the stoma.
3. Treat the mouth and adjacent skin with the selected agent (ointment, paste).
4. Install the device back.

Is it possible to use an enema for a colostomy? This procedure, called irrigation, is advisable to use when constipation occurs, when the use of laxative products does not bring the planned effect.

A colostomy and caring for it are inseparable concepts.

Possible Complications

Given the localization of the stoma and the complexity of the procedure for its formation, with poor-quality performance of the operation or non-compliance with the postoperative recommendations of the attending physician, the likelihood of complications increases.

Complications with colostomy:

1. Specific highlights. Normally, intestinal secretions, which are a lubricant to facilitate the passage of masses and produced by intestinal tissues, have the consistency of egg white. If they contain fragments of blood or pus, we can talk about the development of inflammatory processes against the background of infection or mechanical damage to the intestinal walls.
2. Orifice blockage. This condition is characterized by swelling of the tissues surrounding the mouth, increased gas formation, nausea, sometimes with vomiting, loose stools. The main reason is food fragments adhering to the inside of the colostomy. In order to avoid the progress of negative phenomena, it is necessary to completely limit the intake of solid food, increase the volume of daily fluid intake, massage in the abdomen, especially closer to the mouth.
3. Paracolostomy hernia. The main symptom is the appearance of a bulge under the skin next to the stoma, which is a segment of the intestine that rests on the abdominal muscles. To avoid such a situation, you need to use special bandages, exclude weight lifting, control your body weight. Most often, this formation lends itself to conservative methods of treatment, otherwise surgical intervention is necessary.

There are other complications, including the development of fistulas, purulent processes, the ingress of fragments of feces into the abdominal cavity, necrosis, and others.

Nutrition principles

The operation does not affect the important organs of the digestive system, so there will be no special changes in the patient's diet. Nutrition has a preventive function.

You need to know how each of the products affects digestion and calculate the possible consequences. For example, there are foods that increase gas formation in the intestines (beer, carbonated drinks, legumes, chocolate, eggs, and others). It is desirable to reduce their use to a minimum.

It is necessary to limit the proportion of products in the diet that enhance the smell of gases released. These include garlic, onions, green onions, spices, cheeses and fish. And such as lettuce, spinach, parsley, yogurt and lingonberries, on the contrary, help to reduce the intensity of the smell.

Nutritionists advise carefully choosing foods for a daily diet. It will be useful to switch to fractional nutrition.

Intestinal stoma and foods that cause diarrhea or constipation should be avoided.

Outcome

A colostomy, in some cases, is the only way to let the patient live a normal life, with some caveats. This is especially true when cancerous tumors are detected in the lower intestines in the last stages of the course.

In others, it is an opportunity to operate other organs of the abdominal cavity or genitourinary system without interference and serious consequences, and also to allow them to recover after that.

The effectiveness of the performed colostomy procedure depends not only on the qualifications of the operating surgeon, but also on the consciousness of the patient. Only compliance with all hygiene rules and the recommendations of the attending physician can guarantee the absence of complications.

An intestinal stoma is the removal of a section of the intestine to the outside, which serves as an artificial place for the removal of waste products from the body. That is, the stoma functions as an anus. After such an operation, the patient needs to learn how to properly care for the problem area.

1 Indication for surgery

Intestinal ostomy in medical practice is carried out quite often. It can be either permanent or temporary. Everything will depend on the degree of pathology. For example, if a complete removal of the intestine is performed, then the stoma is installed on an ongoing basis, since there is no other way to ensure the normal functionality of the body. Temporary ostomy is carried out for the duration of the treatment of a disease, such as a hernia, for example. Its surgical removal is planned for the period when the functionality of the body is restored. Patients who have had an external artificial opening made to divert feces are not entitled to disability, since the presence of a stoma is not a disease or serious pathology. Unlike the stoma itself, it is the indications for this procedure that can cause the patient to be assigned a certain disability group.

Do you have gastritis?

The withdrawal of an artificial opening for the discharge of feces may be necessary in the presence of the following pathologies:

bowel cancer; serious injury to the organ; ischemic or nonspecific colitis; fecal incontinence; chemical or radiation damage to the intestines.

There are many other diseases of this organ, the treatment of which may require stomy.

2 Types of stomas and their care

During an operation performed on the intestines, the patient may have an ileostomy or colostomy.

If the installation of the output tube is made in the wall of the large intestine, then the patient is shown a colostomy. When a tap is needed from a thin one - an ileostomy. After the operation is completed, the patient will have a hole (fistula) on the abdominal wall. A container for collecting feces is attached to it. In order to avoid complications in the postoperative period, the patient must independently learn how to care for the stoma. Regular care will also help to avoid the appearance of an unpleasant odor.

According to statistics, a large percentage of postoperative complications are due precisely to the fact that people incorrectly process a device (tube) artificially removed from the body.

In order not to damage the stoma and prevent irritation in the area of ​​the excretory opening, the colostomy bag must be changed in accordance with established standards.

