General Health Tips & News


Understanding Stoma and why it needs?


By A.S. (staff writer) , published on October 27, 2022



Medicine Telehealth Health


 A stoma is an opening in your abdomen and digestive tracts to remove wastes instead of going through your digestive tract, in case your digestive tract has an injury or needs time to heal. To create a stoma, an opening is created into your intestine and then pulled through the skin to sew it there. Stomas are round, red, and 1 to 2 cm in diameter, through which the wastes are emptied via stomas into an ostomy bag. Technically, ostomy and stoma are two different terms, with stoma referring to the end of the intestine that is sewn into ostomy and ostomy is the actual opening in your abdomen. Depending upon the condition, ostomies can be temporary or permanent, if you have permanent damage and injury, you'll have a permanent ostomy or a temporary one in case your gut only needs some time to heal or repair from a condition. 

 

 

What are the different types of Stomas?

Depending upon the procedure used, there are various types of stomas,

● A colostomy is a stoma created with part of your colon to bypass the rectum and it can be permanent in some cases or temporary if your colon only needs some time to heal. You'll need it in cases of colon or rectal cancer, colon injury, or blockage.

● If your doctor makes a pouch using your small intestine, connecting your ureters to it to bypass your bladder, it's called a urostomy. It may be needed in cases of a diseased or injured bladder.

● An ileostomy is the most common type of temporary stoma and is needed in Crohn's disease, ulcerative colitis, or bowel cancer. In this type of ostomy, your small intestine is used to bypass your colon or rectum. 

Your doctor will likely use an end ostomy (cut end of your intestine is pulled and sewn to the opening) or loop ostomy (loop of intestine is pulled, cut, and both ends are attached to the ostomy, one for mucus, while the other for feces.

 

 

What are the reasons for having a stoma?

Several conditions may necessitate the formation of a stoma, a brief description of which is given below,

• Pelvic cancers can result in the patient having a stoma.

• The third most common cancer in men and the second most common cancer in women in the UK is colorectal cancer and each year 18, 500 new cases arise, which makes it an important consideration. Treatment is the excision of the tumor and during the process, a stoma is made.

4% of males and 2% of females in the UK suffer from bladder cancer due to certain environmental factors, chemicals, and smoking and this is another indication of the stoma. • Familial adenomatous polyposis (FAP) is an autosomal dominant disease, characterized by multiple colonic polyps, and requires stoma in certain cases.  Crohn’s disease and ulcerative colitis, collectively called inflammatory bowel disease (IBD) are characterized by abdominal pain, diarrhea, rectal bleeding, and fatigue. A colostomy may be necessary in some cases such as surgery to remove parts of the colon.

• Cancers of the pelvic organs, such as of prostate, cervix, or uterus necessitate the removal of the adjacent whole organ sometimes, and in this case, there is also a requirement of a colostomy or ileostomy.

• The growth of small pouches in the colon that are prone to inflammation/infection and cause stomach pain, fever, and vomiting, is called diverticulitis. It can be acute or chronic and depending upon the type and the treatment options may require a temporary or permanent ostomy.

• The main purpose of stomas is to bypass the colon and the rectum, and it comes in handy in cases of urinary and fecal incontinence. It may be due to stool consistency, low capacity of the rectum, abnormal reflex, or sphincter issues. In all these cases, an option of management is to have a stoma that removes wastes into an ostomy bag bypassing these blocked areas.

• Bowel obstruction, which is the prevention of passage of digested food through the colon, due to severe constipation, hernias, tumors, adhesions, earlier abdominal surgery, or paralysis of the colon. The treatment plan sometimes requires the removal of some part of the colon and the formation of a stoma.

• In colorectal cancer, your doctor may also recommend the removal of affected parts of your colon or rectum to help cure the disease or treat symptoms. And in this temporary case or when reconnection is not possible your doctor will create a colostomy.

• Injury or trauma can severely damage the colon, and later parts of your gut that require the bypassing of these parts and your doctor will give you the option of stoma formation. Moreover, if there are injured areas not possible to repair, these areas may be removed and a stoma is formed.

• Birth Defects and Genetic Disorders are also an indication for stoma formation, as some babies may have a blocked or missing anal opening (imperforate anus), and require an alternate pathway.

 

 

 

How is life with a stoma?

A healthy stoma is red, moist, above skin level, and has no evidence of erythema, rash, or inflammation. Having a stoma establishes some changes in your daily life, which you must know how to take care of. It is a major event and changing bags also pose some psychological effects. Skin irritation or inflammation can arise, so you must keep it clean, free of germs, and use skin ointments prescribed along. There is also some risk of bleeding and dehydration, but are manageable. Stomas can worsen if you travel or do sports, so try to avoid these activities. Your doctor may also prescribe you some medications for pain, diarrhea, and constipation. In short, ostomy embarks on certain changes in your daily living, but the benefits and reasons outweigh the harms, so you must consider it if needed.

 

References:

  • https://medlineplus.gov/ency/patientinstructions/000071.htm
  • https://www.webmd.com/colorectal-cancer/colostomystoma#:~:text=A%20stoma%20is%20an%20opening,bowel%20movements%20the%20 usual%20way.
  • https://www.bladderandbowel.org/bowel/stoma/what-is-a-stoma/ https://www.healthline.com/health/stoma




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