A colostomy is the act of making a hole in the abdomen as a drain for feces or feces. A colostomy procedure is usually performed on patients who are unable to pass stool normally due to problems in the large intestine, anus, or rectum.
The colostomy procedure is done by making an opening or hole (stoma) in the abdominal wall to be connected to the part of the large intestine that is still functioning. Some colostomies are temporary, but some are permanent.
The large intestine will be stitched so that it attaches to the hole in the abdominal wall, so that the feces or feces will not come out through the anus, but through the hole or stoma in the stomach that has been made.
On the outside of the abdominal cavity, the doctor will install a bag that serves to accommodate the patient's stool. This bag is called a colostomy bag and should be changed regularly after the stool is full.
Purpose of the Colostomy Procedure
A colostomy procedure is performed when the colon, rectum, or anus are unable to function normally due to illness, injury, or need to be rested for a while. The goal is that the patient can still expel feces and gas from the digestive tract (fart) from the body.
A colostomy is generally performed to stop an infection, clear a blockage, or prevent further damage to the colon. The following are some medical conditions that require a colostomy:
- Cancer, such as colon cancer and rectal cancer
- Blockage or injury in the large intestine
- Inflammatory bowel disease, eg Crohn's disease and ulcerative colitis
- Colorectal polyps or tissue that grows on the inner wall of the colon and rectum
- Perforation or tear in the colon and anus
- Severe infections of the colon, eg diverculitis
- Congenital disorders of the gastrointestinal tract, such as atresia ani and Hirschsprung's disease
Types of Colostomy and their Risks
The colostomy procedure can be done by conventional surgery (laparotomy) or through laparoscopic surgery. In general, there are two kinds of colostomy, namely:
Permanent colostomy
A permanent colostomy is often performed on patients who are unable to have a normal bowel movement because the bowel damage is severe, permanent, or irreparable.
A permanent colostomy is usually performed in patients with colon cancer, Crohn's disease, diverculitis, colon polyps, and people who have an injury or complete blockage of the large intestine.
Temporary colostomy
A temporary colostomy is done to help the problem of the colon recover, but it can still be repaired. This procedure is done so that the part of the intestine that is recovering is not passed by feces until it recovers and functions normally.
A temporary colostomy is usually performed in children with birth defects in the anus and colon, such as in Hirschsprung's disease.
In surgery involving the large intestine, the doctor may also perform a temporary colostomy so that the area of the colon that was recently operated on can heal. Usually, the recovery period takes up to about 12 weeks, but it can be different for each patient.
Like surgery in general, the colostomy procedure is also at risk of causing several complications. Some of the risks of complications that can occur due to a colostomy, including:
- Bleeding
- Infection
- Damage to organs around the colostomy site
- The formation of scar tissue that clogs the large intestine
- hernia
- The reopening of the surgical wound
Treatment After Colostomy Surgery
After undergoing colostomy surgery, you will still need to stay in the hospital for 3–7 days. Hospitalization may be longer in cases when a colostomy is performed as an emergency measure.
After returning home, you should also perform self-care to keep the colostomy surgical wound clean and free from infection or other complications.
The following are some guidelines for treating colostomy wounds for those of you who are recovering at home:
1. Increase rest
Those of you who have undergone a colostomy and are allowed to go home are encouraged to stay rest for 6-8 weeks at home. During this time, you should not engage in strenuous activities such as driving, strenuous exercise, or lifting heavy weights.
2. Installing and replacing the colostomy bag
Before going home, the nurse or doctor will explain and teach you about the procedure for inserting and using a colostomy bag.
Pay close attention to all instructions from doctors and hospital nurses. Make sure you understand all instructions on how to insert and use the colostomy bag.
If necessary, you can try to practice yourself how to insert a colostomy bag while still in the hospital while being monitored by a nurse.
3. Change the colostomy bag regularly
Some types of pouches can be used for 3–7 days. However, there are also types of pouches that need to be changed daily. Ask your doctor or nurse what type of colostomy bag you need to use.
You should replace the bag immediately when dirt begins to seep or touch the surrounding skin. It is also recommended that you replace the colostomy bag when the stool reaches one-third of the bag's capacity.
4. Care for the colostomy hole properly
You should always keep the colostomy opening in the abdomen and the skin around it clean. How to clean it is with a cloth that has been moistened with warm water and mild chemical soap. Next, rinse thoroughly and dry with a towel.
5. Wash hands before and after treatment
Don't forget to always wash your hands before and after performing the colostomy wound care procedure to avoid the risk of infection. You also need to always wash your hands when your hands come into contact with feces.
6. Follow a special diet
After undergoing a colostomy, you will usually be advised to follow a special diet, such as a low-fiber diet. You are also advised not to eat foods that can increase gas production in the digestive tract, such as onions, cauliflower, asparagus, broccoli, and cabbage.
7. Recognizing signs of infection or complications
Check the condition of the hole every time you clean the skin or change the colostomy bag. Also check for possible allergic reactions that could be caused by the material from the colostomy bag. If this is the case, try using a colostomy bag with a different material.
Normally, the colostomy opening will be pink in color and appear slightly wet or damp for several weeks after the colostomy is performed. An infected or complicated colostomy can be characterized by changes in the shape, color, smell, and size of the orifice.
Usually, these changes are accompanied by prolonged nausea or vomiting, fever, and bleeding at the colostomy opening. You need to contact your doctor immediately if you experience these symptoms.
Living with a colostomy bag in your stomach may feel uncomfortable at first. However, with the right treatment and support from your family and the doctor who treats you, your condition will gradually improve.
Don't hesitate to consult a doctor about when is the right time to start your activities and things that can support your activities after undergoing colostomy surgery.