It is recommended to change colostomy bags of a one-component system only after the contents of the bag of the receiver are half full or when it causes some discomfort to the patient. Using two-component receivers, the adhesive part is changed after 3 days.

The container for collecting feces must be attached exactly at the time of the defecation process. Immediately after emptying, the bag is removed and processed. The stoma of the intestine is treated with a soapy solution. After cleaning, it must be dried. To do this, use a clean napkin. You can not rub, you need to blot. After washing, it is necessary to treat the fistula with a special agent called Stomageziv, or its equivalent. The intestinal mucosa should also not dry out, as cracks may appear, so it is treated with petroleum jelly. The final step is the application of a clean napkin, which is fixed with a plaster.

3 Risk of complications

Despite the fulfillment of all medical prescriptions, complications may develop in the postoperative period. Most often, there is irritation of the skin (or periostomal dermatitis). A rash may appear near the excretory tube, which is accompanied by itching or burning. As a rule, such complications are observed in patients who did not immediately learn how to properly cope with the task - the processing of an artificial hole. An allergic reaction to the drugs used during treatment should not be ruled out.

Other postoperative pathologies include:

Injury to the mucous membrane with a catheter or tube. As a result, the patient may bleed. Even with a small amount of blood released, it is recommended to see a doctor. In most cases, injury does not pose a serious threat, but it can be different. Retraction of the stoma inward (retraction). Treatment of the stomy site and the use of a colostomy bag becomes problematic. A doctor's consultation is required. Narrowing of the outlet (stenosis). As a rule, the process of narrowing is observed during the course of the inflammatory process. In severe stenosis, defecation can be difficult or even impossible. The solution to the problem is surgery. Prolapse of the intestinal stoma. Pathology is typical for people who subject their body to strong physical exertion, but prolapse can also occur during a coughing fit. As a rule, significant prolapse of the intestine is rarely observed, but cases of its complete prolapse are recorded in medical practice. It is not recommended to set the stoma on its own, despite the fact that if it goes slightly beyond the existing boundaries, the patient's condition does not worsen, nor does the functionality of the stoma be disturbed.

If a stoma was performed during the treatment, you should not be upset, because life does not end there. As soon as the patient begins to properly process the operated area and use the collection for feces, he will be able to fully return to his usual way of life.

And some secrets...

Are you tired of stomach pains, nausea and vomiting...

And this constant heartburn ... Not to mention stool disorders alternating with constipation ... It’s sickening to remember a good mood from all this ...

Therefore, if you are tormented by an ULCER or GASTRITIS, we recommend that you read the blog of Galina Savina about how she coped with the problems of the gastrointestinal tract. Read article »

With a number of intestinal diseases, the passage of feces and their exit to the outside in a natural way is impossible. Then doctors resort to colostomy.

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

A colostomy is a kind of artificial anus that doctors make in the abdominal wall. A hole is made in 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 the postoperative period, with traumatic injuries or tumors, inflammation, etc.

Photo of a rectal colostomy

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

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

Indications for a colostomy

A colostomy can be temporary or permanent. Children most often have a temporary stoma.

In general, the indications for a colostomy are as follows:

Anorectal incontinence; Clogging of the intestinal lumen with a tumor formation; Traumatic injuries of the colonic walls such as gunshot or mechanical wounds; Severe cases of colonic pathologies such as diverticulitis or ischemic colitis, cancer or peritonitis, polyposis and ulcerative colitis, abscesses of the intestinal walls with perforation, etc.; Recurrent cases of cancerous processes in the bladder tissues and uterus, cervical canal or rectum; The presence of severe forms of post-radiation proctitis, especially often this occurs after radiation therapy for cervical cancer; In the presence of internal fistulas from the rectum to the vagina or bladder; As a preoperative preparation for the prevention of divergence of sutures and their suppuration; 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 a radical intervention); With rectosigmoid resection, if the sutures fail after the operation.

Stoma types

Colostomies are classified according to their location into several types: transverse, ascending, and descending.

Transverse colostomy.

A transverse stomy is formed in the upper abdomen, in the transverse colonic section.

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

A transverse colostomy is indicated for intestinal blockage or oncopathologies, traumatic injuries and diverticulitis, congenital colonic anomalies.

Typically, these colostomies are placed temporarily for the duration of treatment. On an ongoing basis, transverse stomas are necessary when removing the underlying portion of the intestine.

Stomas of the transverse type are divided into two varieties: single-barreled and double-barreled.

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

The lower part of the intestine may continue to produce mucus, which will exit through the hole formed as a result of the incision or the anus, which is a variant of the norm. Such transversostomy is usually done for a certain time.

Ascending colostomy or accendostomy.

A similar stoma is located on the ascending colonic segment, so it is localized on the peritoneum on the right side. This site 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 should be cleaned as often as possible, and the patient is advised to drink more to avoid dehydration, since thirst is characteristic of the ascendant. An ascending colostomy is usually a temporary therapeutic measure.

