Types of stoma. Some medical conditions make you unable to urinate or defecate normally. Then it may be necessary to create a stoma to support your digestive or urinary system. Part of your large or small intestine or urinary tract is brought out through a small opening in your abdomen and secured. You call this opening a stoma. Via a stoma, urine and/or feces waste products are collected in a removable, odorless, and leak-proof plastic bag. With a stoma, the stool can no longer be held up. This is normally possible through the sphincter of the anus.
To be clear, an ostomy is not a condition, but a change in physical functioning with the aim of improving your current situation – to reduce pain and distress, clear the condition, and/or improve your overall health. A stoma is created when the bowel or bladder is too badly damaged by your disease to recover. A stoma will reduce or even completely disappear many complaints. In the Netherlands there are about 30,000 ostomates and annually about 6,000 to 9,000 people are confronted with the construction of a stoma. Let’s see the reasons for the stoma types.
Reasons for a stoma
There are many reasons for creating a stoma. The most common are:
- Cancer of the colon, bladder, or rectum
- Chronic inflammatory bowel disease, such as Crohn’s disease and ulcerative colitis
- Congenital conditions such as adenomatous polyposis (a type of colorectal cancer that is passed down in families)
- Birth defects
- Stab and gunshot wounds
- Spina bifida or other congenital conditions
- Blockage of the ureter
- Sexual Abuse
Depending on the disease or wound, a stoma can be temporary so that your body can heal and allow normal excretion again. In some cases, a stoma can be permanent. During the initial discussions with healthcare providers, it will become clear whether you are eligible for a temporary or permanent stoma. Let’s see the types of stoma.
Type of Stoma
Not all stomas are the same. They can vary in size, shape, location, and construction. Depending on the reason for your stoma, your doctor will decide which type of stoma should be applied to you. There are three primary types of stomas.
Colostomy / colon stoma
A colostomy is a stoma in the large intestine (colon). A colostomy is created when part of your colon and possibly the rectum has been removed. An artificial outlet is created from the end of the colon to divert waste from your digestive tract.
After surgery, you excrete waste products through a stoma located on the abdomen and lose random control over your bowels. The location of the colostomy is determined by the location of the damaged part of your colon. Depending on the location and reason for the stoma, it can be permanent or temporary.
Ileostomy / small intestine stoma
An ileostomy is a stoma in the small intestine (ileum). This is created when the colon has been completely removed or inoperative. An artificial exit is created from the end of the last piece of the small intestine to divert waste. The small intestine contains digestive enzymes and acids that can irritate the skin.
With an ileostomy, extra care must therefore be taken to ensure that waste products do not come into contact with the skin of your abdomen. With an ileostomy, you lose arbitrary control over your bowels. Depending on the reason for the ileostomy, it can be permanent or temporary.
Urostomy / urostomy
A urostomy is a stoma in the urinary tract and is created when urine can no longer leave the body naturally. A urostomy surgery removes a diseased or damaged part of the urinary system and creates an artificial urinary tract exit.
With a urostomy, urine flow flows as it is produced because you have no arbitrary control over the flow of urine. A pouch or collection system is required. All urostomy bags have a tap at the bottom, so you can empty the bag several times a day.
See also, Prostatitis literally inflammation
Every year thousands of others undergo ostomy surgery. For many, ostomy surgery is a new beginning. But can be a difficult time when you hear that you need a stoma. You can feel completely overwhelmed, but know that you are not powerless. There is an enormous amount of information, help, and support available, so that you can regain control of your life as much as possible.
Before the stoma operation
The support and information provision already starts before the stoma operation. You discuss with the surgeon which type of stoma is best for you. This depends on the type of surgery you need. He or she discusses whether the stoma will be temporary or permanent. The surgeon may also provide the name of the stoma care nurse assigned to you. He or she is the one to contact both before and after the operation. He or she will help you prepare for surgery and adjust your life to the stoma. He or she can also tell you more about the operation and answer any questions you may have.
In the hospital
After you have been admitted to the hospital, you determine together with the surgeon and stoma nurse what is the best place for the stoma on your stomach. The location of the stoma is a determining factor in your future comfort and ability to care for your stoma. You want to make sure that the stoma is placed on a smooth surface of the skin and that you can easily and easily access the stoma so that you can change the bags yourself as much as possible. After ostomy surgery, the specialist stoma care nurse will usually come to talk to you about the surgery so that you better understand what happened to your body and learn how to take care of yourself to recover in the hospital and later at home. The nurse will also help you find the right products and the right stoma system for your individual needs.
So you have every chance to ask questions after the operation. It often happens that because of the nerves before the operation, you forgot to ask half of what you wanted to know. Or that the information transferred has gone in one ear and out the other.
Once at home with your new stoma, it often happens that uncertainty strikes. This can make you anxious when you have to change the pouch for the first time. It is important to remember that you are not alone. Read more about what to expect in the 12 weeks after stoma surgery and how to deal with it.
