Understanding Ostomy Care


A stoma is created by an operation, which brings the end of the intestine to an opening on the abdominal wall. Bodily wastes are then excreted and collected into an ostomy appliance which is attached to the area around the stoma.

 

How is a colostomy created? 

 

During a colostomy operation, part of the large intestine (colon) is brought to the surface of the abdomen to form a stoma (opening). A colostomy is usually made on the left-hand side of the body, but can also be on the right. The colostomy can be formed either as an end colostomy or a loop colostomy.

End colostomy

End Colostomy PhotoHealthy end colostomy - some time after operation.
An end colostomy is usually formed when parts of the large intestine and/or rectum are removed and the remaining part of the large intestine is brought out to the surface of the abdomen to create a stoma.
An end colostomy can be temporary, and is usually performed when a diseased part of the intestine is removed and the anastomosis must heal without being affected by faeces, or when joining the two ends of intestine is thought to be risky at the particular time.

There are two types of frequent end operations: Abdomino-perineal excision of rectum and Hartman’s procedure.

Loop colostomy

Loop Colostomy PhotoLoop colostomy - just after operation and with plastic bridge

Formed in order to protect an anastomosis, a loop colostomy is expected to be temporary.
Usually, the intestine is lifted above skin level and held in place by an ostomy rod. The surgeon makes an incision on the exposed loop of intestine, and rolls the bowel down before sewing it to the skin. This means the loop ostomy actually consists of two stomas (a double-barrelled stoma) that are connected to one another.

 

 

 

The most common operation is a low anterior resection. Low anterior resection is lower abdominal surgery to cut out the upper part of the rectum, where it connects with the colon; the colon is attached to the anus and waste is passed as usual.