Descending and sigmoid method of colostomy (decendostomy and sigmostomy).

These varieties of colostomy are installed on the left side of the peritoneum in its lower part, in fact, at the end of the colon. Therefore, masses come out of it in terms of physico-chemical properties similar to ordinary feces.

A distinctive feature of such colostomy is the ability of the patient to regulate the processes of defecation. 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 of the colostomy allows you to install them for a long time and even for a permanent period.

Advantages and disadvantages

The procedure is often vital, providing the patient with a normal life after a radical intervention by surgeons for cancer of the sigmoid or rectum.

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 permanent colostomy.

There are certainly disadvantages to the methodology. 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 the proper care of the stoma, clarify important nuances, talk about feelings, etc.

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

Types of colostomy bags

The colostomy bags are available in one and two-component types. Two-component ones are equipped with ostomy bags and a self-adhesive plate connected with a special flange. But such colostomy bags are inconvenient because they can provoke irritation of the skin. 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 the equipment of the colostomy bag with a special filter that eliminates gases and odors.

Unlike a two-component one, a one-component colostomy bag needs to 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, make sure the drain hole is closed.

How to take care of your stoma at home?

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

The whole process proceeds in several algorithms:

First eliminate the feces; Then, the outlet is washed with boiled warm water, the skin around it is thoroughly washed, and then dried with gauze napkins; The skin surface is treated with Lassar paste or Stomagesive ointment, after which gauze soaked in petroleum jelly is applied around the stoma, and covered with a sterile bandage and cotton wool on top. From above, the treatment site is covered with a gauze bandage, which is changed every 4 hours. When the stoma heals and is finally formed, you can use colostomy bags. The mouth that does not protrude above the skin and the absence of an inflammatory infiltrate speaks of the final formation and healing. Only with such a clinical picture is the use of a colostomy bag allowed. Change of fecal bags is recommended to be done in the evenings or in the morning. First, the used fecal receptacle is carefully removed, after which the remnants of feces are removed and the stoma is washed. Then the mouth and the skin around are treated with ointment or paste, and then the colostomy bag is fixed again.

Typically, a Coloplast paste containing a small amount of alcohol is used to glue the receiver. The tool does not cause irritation even damaged by injuries and inflammation of the skin, and also improves the fixation of the device.

Some patients, before sticking 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, after the operation, significant changes in the patient's diet are not expected.

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

Gas-promoting foods, which include eggs and beer, carbonated drinks and cabbage, mushrooms and legumes, onions and chocolate, for obvious reasons, are recommended to be limited. Foods such as garlic and eggs, spices and fish, onions and cheese noticeably increase the smell of intestinal gases. Salad and yogurt, lingonberries and spinach, parsley, etc. have the opposite effect.

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

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

Operation types

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

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

Patients may require surgery to create or close a colostomy, as well as surgical intervention for reconstructive and restorative 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 under sterile operating conditions.

First, the surgeon cuts off a rounded area of ​​subcutaneous tissue and skin at the site of the proposed location of the stoma. In the second stage of the operation, the muscles are separated along 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 if the stoma is applied for a long time is taken into account in advance. Then the intestine is brought out with a loop and the necessary incision is made on it. The intestine is sutured to the muscle tissues of the peritoneum, and its edges are attached to the skin.

Unfortunately, it has not yet been possible to invent drainage agents in the stomal mouth, since the immune system includes protective functions and actively resists foreign materials, provoking dystrophy 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 from the intestinal lumen and brought out.

closure

The operation to close the stoma on the intestines is called a colostomy.

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

A prerequisite for closing the operation is the absence of obstructions in the underlying sections of the intestine up to the anus.

Approximately a centimeter from the edge of the stoma, the surgeon makes a dissection of the tissues, slowly separating the adhesive elements. Then the intestine is brought out and the edge with the hole is excised. Then both ends of the intestine are sutured and returned back to the peritoneum. Then, with the help of contrasting, the seam is checked for tightness, after which layer-by-layer suturing of the wound is carried out.

Reconstructive and restorative operation

Usually, such interventions are prescribed for patients with temporary colostomies imposed during the treatment of the underlying parts of the intestine. Many patients believe that intestinal function is fully restored after stomal closure, which is not entirely true.

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 for closing the stroma is the first 3-12 months after the operation. This is the only way to count on the successful healing of intestinal tissues without consequences for the body. In fact, a reconstructive operation is a stoma closure or colostomy, the description of which is presented above.

Diet after surgery

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

The dietary diet is reduced to the exclusion of foods like:

Hot condiments or spices like curry, chili, etc.; Excessive amount of soda, kvass or beer; Gas-forming products such as beans, garlic or cabbage, etc.; fatty foods; Food that provokes irritation of intestinal tissues, for example, currants or raspberries, grapes or citrus fruits.

If necessary, the doctor prescribes individual restrictive prescriptions for the patient's diet.

