A Comprehensive Guide to Colostomy

A colostomy is an intricate surgical procedure that involves the diversion of the large intestine and its connection to a specially created opening in the abdominal wall. This opening, more accurately termed a 'stoma', effectively replaces the natural function of the anus. Attached to this stoma is a bag for collecting feces, which must be periodically changed and cleaned.

The Necessity for Colostomy

A colostomy becomes necessary due to various pathological conditions, such as colorectal cancer or intestinal obstruction. The procedure can be performed using two surgical techniques: the traditional surgical technique and laparoscopy. The diversion of the intestine and the stoma can be made in different ways, depending on the pathological conditions that require the colostomy.

Understanding Intestinal Anatomy

The intestine is a part of the digestive system situated between the pylorus and the anal orifice. Anatomically, it is divided into two main sectors: the small intestine and the large intestine. The small intestine is the first section beginning at the pyloric valve, which separates it from the stomach, and ends at the ileocecal valve, located on the border with the large intestine. The large intestine, on the other hand, is the terminal section of the intestine and digestive system. It starts at the ileocecal valve and ends at the anus.

The Colostomy Procedure

A colostomy is a surgical procedure that involves diverting the large intestine towards an opening made in the abdomen. This opening, or stoma, is connected to a special waterproof bag, allowing feces to escape. The colostomy procedure modifies the normal intestinal path and creates an orifice in the abdomen, which effectively replaces the functions of the anus.

Colostomy can serve as a temporary or permanent solution for stool elimination. If it's a temporary solution, another surgical operation is required through which the patient's intestine is reconnected with the anus. The type of colostomy performed depends on the section of large intestine that the surgeon diverts towards the abdomen.

Conditions Necessitating Colostomy

Colostomy is performed in the presence of certain pathologies of the large intestine. These diseases may also require the removal of portions of the colon (colectomy). They include colorectal cancer, diverticulitis, Crohn's disease, bowel obstruction, fecal incontinence, intestinal injury from abdominal trauma, and Hirschsprung's disease.

Preparing for a Colostomy

Colostomy is a procedure that requires general anesthesia. Therefore, before its execution, the individual to be operated on must undergo a thorough physical examination, complete blood test, electrocardiogram, and evaluation of their medical history. If no contraindications emerge, the operating surgeon will illustrate the procedure, the possible risks, the pre- and post-operative recommendations, and finally, the recovery times.

Post-Operative Phase and Risks

After the colostomy, a hospital stay is expected which can last from a minimum of 3 to a maximum of 10 days. The duration generally depends on the severity of the intestinal problem that necessitated the colostomy operation. During hospitalization, a member of the medical staff teaches the patient how to take care of the pouch and how to keep the stoma and the surrounding area clean.

As with any surgery, when performing a colostomy there is a risk of internal hemorrhages, infections, formation of blood clots in the veins, stroke or heart attack during the operation, and allergic reaction to anesthetic drugs or sedatives used during surgery. Once the operation is completed, a series of different complications can occur, such as leakage of mucus from the remaining portion of the rectum, skin irritation due to loss of mucus, parastomal hernia, stoma obstruction, skin problems, stomal fistula, stomal prolapse, stomal stenosis, stomal retraction, internal or external leaks, and stomal ischemia.

Colostomy and Daily Life

Although it imposes some limitations, the colostomy still allows individuals to lead an active and social life. The greatest attention must be paid to the diet (especially in the first phase of post-operative recovery) and to the periodic change and cleaning of the stool collection bag. Regarding work, physical exercise, and sexual intercourse, it is advisable to seek advice from your doctor or the surgeon who performed the colostomy. Each patient represents a unique case and therefore, specific advice is necessary.

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