A colostomy is a surgical procedure that involves connecting a part of the colon (large intestines) onto the exterior of the abdomen, leaving the patient with an opening on the abdomen called a stoma.

The opening is formed from the end of the large intestine drawn out through an incision and sutured to the skin.

Following colostomy waste products from the digestive tract leave the patient's body through the stoma, and collect in a bag (pouch) attached to the patient's belly. The bag can be changed as required.

The stoma is swollen just after the operation but it gets smaller with time. It is also normal to ooze white mucus. This collects into the bag.

The operation usually takes between two and four hours. It is done while the patient is under general anaesthesia (unconscious and pain-free).

During the operation there will be a catheter installed to drain the urine. This normally stays in for a couple of days. You will also have an intravenous line for medication and fluids. This will remain in place for several days.

When is colostomy needed?

There are several reasons for this procedure. It may be necessary for the lower end of the colon to be removed due to bowel cancer.

Another reason is that a portion of the colon may have been operated upon and needs to 'rest' until it is healed. In this case, the colostomy is temporary and is usually reversed later, leaving the patient with a small scar where the stoma was.

Another reason for performing the surgery is the rare case of absence of an anal opening.

Colostomy Bag and Colostomy Care

A Colostomy bag is a removable and disposable bag that attaches to the exterior opening of the colostomy (stoma). It permits sanitary collection and disposal of bodily wastes.

The positioning of the stoma on the abdomen is one of the most important factors determining the success of the stoma. As a result, colostomies, which are planned, have a high rate of long-term success and satisfaction than those done in emergency surgery.

Colostomies are dreaded as it is difficult to hide the smell of human waste especially when changing the bag or keeping it securely attached. A poorly fitted bag will create problems of smell and possibly even leaking.

Nevertheless, modern colostomy bags are well designed and allow stoma patients to continue normal activities.

You should only be aware of the smell when changing or emptying the bag. If you have a smell problem with your colostomy bag, check, the type of bag you are using, the fit of the bag and your diet.

There are very many different types of bags available and different one suit different people. You may try several before you find one that suits you.

Some bags have charcoal filters built into them. Charcoal absorbs smells very well and the filter lets gas escape from the bag. This prevents the bag from becoming overfull and uncomfortable.

Limiting the following foods may help reduce the smell; onions, beans, sprouts, cabbages, fatty foods as well as strongly spiced foods and garlic. In addition, there are products available to reduce the smell from colostomy.

It is vital to chew foods completely. This will help the digestive process.

In addition, eat foods at a regular time each day.

Eating 4 to 6 smaller meals a day may help to promote a regular bowel pattern.

Eating the main meal at noon and a smaller meal in the evening is helpful. Ensure you drink enough water every day.

Medications such as Imodium, Lomotil, Levsin, and Bentyl can help to slow the bowel when diarrhoea is a problem.

Foods containing large amounts of fibre and bran need to be avoided for 6 to 8 weeks after surgery. After 8 weeks, certain bulking agents such as Metamucil and Citrucel can be taken if advised by the doctor.

Many patients now are opting for an ileostomy. Ileostomy eliminates the awkwardness and perceived social stigma associated with external bags. In Ileostomy, an internal pouch is constructed using a portion of the patient's lower intestine instead of the external bag.

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