Complications

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

Specific highlights. This mucus is produced by the intestinal tissues as a lubricant to facilitate the passage of stool. Normally, the consistency of the secretions may be sticky-sticky or similar to the white of an egg. If purulent or bloody impurities are present in the mucus, then this may indicate the development of an infectious process or damage to the intestinal tissues. Blocking the mouth of the stoma. Usually, this phenomenon is the result of sticking food particles and is accompanied by watery stools, swelling of the stoma, flatulence, or nausea-vomiting symptoms. If there is a suspicion of the development of such a complication, then it is recommended to exclude solid food, periodically massage the abdominal area near the mouth of the stoma, increase the amount of fluid consumed, take hot baths more often, which helps to relax the abdominal muscles. Paracolostomy hernia. A similar complication involves protrusion of the intestine through the muscles of the peritoneum, and a clear subcutaneous bulge is observed near the mouth of the stoma. Special support bandages, weight control and avoidance of lifting and dragging weights will help to avoid a hernia. Usually hernias are eliminated by conservative methods, but sometimes you can not do without surgery. Unfortunately, there is always the possibility of re-formation of the hernial process.

Also, other complications can develop with a colostomy, such as fistulas, prolapse or retraction of the stoma, stenosis or ischemia of the colostomy, leakage of digestive waste into the abdominal cavity or on the skin surface, strictures or evaginations,

bowel obstruction

and necrosis, purulent processes, etc.

You can avoid such troubles, most importantly, strictly follow medical recommendations, especially the diet and hygiene requirements for caring for a colostomy.

The video is about how to care for a colostomy:

Modern medicine has a variety of means in order to save the life of the patient. But until now, in medical practice, there are methods known to ancient healers. One of them is such a surgical intervention, which is called "stoma". What it is, what indications it has, how it is carried out - you will learn about all this by reading the material. We also paid special attention to caring for different types of stoma, since such manipulations are often carried out at home, and the quality of their implementation affects the healing process.

The concept of stomy in medicine

Stoma - what is it in surgery? This is a special hole that is surgically made to the patient for medical reasons. Most often, a stoma of the intestine, bladder is performed, less often - the trachea. What is a stoma? This is a hole that communicates a hollow broken organ with an external catheter or tube in order to normalize the patient's condition after surgery or other manipulations. The most common operation is the creation of an opening in the abdominal cavity. In this case, the indication for stomy is the removal of the intestine (or part of it).

Stoma - is it temporary or for life, is such a condition of a person considered a disability? An artificial hole is not considered a disease and in itself is not a reason for disability, as it does not exclude the possibility of a full life. Having learned how to properly use a colostomy bag or other devices for caring for an ostomy, a person can fully work, study, play sports, build a family. But often it is the indications for stomy that are a serious pathology leading to disability and limited abilities of the patient.

An ostomy can be temporary, for example, such an operation is performed to rehabilitate a patient after an operation or a severe infection that has disrupted the excretory system. After restoration of impaired functions, the stoma can be removed surgically. But in some situations, for example, after removal of the intestine, a stoma is a necessary condition for ensuring the patient's normal life.

Indications for stoma

Indications for an ostomy operation are congenital pathologies, injuries, operations that led to the complete or partial removal of excretory organs. Accordingly, the normal operation of damaged systems is disrupted. Stoma helps to restore the body's natural functions. In what cases does it become necessary to completely or partially remove the intestines, bladder or trachea, after which an artificial opening is required:

The first place is occupied by cancer of these organs, which leads to surgical intervention to remove damaged tissues. Injuries. Nonspecific and ischemic colitis. Incontinence. Radiation and chemical injuries.

There are different types, shapes and sizes of stoma. What it is? The photo below shows an artificial intestinal fistula.

Types of stoma

Stomas are distinguished depending on the area of ​​​​surgical intervention:

gastrostomy; intestinal: ileostomy, colostomy; tracheostomy; epicystostomy.

The shape is convex and retracted. There are single and double barrels. Depending on the duration of use: temporary and permanent.

According to statistics, stoma of the intestine is more common than other types.

Each type differs in the principle of setting, mode of action and needs a certain care and rehabilitation period.

Tracheostomy: indications, features

A tracheostomy is an artificially created opening in the neck with a tube removed, which is installed in order to recreate the damaged functions of a person's breathing. In case of violations of the respiratory system, the impossibility of performing an independent act of inhalation-exhalation, the patient often undergoes an emergency tracheal stoma.

Such a stoma is a rather difficult formation to care for. It brings a lot of discomfort to a person. Especially if it's permanent. Open airways make it easy for viruses and bacteria to enter, which leads to various diseases and weakens the general immunity of a person. In addition, the artificial "trachea" does not humidify or warm the inhaled air, which also contributes to the penetration of infections and the risk of developing various diseases. Therefore, it is necessary to control the quality of the inhaled air from the outside - carefully monitor the air temperature in the room in which the patient is located. For moistening, special devices are used or a wet wipe is applied to the surface of the tracheostomy tube, changing the tissue as it dries.

