An ostomy , commonly known as “artificial anus” or “pouch” or “ostomy bag” is the surgical diversion of part of the intestine or urinary system towards the abdomen to ensure the evacuation of intestinal or urinary contents.
When to have an ostomy?
Imagine the intestine or the urinary system as a pipe. When a pipe gets clogged, we have to disassemble it in order to eliminate the cause, then reassemble it and reconnect it. Likewise when we have an obstruction in the intestine or urinary system, we need to perform a surgery to remove the cause. During the operation when the cause of the obstruction has been found, the surgeon may face two scenarios:
- The system can be reconnected: in this case, the suture performed is technically called an “anastomosis”.
- The system cannot be reconnected for various reasons, due to the condition of the tissues, excessive dilation, to protect the suture of the surgery or because the obstructed organ had to be removed (partly or completely). In this case, an ostomy is performed.
Why an ostomy?
An ostomy is necessary for different reasons and different pathologies:
- Protection of the anastomosis, preventing feces from passing through the suture and thus guaranteeing good healing. For example in rectal surgery, when a colorectal anastomosis is performed very close to the anus.
- Tumors of the colon-rectum which obstruct the passage of stool.
- Inflammatory bowel disease: Crohn’s disease or ulcerative colitis.
- Tumors of the urinary tract or urinary tract that does not let urine pass through it.
- Post-surgical complications or other diseases. For example a fistula, abnormal communication between two organs.
- Trauma or perforation, for example in gunshot wounds or by foreign bodies that can perforate the intestine.
- Congenital malformations. Most common cause of ostomy in babies.
The ostomy can be performed in elective or emergency surgery. It will depend on the disease and the clinical situation of the patient.
Types of ostomy (according to its temporality)
There are two types of ostomies:
- Temporary: As explained above, when, during the surgery, it is decided to perform the ostomy to protect the suture (anastomosis). After a time that the surgeon deems appropriate, a new surgical intervention will be performed to recover the intestinal transit.
- Definitive: There is no possibility of recovering the original intestinal or urinary transit.
Patient education on ostomy such as pouch handling or skin care, is essential. It will be done by an expert nurse called: stoma therapist. In the case of a planned ostomy, it is very important to meet with the nurse before surgery to learn what an ostomy actually is, to know the different types of devices and to decide how to best place it onto the abdomen (avoid skin folds, scars, etc.). This visit improves the comfort of wearing the pouch and reduces preoperative anxiety.
After the surgery, the stoma therapist will teach him how to handle the device and how to take care of it. After discharge from hospital, check-ups will continue until the wearer is independent in handling the ostomy. Follow our series on ostomies, next chapter: types of ostomies according to their location. The center Owings supports you in the management of your ostomy.