What is a colostomy?
A colostomy is a surgical procedure that is done when part of the large intestine (colon or rectum) has been removed and the remaining bowel cannot function normally. The colostomy may be temporary, until the colon or rectum heals, or it may be permanent if the entire lower colon or rectum was removed.
In colostomy surgery, the surgeon makes a cut through the skin on the person's abdomen. He or she then sews the end of the upper part of the intestine (where the stool continues to be made) to the opening in the skin. This opening is called a colostomy. The diseased part of the intestine is usually removed during the surgery. (Sometimes, it may be left in place and allowed to heal, depending on the type of disease or injury the person has.)
Stool continues to be made in the upper part of the intestine and passes out of the body through the colostomy. A disposable bag is placed on the skin over the colostomy opening to collect stool. A pouch may also be created inside the person's body, where stool collects and is then removed with a procedure like an enema.
A colostomy is surgery to make an opening in the skin on the belly and connect your bowel (colon) to that opening. The opening is called a stoma.
After surgery, stool will no longer leave your body through your anus. It will go through the stoma and into a plastic bag. The bag is attached to the stoma.
The surgery can be done in two ways. In open surgery, the doctor makes one large cut (incision) in the belly. In laparoscopic surgery, the doctor makes several small incisions in the belly. Then he or she puts a thin, lighted tube and special surgical tools through the incisions. The tube is called a scope. It lets the doctor see your organs and do the surgery. In either surgery, the incisions leave scars. These will fade with time.
You may worry about life after this surgery. Many people with colostomies lead active, normal lives. It may help to know that the bags don’t smell bad. They also don’t show under clothes. Other people won’t know that you have a colostomy unless you choose to tell them.
In the hospital, an ostomy nurse will help you learn to care for your colostomy. You will probably go home in 4 to 7 days. But it could take 6 weeks to fully recover.
What to expect after a colostomy
After a colostomy you can expect to feel better and stronger each day, but you may get tired quickly at first. Your belly may be sore, and you will probably need pain medicine for a week or two. Your stoma will be swollen at first. This is normal.
You may have very loose stools in your colostomy bag for a while. In time your stools may become firmer, but they will be less solid than before your surgery. You may also have a lot of gas pass into your colostomy bag in the weeks after surgery. This will decrease as you heal.
How quickly you get better depends, in part, on whether you had a laparoscopic or open surgery. But you will probably need at least 6 weeks to get back to your normal routine.
Colostomy self care
Rest when you feel tired. Getting enough sleep will help you recover.
Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia.
Avoid strenuous activities, such as biking, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay.
For at least 6 weeks, avoid lifting anything that would make you strain. This may include heavy grocery bags and milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or a child.
Ask your doctor when you can drive again.
You will probably need to take 6 weeks off from work. It depends on the type of work you do and how you feel.
You can take a bath or shower as usual. You can bathe with your colostomy bag on or off. Ask your doctor when it is okay for you to have sex.
You may need to follow a low-fiber diet for the first few weeks after your surgery.
Drink plenty of fluids (unless your doctor tells you not to).
Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.If you take blood thinners, such as warfarin (Coumadin), clopidogrel (Plavix), or aspirin, be sure to talk to your doctor. He or she will tell you if and when to start taking those medicines again. Make sure that you understand exactly what your doctor wants you to do.
Take pain medicines exactly as directed. If the doctor gave you a prescription medicine for pain, take it as prescribed. If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.
If you think your pain medicine is making you sick to your stomach:
Take your medicine after meals (unless your doctor has told you not to).
Ask your doctor for a different pain medicine.
If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off. Or follow your doctor’s instructions for removing the tape.
Wash the area daily with warm, soapy water, and pat it dry. Don’t use hydrogen peroxide or alcohol, which can slow healing. You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage every day.Keep the area clean and dry.
Keep the area around your stoma clean and dry.
Follow all instructions from your doctor or ostomy nurse.
Empty and replace your colostomy bag as often as directed by your doctor or ostomy nurse.
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