The patient should not engage in active sports, swim (especially dive under water). Any, even a slight ingress of water into the tube can lead to respiratory arrest.

Tracheal stoma - is it forever? Most often not. It can be permanent only in the case of removal of the trachea (which is extremely rare) or the complete inability of a person to breathe independently, when such a condition cannot be treated and restored.

A temporary tracheostomy is placed during surgery to provide anesthesia if it is not possible to perform anesthesia by other means.

Tracheostomy Care

Tracheostomy requires regular proper care:

Every few hours, the outer tube should be flushed with a solution of sodium bicarbonate (4%) to remove residual mucus from the cavity. To prevent the formation of skin inflammation and diseases, it is necessary to treat the area around the tracheosome. To do this, cotton balls are moistened in a dish with a solution of furacilin. Then, using tweezers, they blot the skin area around the tracheostomy. After that, zinc ointment or Lassar paste is applied. The treatment ends with the application of sterile napkins. The bandage is fixed with a plaster. Periodically, it is recommended to aspirate the contents of the trachea, since often patients with a tracheostomy cannot fully cough up, which leads to mucus stagnation and, as a result, difficulty breathing. To carry out such a manipulation, you need to seat the patient on the bed and perform a manual chest massage. Through the tube, pour 1 ml of sodium bicarbonate (2%) into the trachea to thin the mucus. Then you need to insert a tracheobronchial catheter into the tube. By attaching a special suction, remove the mucus from their trachea.

Proper care of the stoma is extremely important, as a violation of its functions can lead to respiratory arrest.

gastrostomy

The gastrostomy is removed from the abdominal area to provide a person with food in cases where the patient cannot eat on his own. Thus, liquid or semi-liquid nutrition is introduced directly into the stomach. Most often, this condition is temporary, for example, with serious injuries and in the postoperative period. Therefore, the gastrostomy is rarely permanent. When the function of self-feeding is restored, the gastrostomy is closed surgically.

How to properly care for a gastrostomy?

Gastric stoma - what is it, in what cases is it installed? When applying a gastrostomy, a rubber tube is brought out, designed directly to transport food to the stomach. During feeding, a funnel is inserted for convenience, and between meals, the tube is clamped with a thread or a clothespin.

With a gastrostomy, the main goal of care is to treat the skin around the hole in order to prevent skin inflammation, diaper rash, and rashes. The skin area around the stoma is treated first with a solution of furacilin using cotton balls and tweezers, and then with alcohol. Then it is lubricated with aseptic ointment. The procedure ends with the application of a bandage.

Epicystostomy: indications, care

Epicystoma is removed from the bladder to the surface of the abdominal wall using a special catheter. Indications for the appointment of such manipulation is the patient's inability to naturally urinate for various reasons. There are temporary and permanent epicystostomy.

Such a stoma requires special monitoring. What does it mean? Caring for an epicystostomy is quite complicated: you need to be able not only to clean the catheter and take care of the skin around it, but also to flush the bladder and replace the urinal. Therefore, it is better if such procedures are carried out by a qualified nurse or nurse.

Epicystoma introduces certain restrictions on the patient's life. So, the patient is not recommended to swim, play sports, stay at low air temperature for a long time.

It is necessary to carefully monitor the cleanliness of the catheter and the skin around it. Twice a day, the skin should be washed with soapy water, and the outer tube and urinal should be washed as it becomes clogged.

It is important to monitor the quantity and quality of secretions. There should be no pus and blood - with such symptoms, it is necessary to urgently seek medical help. It is also required to consult a specialist in case of an increase in the patient's body temperature, a decrease in the volume of urine, a change in its color, damage to the catheter or a violation of its position, and pain in the lower abdomen.

Intestinal stoma: types

Intestinal stoma - what is it, what types exist? This type of hole is also called "artificial intestine". They are installed in case of violations of the work of the corresponding organ after various surgical operations. For example, when removing the intestine or part of it. In this case, a permanent stoma is placed. And, for example, after a hernia removal operation, which led to the inability of the body to cope with the excretion of feces in a natural way, surgeons perform a temporary stoma.

Removal of the colon on the abdominal wall is called a colostomy. A thin one is an ileostomy. Outside, both types are a section of the intestine that is brought out to the front wall of the abdominal cavity. Such a stoma is a fistula in the form of a rose, on which a colostomy bag is installed from the outside.

In order to prevent postoperative complications and the spread of an unpleasant odor, the stoma of the intestine needs regular care.

How to care for intestinal stoma?

With intestinal stomas, more often than with other types, the development of complications associated with improper care is observed. Contrary to popular belief, colostomy bags should only be changed when necessary, as frequent changes lead to irritation and damage to the stoma and the area around the opening. Depending on the type of colostomy bag, it should be changed with the following regularity:

when the contents of the one-component system have reached half or the patient has experienced discomfort from the receiving bag; with a two-component system, the adhesive plate is left for 3 days.

