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given. Before acting on suggestions from anyone, ostomates are advised to check with a doctor or stoma care nurse that the course of action is suitable
for them. Whilst every care is taken, the author will not be held responsible.
An ascending colostomy is a colostomy in which the ascending colon is brought to the abdomen surface. The stoma is usually located in the right abdomen. This is a rare and temporary stoma.
A descending colostomy is a stoma in the descending colon, and may be temporary or permanent. It is usually located in the lower, left abdomen. Occasionally, it can be managed with irrigation, but usually a pouch is worn at all times.
A sigmoid colostomy is where the stoma is located in the sigmoid colon (final part of the colon), and is located in the lower, left abdomen. This stoma is the most common type of permanent colostomy, but it can be temporary, if the rectum and anus are left. This type of colostomy can be managed via irrigation, or if preferred, by wearing a pouch.
A transverse colostomy is where the stoma is positioned in the transverse colon (right upper quadrant), resulting in one or two openings. It is located on the upper abdomen, usually at or above the waistline. Normally, this is a temporary procedure.
Candidiasis is a mild infection caused by the candida fungus, which lives naturally in the gastrointestinal tract. The infection occurs when a change in the body, such as surgery or reduced immunity, causes the fungus to overgrow.
A catheter is a flexible, hollow tube designed for draining urine from the bladder, either temporarily
(e.g. recovering after surgery) or permanently.
CATHETERISABLE URINARY STOMA
See Crohn’s Disease.
A caecostomy is a tube, which goes through the skin into the beginning of the large intestine
(caecum) to remove gas or faeces. This is a short-
heals after surgery. It functions like an ileostomy.
The caecum is the beginning of the large intestine. The caecum is connected to the lower part of the small intestine (the ileum).
Chemotherapy is a treatment for cancer, which uses anti-
for cancer, meaning that it affects cells and tissues throughout the body, and not just in the cancerous area.
Chronic is a term, which refers to disorders that last a long time, often years.
A closed pouch is a pouch, which is not drainable from the bottom. Closed pouches come in all shapes and sizes from mini to maxi. Minis have a small capacity for times when the stoma is unlikely to be active or for going swimming. Maxis can be worn for longer periods of time, or by patients who have a high output during the night.
Usually when a closed pouch needs to be emptied, it is removed and thrown away. Most often, a patient with a colostomy with formed stool prefers this type of pouch.
A colectomy is an operation to remove the colon (large intestine), either in part (partial colectomy) or
all of it (total colectomy).
Colitis is inflammation of the large bowel.
The colon is the large bowel (large intestine), which stores digestive material and absorbs water.
This is a segment of colon used to form a stoma (opening to the skin). This surgery differs from the ileal conduit, only in the fact that a segment of the large bowel is used to form the conduit, instead of the small intestine. Usually, the stoma is in the lower left portion of the abdomen.
A colonoscopy is a method, whereby medical professionals can inspect the entire large intestine, from the lowest part (the rectum), through the colon to the lower end of the small intestine. The medical professional uses a long, flexible, narrow tube, which has a light and small lens on the end. The tube itself is called a colonoscope, and is passed via the rectum.
The procedure is used to look for early signs of cancer in the colon and rectum. In addition, it is used
to diagnose the causes of unexplained changes in bowel habits. A colonoscopy enables the medical professionals to see inflamed tissue, abnormal growths, ulcers and bleeding.
Colorectal cancer is a cancer, which occurs in the colon (large intestine) or rectum (the end of the large intestine). It is the most common reason for a permanent colostomy.
A number of digestive diseases may increase a person’s risk of colorectal cancer, including polyposis
A colostomy is a surgically-
The colostomy diverts the faecal flow through the stoma and the faeces can then be collected in a pouch (colostomy pouch), which is attached around the opening. The stoma does not possess any nerve endings. Therefore any trauma to the stoma will be painless, but it could be harmful, e.g. injury from an ill-
In some cases, the colostomy can be permanent, because joining up the cut ends of the bowel is impracticable. A colostomy may be needed in many diseases of the bowel. In other cases, a colostomy may be a temporary measure, until the colon can heal or other corrective surgery can be done.
Colostomies are named according to where the stoma is located in the colon:
A colostomy may stop functioning due to a blockage caused by adhesions or undigested food. The patient may experience abdominal pain, distension, nausea and vomiting. There will be minimal or no output from the stoma.
Management will include fluids only, relaxation and abdominal massage. A food blockage will in most cases resolve spontaneously, but if symptoms persist, the stoma patient may require admission to
hospital for conservative or surgical treatment.
A colostomy generally starts to function two to three days after an operation. The output, volume and consistency vary in each individual case and on the location of the stoma within the colon. This means that a colostomy in the distal colon will produce stool of thicker consistency and lower volume, than a colostomy in the proximal colon. There is frequently an ‘adaptation phase’, which may last for several weeks. The average person with a colostomy would change or empty the pouch twice a day.
Colostomy irrigation is a method of bowel management suitable for sigmoid/descending colostomies
to regulate bowel movements and provide continence between procedures.
