Colostomy - what is it? How to behave with her, what is possible and what cannot be, what care does this type of stoma require? All these questions are asked by people who have a temporary or permanent colostomy.
The definition of colostomy
What it is? A colostomy is an artificially removed part of the large intestine on the anterior abdominal wall after surgery on the lower intestine.
It is necessary to remove vital products from the body in cases where you need to bypass the rectum after surgery for tumors, injuries and some inflammatory diseases of the colon that require surgery (Crohn’s disease, ulcerative colitis). Permanent colostomy of the rectum is indicated in cases where restoration of the lower intestine is not possible.
A healthy person can control the bowel movement. This is achieved with the help of sphincters, the activity of which is provided by a conditioned reflex and depends on nerve impulses coming from the cerebral cortex. Through the colostomy, feces come out 2-3 times a day in the form of formed or semi-formed feces, the activity of the intestine is not disturbed.
Types of colostrum
There are several types of colostomy:
- temporary or permanent;
- single or double-barreled:
- separate or loopback.
A permanent colostomy is established for life, there is no possibility for its elimination due to irreversible changes in the sphincters or with a significant malignant degeneration of the rectum. A temporary colostomy after some time is removed operatively by restoring patency of the large intestine.
Single-barrel - through the hole one trunk of the intestine is removed, two-barrel - two. Loop colostomy - two holes are located nearby, separate - at a certain distance from each other.
Colostomy - what is it? What types of it are, which is more acceptable in each case? All these questions will be answered by a surgeon or a nurse who has completed specialized courses. A colostomy after surgery on the intestine looks like a hole or mouth through which the colon enters the surface of the abdomen. At first, it is inflamed and protrudes significantly above the surface of the skin. Then the swelling gradually decreases, the mouth turns into a small hole through which feces freely go to the surface of the anterior abdominal wall. The colostomy does not have nerve endings, so you must be extremely careful so as not to damage the hole. Constant secretion of white mucus is a normal process, you should not be afraid of this.
Colostomy need
Many people do not know what a colostomy is. What is this device, they will find out only in the hospital. Therefore, they often ask in fright the question of whether it is possible to live normally with her. It excites any person who is offered such an operation. The artificial exit of the large intestine is necessary for the removal of feces. Sometimes it saves and prolongs a person’s life.
Do not be afraid that there is no urge and the ability to properly empty the intestines in a convenient place and at a convenient time. With proper care of the colostomy, the quality of a person’s life does not change, he can lead a full-fledged lifestyle, not being limited to his illness. Currently, there are a large number of kalopriemniki that are well attached to the skin, do not pass the smell, do not rustle and are not visible to others, and with proper care and do not irritate the skin.
Having a colostomy, a person changes, especially emotionally and physically: he loses interest in life, feels restrained and inferior. In some cases, patients get disability and become self-conscious, think about suicide. Do not worry about this, because it’s easy to take care of the colostomy. Before the operation, the surgeon will specify the place of excretion of the colon in order to make it easier for the patient to see and care for her. After the operation, the nurse will tell and show what needs to be done so that the colostomy does not interfere, which colostomy bags must be worn immediately after the operation, and which after some time.
Only according to strict indications, surgery is performed to remove part of the intestine to the anterior abdominal wall, the doctor must ensure that a colostomy is formed without complications.
The operation to eliminate the mouth and the formation of the natural intestinal patency is a complex process that can last in several stages for people who have a colostomy. Doctors perform reconstructive surgery without much enthusiasm due to the high risk of complications, the complexity of this type of surgical intervention and disbelief in the cure. Colostomy of the rectum is most often formed with cancerous lesions, injuries and anorectal incontinence, therefore, in most cases it is constant.
How to care for a colostomy
Care for the colostomy begins immediately after surgery. At first, the nurse helps the patient, changes, rinses her, and then teaches him to do it on his own.