The stool bag is directly put on at the time of defecation. After that, they are immediately removed, the stoma of the intestine is cleaned with soapy water, blotted dry with napkins. Then they are lubricated with the drug "Stomageziv", and the intestinal mucosa - with petroleum jelly to prevent cracks. A napkin folded in several layers is applied, the bandage is fixed with a plaster, and then underwear is put on. Stoma care is an important part of a patient's recovery.

Complications

Complications after an ostomy operation is a fairly common situation. A stoma after surgery requires careful medical supervision and proper care. What problems can arise, how to deal with them and prevent them, let's take a closer look:

Periosteal dermatitis (skin irritation). Irritation can occur due to improper care, unsuitable products and preparations, incorrect strengthening of the catheter. Burning, itching, rashes appear. Bleeding from the area of ​​​​the artificial opening can be caused by trauma to the mucous membrane with a catheter or tube. Usually, such injuries do not cause concern to doctors and go away on their own. But if the bleeding is profuse and does not stop within a few hours, urgent medical attention is needed. Retraction (the stoma is pulled inward). This condition makes it difficult to use colostomy bags, external parts of the tubes and the catheter. Skin care is also complicated. Consultation of a specialist is necessary. Stenosis (narrowing of the opening). If the stoma narrows to such an extent that its functions are impaired (fecal masses do not pass during an intestinal stoma or breathing is difficult during a tracheostomy), then surgical intervention is necessary. The narrowing of the opening occurs due to inflammatory processes. The prolapse of the intestinal stoma by several centimeters does not violate its functions and does not affect the patient's condition in any way. But there are cases of complete loss. Often this happens with increased physical exertion, coughing. Depending on the situation, the prolapsed stoma can be adjusted independently. With frequent loss, you should consult a doctor.

Stoma is not a disease, but, nevertheless, a person in this condition needs careful treatment and care. Both temporary and permanent ostomies require adherence to medical prescriptions. Choose care products of the type, shape and brand recommended by the specialist, since only the surgeon can determine which type of receiver and catheter, paste and ointment will be most effective and comfortable for the patient in a particular medical case. When choosing, the size and type of the hole, its purpose, skin type, the patient's tendency to allergies and many other related factors are taken into account. Do not self-medicate - strictly follow the appointment of a specialist.

Visit your doctor regularly. Control examinations are recommended after a month, 3 months, 6 months, the first 2 years - 1 time in 6 months, then - 1 time per year. Shared toilet: it is recommended to share a shower (avoid a bath, a bath) Wash the stoma (reduced intestine) with soap and water, then do not wipe it, but blot it with a soft cloth or gauze (do not use cotton wool) After using the toilet, treat the stoma (reduced intestine) with baby cream. In case of irritation of the skin around the stoma (lower intestine), treat with Lassar paste (salicylic-zinc paste), baby powder or company products Coloplast,Convatec(information by phone. 324-10-55 ) In case of bleeding from the stoma (reduced intestine), apply a dry napkin and press firmly for 10-15 minutes. After the “relegation” operation, high cleansing enemas are recommended every 2-3 days in order to mechanically clean the intestines. In case of cramping pains in the abdomen, retention of stools and gases, nausea, vomiting, bloating, apply: 2-3 tablets of No-shpa at the same time stop eating, do not drink cold water on the stomach (any product from the freezer of the refrigerator) if there is no relief after 2-3 hours, contact your doctor, if impossible, call "03"

What is a stoma?

In order to understand what changes and problems await ostomy patients after stoma, let's start with a brief description of the gastrointestinal tract.

From the stomach, food enters the small intestine (length about 7-10 m), consisting of the duodenum, jejunum and ileum. The latter in Latin is called ILEUM (ileum). In the small intestine, the process of chemical processing of food under the influence of digestive juices and enzymes and the absorption of nutrients into the blood is completed. The contents of the small intestine are liquid. Further, the products unnecessary for the body enter the large intestine, where, as they pass through it, they acquire the consistency of dense fecal masses. The large intestine (length about 1.5 m, diameter about 5 cm) consists of the caecum, ascending colon, transverse colon, descending colon, sigmoid colon, and rectum.

Thus, the large intestine plays a small role for digestion of food, therefore, if surgical intervention is necessary (disease, intestinal injury), the surgeon can form an artificial anus on the abdominal wall, i.e. to impose a stoma (from the Greek stoma means mouth).

Depending on the part of the bowel that is brought out, the operation is called a colostomy or an ileostomy. In a number of diseases of the genitourinary system (bladder cancer, bladder stenosis, trauma), the surgeon imposes a urostomy.

The ileostomy is placed on the right side of the abdominal wall, on the border of the small and large intestines. The colostomy is located on the left side of the abdominal wall. The stoma may also have a different localization, depending on which part of the intestine needs to be removed. There are three types of stoma, depending on the surgical intervention: double-barrel (loop), single-barrel (terminal) and parietal. The stoma can be convex, flat and retracted.

