COLOSTOMY

General Information

DEFINITION--Creation of an artificial opening between a part of the colon (large intestine) and the surface of the body. All feces will leave the body through this opening, which is called an ostomy or stoma.

BODY PARTS INVOLVED--Large intestine.

REASONS FOR SURGERY--Creating a temporary or permanent exit for feces to leave the body above any abnormal parts of the colon.

SURGICAL RISK INCREASES WITH

• Stress.
• Obesity.
• Smoking.
• Excess alcohol consumption.
• Poor nutrition.
• Recent illness.
• Chronic illness of the heart, lungs, liver or gastrointestinal tract.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; narcotics; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon; colon-rectal surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: Blood and urine studies; x-rays of kidneys, chest and gastrointestinal system; ECG; colonoscopy (See Glossary for both).
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen. The abdominal muscles are separated to expose the abdominal organs, which are inspected for any undetected disease. Other surgeries may be performed at this time.
• The colon section that is to be opened is isolated and clamped on both sides, then cut between the clamps. The end of the colon closer to the stomach is brought out of the abdomen and clamped outside the skin. The end farther from the stomach is closed.
• The abdominal contents are replaced, and muscles are closed around the stoma. Skin is closed with sutures or clips, which usually can be removed in about 1 week.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Incisional hernia.
• Skin irritation around the stomach.
• Diarrhea.

AVERAGE HOSPITAL STAY--7 to 10 days.

PROBABLE OUTCOME--Expect complete healing without complications. You can look forward to a relatively normal life, except that bowel movements will now pass through the stoma instead of the rectum. Allow about 6 weeks for recovery from surgery.

Postoperative Care

GENERAL MEASURES

• A hard ridge should form along the incision. As it heals, the ridge will recede gradually.
• Use an electric heating pad, a heat lamp or warm compress to relieve incisional pain.
• Bathe and shower as usual. You may wash the incision gently with mild unscented soap.
• An enterostomy specialist (See Glossary) will provide education and counseling for the patient and family.

MEDICATION---

Your doctor may prescribe:

• Pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need. > Antibiotics to fight infection. > Ointment for skin around ostomy site.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Resume sexual relations when able. > Resume driving 6 weeks after returning home.

DIET--Clear liquid diet until the gastrointestinal tract begins to function again. Then eat a well--balanced diet to promote healing.

Call Your Doctor If

† You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.

• Pain, swelling, redness, drainage or bleeding increases in the surgical area.
• Skin around stoma becomes irritated or infected.
• New, unexplained symptoms develop. Drugs in treatment may produce side effects.