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Ileostomy and colostomy

Ileostomy and colostomy are procedures that may be recommended after bowel cancer surgery.

An ileostomy operation diverts the small intestine or small bowel out through an opening in the abdomen.

A colostomy is a similar procedure diverting a section of the large intestine or colon.

These procedures are usually carried out laparoscopically using keyhole surgery techniques.

In both cases the opening in the abdomen, called a stoma, is connected to a special bag to collect body waste.

Stomas can be permanent or temporary, depending on whether the anus and rectum have been removed or not.

How is the stoma made?

There are two main types of stomas: The end stoma and the loop stoma.

End stoma

An end stoma can be made in the ileum (end of the small intestine, called "end ileostomy") or colon ("end colostomy"). First, a small piece of skin will be removed from the stoma site. Next, your surgeon will bring 1-2 inches of healthy bowel up through the abdominal wall to skin level. If you are having a colostomy, the end of the large intestine will be stitched to the opening in your skin. If you are having an ileostomy, the end of the small intestine will be stitched to the opening in your skin.

Loop stoma

A loop stoma can be made in the ileum ("loop ileostomy") or colon ("loop colostomy"). A loop stoma is often made when the stoma will be temporary. However, not all loop stomas are temporary.

To make the loop stoma, a small loop of intestine will be brought up through the abdominal wall to skin level. A plastic rod will be passed under the loop to keep the new stoma in place. The loop will be cut half way through to make the site for the bowel opening. Each open end of the bowel created by this cut will appear as two openings in the stoma. If you are having a loop colostomy, the end of the intestine will be stitched to the opening in your skin. If you are having a loop ileostomy, the loop will be turned back on itself like a small cuff and then stitched just below your skin. The abdominal cavity will be carefully inspected and the rod will be removed several days after surgery.

Recovery from surgery

Hospital stays after “keyhole” surgery are usually about five days. You may need to stay in hospital for 10 to 14 days after open surgery. You will be fitted with a bag as soon as your operation is complete. It will take a day or two for your digestive system to become active again. When it does start functioning, you will notice changes in the consistency of your stoma output.

After surgery you will be referred to a stoma care nurse. These nurses are experienced in helping people manage stomas. You are bound to go through many psychological and physical adjustments after surgery. It will take time to cope with all of these changes and, at times, you may feel overwhelmed. Your stoma care nurse can be a great help. There are also bowel cancer support and stoma care organisations available.

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