The colostomy is bright red. Its color is the same as the color of the oral mucosa. Most often, the stoma is lagging behind the edges of the skin of the abdomen. After surgery, the stoma may be swollen, with time the swelling goes away. Its normal size is about 2-5 cm in diameter. Depending on the type of operation, the formed stoma may have one or two openings that expand during stool discharge. Due to the lack of innervation of the mucous membrane, touching the stoma during care is painless. A little bleeding during stoma care is also normal and should not cause you fear. If the bleeding is prolonged and profuse, you should consult a doctor.

Stoma is not a disease

Thanks to modern stoma care products, a person is able to lead a habitual active lifestyle, work, love. The products of the company "Coloplast" have been used in the Department of Oncoproctology of the Russian Cancer Research Center of the Russian Academy of Medical Sciences for the past few years. The main components that are popular are colostomy bags and various stoma care products (ointments, pastes, powders, plugs, cleansing wipes, etc.).

Despite the tendency in the clinic to perform sphincter- and organ-preserving operations, the percentage of operations ending in a colostomy is about 25%. Of all types of colostomy bags, our patients are most satisfied with two-piece colostomy bags with open pouch. This is due, first of all, to economic considerations - the ability to use ostomy bags several times. After all, the cost of colostomy bags does not allow their regular use by all patients. The most common sizes of colostomy bags are 45, 55, 60, 72 mm in diameter.

It is extremely rare that stoma bags are needed for ileostomies. In our clinic, we try to avoid their formation.

An important point is the presence of flavors that eliminate unpleasant odors, which contributes to better adaptation of patients in society.

The most popular among patients are various creams, lotions, for treating the skin around the colostomy. Also interesting are the stubs for the colostomy and the "second skin" protective film.

I would like to note that the products of the Coloplast company, despite their higher cost compared to some analogues, are distinguished by their simplicity and ease of use, aesthetics and durability of use, which allows patients to neutralize the painful sensations associated with the presence of a colostomy.

After the surgical imposition of a stoma, it is impossible to control the emptying of the contents of the intestine, since there are no adductor muscles, such as in the anus. The contents of the intestine, as they form, regardless of your will, exit through the stoma: through the ileostomy - continuously 4-5 hours after eating, and its amount reaches 800-1500 ml; through a colostomy - the stool is usually semi-solid and formed. Normalization of the discharged contents from the stoma occurs in most cases after 6 months or earlier, after a few weeks. Therefore, it is necessary to constantly use stoma care products.

They are one- and two-component systems. The one-piece system is self-adhesive ostomy bags. The two-component system is ostomy bags with an adhesive plate. Ostomy bags can be closed and open, with the discharge of contents; transparent and opaque. The adhesive plate is provided with a flange connection in the form of a ring. The ostomy bag is also equipped with a ring that seals tightly to the flange connection of the adhesive wafer. Open bags have clips. The ostomy bags are equipped with an odor-absorbing filter containing activated charcoal. There is also a special powder to absorb odor. Ostobon.

Stoma care is simple:

The skin around the stoma is cleaned with either warm water and soap or cleansers. Comfeel(also remove hair). Then dry the skin with a soft towel with soaking movements.

The adhesive layer of the plate is protected by a paper layer. Remove the backing paper from the plate, warm it up with your hands for easy adhesion.

Place the plate so that the hole in the plate fits exactly on the stoma, i.e. the mouth of the intestine. Starting from the bottom edge of the plate, stick the plate to the skin, being careful not to wrinkle the adhesive plate, which could lead to a leak.

The hole of the plate is also provided with a paper stencil. Cut out the hole according to the marked contour according to the diameter of the stoma. In this case, the size of the cut hole should be 3-4 mm larger than the size of the stoma. We recommend using scissors with curved ends.

Then the ostomy bag is accurately placed on the ring of the plate until it "slams". You will hear a click. The ring of the ostomy bag has lugs to which you can attach a strap for added security.

The used bag emptied in the toilet must be discarded. Closed bags are usually single use, while open bags are washable and can be used multiple times.

Stomatized patients change bags 1 or 2 times a day. To avoid tearing off the pouch, do not allow it to overflow. The plate is changed when it begins to separate from the skin and does not fit tightly. This condition is identified by the whitish color of the adhesive wafer.

To avoid injury to the skin, the pouch should not be removed by jerking or using mechanical means or chemical solvents. Removal occurs in reverse order, starting from the top edge.

If there are irregularities around the stoma, then they can be filled with special pastes manufactured by the company. « Coloplast».

There are also special adhesive rings and wipes that protect the skin around the stoma from irritation and contact with the separated contents of the intestine.

So-called anal tampons conseal are used to close the stoma when emptying the intestines using irrigation (irrigation), during water procedures, visiting the pool or bath, during sex.