See also, Prostate enlargement
Living with an ostomy
Learning to live with a stoma can take some time and involves trial and error. Yet for many people the operation is the beginning of a more pleasant life.
After the adjustment process, you will find that your improved health gives you the freedom to enjoy activities that you previously thought were impossible. By providing yourself with the right information and making adjustments, you will be able to exercise, travel, eat out, and be intimate with your partner again.
Care of stoma and skin
The most common reason people with a stoma seek medical attention is a complication of the skin around your stoma called peristomal skin. When urine or feces come into contact with your skin, they can cause irritation to your skin. Peristomal skin complications can seriously affect your daily comfort and quality of life. That’s why it’s essential to keep the skin around your stoma healthy.
Prevention of Complications
Prevention is key in maintaining healthy peristomal skin. Because once your skin is damaged, the baseplate becomes more difficult to stick to your skin, which increases the risk of irritation even more. Therefore, check that the skin is intact and dry before applying the baseplate. This ensures that the stoma system remains in the correct place between changing the bags. It is also important that you have the best fit between the baseplate and stoma. Skid plates are the necessary separation between your skin and stoma output. There are more important things to keep in mind to keep peristomal skin healthy.
Recognizing Peristomal Skin
Complications To recognize a complication, you need to know what healthy and irritated peristomal skin looks like. The peristomal skin should look similar to the skin on the other side of the abdomen (ie intact, not irritated). Knowing what your skin normally looks like can help you keep an eye out for signs of possible skin conditions. If you suspect you have a peristomal skin complication, contact your healthcare provider as soon as possible.
Nutrition and a stoma
It makes sense that nutrition affects the output of the stoma. Fortunately, this fact does not mean that good food is a thing of the past. It just takes some time and patience to find out what works for you and therefore what doesn’t ..
There are no strict dietary rules for people with a stoma, but it is advisable to at least follow these general guidelines:
- Eat regularly
- Drink plenty of fluids
- Chew your food carefully
- Enjoy your food and don’t be afraid of it
- Talk to your stoma care nurse or a dietitian about vitamin supplements
- Try new foods one at a time in small batches.
If a problem arises then, you know the cause. There are also more specific nutritional guidelines for each type of stoma. For example, a high-fiber diet is recommended for a colostomy, while this can cause problems with an ileostomy. In any case, always ask your stoma care nurse which dietary restrictions and dietary rules may apply to you.
Exercise with a stoma
With a stoma, you can still be active whether you play tennis, swim, jog, or do yoga, provided you have permission from your stoma care nurse. However, not all sports are recommended with a stoma. These particularly contact sports such as boxing, wrestling, or rugby, as the stoma can be damaged by a major blow.
There are plenty of inspiring stories about people with a stoma who have come a long way in sports. For example, many patients are long-distance runners, weightlifters, skiers, and swimmers or participants in athletics.
Traveling with an ostomy
After ostomy surgery, you don’t have to leave challenging travel plans in your suitcase in the attic. It just takes a little more planning and preparation if you have a stoma. This is partly due to the extra security measures that are currently taken worldwide when traveling. These measures can cause safety-related and potentially embarrassing problems. But with these tips you can avoid a lot of trouble:
- Cut all baseplates to size at home — This allows you to put the scissors in your suitcase. After the events of September 11, security has been tightened at many international airports, making it difficult, if not impossible, to carry scissors in your hand luggage.
- Put stoma care products in your hand luggage and in your suitcase.
- Bring extra supplies in case they are not available at the destination.
- Carry a statement from your stoma care nurse stating that you have a stoma and are using products for it. You can then show this statement to the security officer when he/she asks about the products.
- When traveling to another country, make sure that you carry information about ostomy care in that language. One of the 70 related associations of the International Ostomy Association can help you with the translation. This allows you to find the right equipment when traveling abroad. Airport checks should be carried out in a courteous, dignified, and respectful manner for travelers. If you wish, you can request a personal check in a secluded area.
Sex and relationship and a stoma
A satisfying intimate relationship is still possible with a stoma. But it is only natural that integrating the change to your body into your sexual relationship takes time. At first, your stoma may still be a sensitive topic for you and / or your partner.
Communication and trust are at the heart of the healing process. It is recommended that you share your insecurities or concerns with your partner, friends or family. And ask about your partner’s feelings. Tell him or her that a sexual relationship will not harm your stoma. With time, understanding, and a positive attitude, you will both be able to enjoy a satisfying sexual relationship.
Tips to improve your sexual relationship
- Empty the pouch before engaging in sexual activity.
- Carry a small pouch — Special pouches are available that are smaller and thinner, especially for intimate moments.
- Cover the pouch with specially designed underwear, lingerie, or an ostomy pouch if you feel uncomfortable when your partner sees the pouch.
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