The irrigation is self-
A colostomy plug is a lubricated stoma device, which allows patients to achieve a temporary degree
of continence, eliminating the need for a pouch. A small foam plug is inserted onto a specialised adhesive flange. The plug expands into the bowel lumen, so blocking the passage of faeces for up to twelve hours.
This reinstates control over the bowel function, reduces the noise associated with flatus, reduces odour and is painless. However, there can be problems of intermittent colicky pain, leakage, and the fact that the plug can only be used for end colostomies.
A colostomy plug should not be used without consulting a stoma care nurse, so as to ensure that it is suitable for an ostomate’s stoma.
A colostomy pouch (sometimes called a colostomy bag) is an appliance attached to the outside of the abdomen wall to collect the waste, when it leaves the body.
A colostomy pouch can be either open-
to the body, whilst emptying. Closed-
can irrigate or by patients, who have regular elimination patterns. Closed-
discarded after one use.
Colostomy supplies are products used by stoma patients, who have a colostomy.
A cone is part of a colostomy irrigation set. The soft, plastic, cone-
tubing fits snugly against the stoma, in order to keep irrigation fluid in the colostomy.
Constipation is a very common condition, which can affect people of all ages. When a patient is constipated, they feel that they are not passing stools (faeces) as often as they normally do. It can mean that a patient has to strain more than usual, or is unable to completely empty their bowels. Constipation can also cause stools to be unusually dry, hard, lumpy, large or small.
The severity of constipation can vary greatly. Many people only experience constipation for a short period of time, with no lasting effects on their health. Some painkillers are known to cause constipation.
A continent ileostomy is a surgical variation of the ileostomy, where a reservoir pouch is created inside the abdomen. The ileum is used to create the pouch inside the lower abdomen. A valve is constructed in the pouch, which is brought through the abdominal wall via a stoma. A catheter or tube is inserted into the internal pouch, several times a day, to drain faeces from the reservoir. Patients do not wear
an appliance. A continent ileostomy is also known as Kock Pouch or BCIR Pouch.
Generally, this procedure has been replaced in popularity by the ileoanal reservoir.
A modified version of this procedure, called the Barnett Continent Intestinal Reservoir (BCIR), is performed at a limited number of facilities.
CONTINENT URINARY RESERVOIR
A continent urinary reservoir is a urinary reservoir made from a segment of bowel after bladder removal. It includes a valve to retain urine.
A continent urostomy is a kind of urinary diversion. It is the surgical construction of an internal pouch
or conduit, usually from a short length of ileum, constructed as in the continent ileostomy, but with ureters attached. A valve is constructed in the pouch, and is brought through the abdominal wall. A catheter is inserted several times daily to drain urine from the reservoir. Patients do not wear an appliance.
Forms of urostomy include a Mitrofanoff (commonly using the appendix), a Kock Pouch or Indiana Pouch. A Kock Pouch is made from the last section of the ileum, whilst an Indiana Pouch uses a small piece of ileum and the segment at the beginning of the large intestine.
A conventional ileostomy is where the intestine is severed and the end of the ileum is brought through the abdominal wall to form a stoma, usually on the lower right side of the abdomen. The entire colon and rectum is removed or bypassed. A pouch is worn over the stoma at all times.
Convex flanges/pouches are used for stomas, which are flush to the skin. It is a small part, which can
be incorporated into the flange, which presses in the skin around the stoma, thus making the stoma
procedure protrude a little more.
The term convexity, or a convex flange/pouch, refers to outward curving of a portion of a pouch,
which has contact with the skin, i.e. the flange, rather than being flat as on a standard pouch. The convexity allows for continuous contact and support between the peristomal skin and the pouching system. When in contact with the skin, the convexity creates pressure on the peristomal area to partly avert a retracted or flush stoma. This helps to provide security and prevents leakages.
Convexity products can be made as a one-
7 mm., and they can vary in the strength or firmness.
Stoma patients should be carefully assessed for the appropriate use of hard convex products, and
these should only be used under the guidance of a trained, competent stoma care nurse. Deep, hard convex products have been known to trigger peristomal skin problems, e.g. pressure ulcers, etc.
Corticosteroids are medicines, such as cortisone and hydrocortisone. These medicines reduce irritation from Crohn’s Disease and Ulcerative Colitis. They may be taken either by mouth or suppositories.
Crohn’s Disease is an inflammation of the small intestine, which usually occurs in the lower part, called the ileum, but can affect any part of the digestive tract, from the mouth to the anus. It results in swelling, and the inflammation can extend deep into the lining of the affected organ. It can cause pain and bleeding, and may make the intestines empty frequently, resulting in diarrhoea. Sometimes, it can cause a blockage.
It is also known as Granulomatous Colitis, Regional Enteritis and Ileitis.
A CT scan (computed tomography) is a modern, medical, diagnostic x-
into a vein to show body parts more clearly.
the abdomen. This type of flange contains a small starter hole in the centre, where scissors can be placed to make the cutting easier. A cut-
or if the stoma is still changing size.
A cystectomy is the removal of the bladder, either part (partial cystectomy) or all of it (total cystectomy).
A cystoscopy is a test to evaluate the bladder. A small, telescope-
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