Rehabilitation of stoma patients

It is difficult for stoma patients immediately after surgery to come to terms with the idea of ​​leading a normal daily life in the new conditions with an educated stoma. Over time, habituation and adaptation gradually follows. To lead a normal life, you need to learn how to quickly and properly care for the stoma and overcome the psychological barrier, which, of course, will help you close people. After a while, when you get used to the daily emptying and changing the bags, you will not think so much about it, and after rehabilitation and returning to work, you will even forget.

Who can tell about a stoma? Do not talk about this without special need to relatives and friends. Your close family members with whom you live should know about it.

You can wear normal clothes, the pouch is not visible. You can dress the same way you did before your stoma. You need to know that you can swim, take a shower and ostomy bags do not come off. If the stoma is in the waist area, it is recommended to wear suspenders instead of a belt.

After complete rehabilitation, you can and even should return to your work. However, this work should not cause physical effort.

Sexual life is not subject to restriction. Difficulties in this matter are, as a rule, psychological in nature. Over time, you will see that your sex life gives you the same joy and satisfaction as before the operation. Women also retain their reproductive function: they can become pregnant and give birth.

There is no special diet for stoma patients. Most patients can eat and drink the same as before the operation. But certain foods and drinks can cause gas buildup. You need to limit the consumption of eggs, cabbage, onions, asparagus, chocolate, beer and lemonade. The approach to nutrition is very individual: you decide what is possible and what should be avoided.

Your diet should be varied and rich in vitamins. Eat slowly and chew your food thoroughly. It is necessary to take food three times a day, and plentiful food - in the morning. Meals should be not very fatty and not very sweet, it is necessary to remember the large losses of water and electrolytes. Therefore, it is necessary to take 2 liters of fluid per day. Alcohol in small quantities is not contraindicated, with the exception of beer, which should be crossed off the menu. Bran, buttermilk, yogurt, lingonberry juice are recommended, which reduce the amount of gases and their unpleasant smell.

With an ostomy, you can do many sports without much physical effort. You can travel without restrictions. Take enough stoma care before you travel. You can swim in natural waters and in the pool.

Visit theaters, cinemas, exhibitions.

Helpful tips for caring for your stoma

Pouches « Coloplast» do not pass gases. They are reliable and contain an activated carbon filter, which eliminates unpleasant odors.

The skin in the stoma area requires constant attention. Skin irritation can be caused by secreted contents from the intestines, sweat, insufficient care. Its manifestations are of varying degrees: redness, bubbles, cracks, abscesses. The skin needs to be cleaned regularly. Irritated skin after washing should be covered with a special healing cream. Comfeel. Bags need to be changed in case of a slight ingress of the separated intestinal contents under the adhesive layer, which indicates a leak. In cases of skin irritation, it is better to use two-component systems. In these systems, only the ostomy bags are changed, while the adhesive plate remains on the skin for several days. Coloplast adhesive material not only adheres to the skin, but also has a healing property.

Diarrhea most often occurs due to a gastrointestinal infection or due to poor diet. In such cases, spicy foods, vegetables and juices should be avoided. Be sure to take more fluids.

Constipation can cause discomfort. Foods such as oranges, nuts, asparagus, mushrooms take a very long time to digest and can lead to constipation. At this time, it is recommended to eat more fruits and vegetables, move more and do physical exercises. If constipation recurs, you should consult a doctor.

Irrigation is the controlled emptying of the bowels by flushing. In practice, bowel lavage consists of introducing very slowly warm water into the stoma in an amount of 0.5 liters once a day or every two days. You can wash only the large intestine. After washing, the patient remains without stool for 24-48 hours. He can use anal swabs instead of pouch conseal or MiniCap.

Sometimes ostomy patients have to deal with various complications, in addition to skin irritation, diarrhea, constipation: narrowing of the stoma, prolapse of the stoma, hernia in the stoma area. In all such cases, you must consult a doctor.

During your stay in the hospital after surgery, the staff will help you choose the company's stoma care products. Coloplast and teach you how to use them.

There are societies of ostomy patients whose activities are aimed at the exchange of experience, mutual advice, information about new devices, solving family and employment problems. Stomatized patients in these societies do not feel their loneliness so much, they can speak openly and without false shame about their problems.

Featured: beef, veal, lean pork, poultry, rabbit, lean ham, soft smoked meats, offal - liver, brains; language. Meat can be boiled, stewed, fried in the oven or sometimes fried.

Reception of milk as an independent dish is completely individual. It forms considerable slags and consequently in many cases causes bloating and other troubles. Need to try. To maintain the correct composition of the intestinal environment, it is recommended to take kefir and yogurt regularly several times a week.

Cheese and dairy products

Bakery products

Featured: peeled tomatoes or tomato juice, carrots. Vegetables, on the one hand, are suitable because of the large amount of indigestible cellulose, and on the other hand, they are of great importance as a source of minerals and vitamins.

Featured: boiled, mashed potatoes, compotes from peeled fruits (without peel), jams, juices (orange, lemon, raspberry). From fruits: bananas, peeled peaches, apricots, peeled grated apples, stewed fruits, kissels.