A colostomy requires an attentive attitude and care, which consists of two stages: directly processing the hole and changing the air intake. First, when forming a stoma, it is required to remove feces, rinse the mouth with warm boiled water , wash the skin and dry with gauze napkins. Then it is necessary to apply ointment “Stomagesiv” or Lassar paste on the skin . Then place a napkin soaked in petroleum jelly around the hole so that the mouth remains. Put a sterile gauze napkin on top, cover with cotton wool and apply a bandage. It is advisable to change the dressing every 4 hours. After the formation and healing of the stoma, kalopriemniki can be used. A stoma is considered formed when there is no inflammatory infiltrate, and the mouth does not protrude above the surface of the skin. After that, you can stick on the kalopriemniki.
People who have removed the colostomy need to change the colostomy bag in the morning or before bedtime. To change the kalopriemnik it is necessary to carefully, without pulling the skin, remove the used device and, wrapped in paper, throw it away. Remove the remains of feces and wash the colostrum with warm boiled water. You can use liquid soap with an antiseptic. After this, it is necessary to dry the skin well and apply a paste or ointment. A measure requires measuring the size of the stoma and increasing the opening in the colostomy receiver to such a size that it fully accommodates the colostomy opening. If adhesive kalopriemniki are used, then it is required to combine a stoma opening with a kalopriemnik opening, with a small pressing to press it to skin. It is important to ensure that there are no wrinkles. The latch must be in the closed position.
Types of Receivers
There are one-component and two-component kalopriyemnik. The latter have an adhesive plate and ostomy bags, which are interconnected using a flange. However, their inconvenience is that skin irritation may occur. Therefore, when using them, the plate can be left for 3-4 days and only the bag should be changed. Peel off the plate earlier if discomfort occurs: itching and burning, or with severe contamination. It is very convenient that the bag has a special filter that eliminates odor and excess air. One-component must be changed after 6-8 hours, when using two-component only the bag changes, the plate - 2 times a week.
Rules for sticking the kalopriemnik
Each kalopriyemnik has a special cliche for measurement of a stoma opening. If there is no such ruler, you can use a transparent film, which must be applied to the mouth and circle the edges with a pen, then cut this hole in the film, put it on paper, outline the edges of this oval and cut the hole. A hole 2-3 mm larger than the size of the mouth is cut out on the glue plate of the kalopriemnik. Glue it with smoothing movements after slightly warming and removing the protective film from bottom to top, so that the latch is on top to facilitate further removal.
If the kalopriemnik is equipped with a drainage bag, then it needs to be emptied after the bag is filled to one third. This can be done over the toilet by opening the drainage hole, then rinse and dry the stool bag. After processing, do not forget to close the drainage hole.
Skin care
The skin with a colostomy is subject to constant irritation. Therefore, it is necessary to properly care for her in order to prevent inflammation and injury. There are several types of effective preparations for treating the skin, the main purpose of which is to protect the skin from the aggressive action of the adhesive base of the receiver box and feces.
To glue the plate, Koloplast paste with a small alcohol content is used. It does not irritate even inflamed and injured skin and contribute to better fixation of the receiver.
To clean the skin after peeling off the kolopriemnik will help paste "Klinser", which is used for healthy and slightly damaged skin. It not only cleans the skin well of feces, mucus and chemicals of the adhesive base, but also does not dry it and has antiseptic properties.
The second skin protective film received good consumer reviews. It is used before gluing the kalopriemnik. Creating a protective layer, it protects the skin from irritation by aggressive environments and subsequent inflammation and allows it to breathe.
Proper nutrition of patients with colostomy
There are no special restrictions in the reception of certain products. However, it should be remembered that it is better to avoid food that causes liquefaction of feces or helps to reduce intestinal motility: white bread, rice broth, tea, cocoa, some fruits and vegetables, etc. Onions, garlic, alcohol should not be abused to stop the unpleasant odor from the colostomy. boiled eggs. Food should be consumed often and in small portions. After surgery, you should gradually expand the diet and switch to normal nutrition.