Useful Facts about Ileostomy: Everything you need to know

An ileostomy is a certain type of ostomy which is a surgical procedure that creates an artificial bowel opening on the surface of the abdomen. It is done to cure severe diarrhea, ulcers, or cancer. It allows for the elimination of body waste through one way, which reduces complications and discomfort. An ileostomy is often created after the removal of part or entire rectum and colon. An individual with this condition is required to wear an external pouch device that collects the waste. Below are conditions under which a doctor recommends for an ileostomy, surgical procedure, and recovery.

An ileostomy can either be a temporary remedy to allow the bowel to heal or a permanent remedy for a damaged rectum or colon. A doctor might recommend an ileostomy if a person has cancer, ulcerative colitis, Crohn's disease, or diverticulitis. Ulcers are quite painful and even debilitating to the point that individuals cannot go about their daily activities. An ileostomy is one of the best options for managing severe ulcerations in the colon because it will allow an individual to keep their healthy bowel rather than removing the entire section of the digestive system. During this procedure, a small opening is made on the abdomen just above the patient's navel so that waste can leave the stomach through this hole instead of exiting via the anus. It collects waste in a pouch which must be emptied regularly during bowel movements.

How does one prepare for ileostomy?

Before an individual can get ready for ileostomy, it is important to prepare mentally and physically for what's ahead. Make sure that the patient does not have any underlying conditions which can result in complications. Other considerations include their relationships, nutrition, and physical activity.

This surgical procedure involves a long incision made on the abdomen and a part of the colon attached to an opening on the patient's abdominal wall. It should be done by a skilled surgeon who has expertise in performing this procedure. Not all patients will have sedative or pain relief methods before, during, or after the surgery. Many surgeons only provide pain killers if needed.

The length of time for recovery from ileostomy varies from person to person because it depends on their health conditions and how they were treated during surgery. The body might take some time to recover, especially after such procedures, but one can heal faster with adequate rest and proper nutrition. As expected, it completely depends on each individual whether they want to start working right away or take some time off.

After an ileostomy, it is vital to ensure that you eat healthily and drink plenty of fluids to aid bowel movements. It is important to eat small portions of food several times daily rather than frequent large meals, which might increase instances of diarrhea. Also, avoid foods like dairy products, coffee, raw vegetables, and fruit juices until the fistula (a newly formed scar similar to the anus) heals completely. This condition can be caused by ingesting roughage which may result in infections.

What are the complications after an ileostomy?

There are several complications associated with having an ileostomy, one of which is a skin irritation on the affected area if improperly managed. This condition is called stoma itch and can be treated by regular cleaning of the affected area. It is also important to note that some individuals might be allergic to adhesive tape. To avoid such problems, one should ensure that the external pouch or barrier fits properly but is not too tight or loose.

This procedure often results in diarrhea and abdominal pain because of inflammation and irritation of the bowel lining. This can be remedied by drinking plenty of fluids and taking medications prescribed by a doctor, managing symptoms of Crohn's disease, including rectal bleeding and cramps.

What are some precautionary measures after an ileostomy?

After surgery, an individual will experience discomfort at least for several days, after which they start feeling better. A patient should also be careful with activities like lifting heavy objects, straining during bowel movements, and coughing because it might increase the chances of leaks. Those with an ileostomy should also avoid eating certain foods that cause diarrhea, cramping, and bloating.

Invasive Bladder Cancer

Invasive bladder cancer is a condition when cancer spread throughout your bladder or even further into nearby organs. 

Though it is a more devastating type of bladder cancer, there are two types of treatments that can be helpful. These treatments are radiotherapy and chemotherapy.

Removal of bladder

The removal of bladder along with the prostate in men, cervix in women, portions of the urethra is called radical cystectomy (RC). It’s major surgery and takes at least six hours, but it’s a good opportunity to wipe out cancer forever. Nowadays robotic surgery has been introduced but there is no evidence of whether it is successful or not. You will feel very weak after the surgery, it's normal. You will be discharged from the hospital after 10 days following the surgery.

RC has a major disadvantage in that you will lose your bladder permanently. An alternation will be created that will help you to pass out your urine. This process is called urine diversion. There is a total of three types of urine diversion; you can choose one of them. These are:

• A urostomy

• Bladder reconstruction

• Continent urinary diversion

A urostomy is the most common and most successful urinary diversion in medical history. Typically, this hole is called a stoma. During the surgery, a hole will be created in your abdomen. Then a small part of the ileum (small bowel)will be removed and the surgeon will connect it with the ureters. And then he connects the other terminal of the bowel to the abdomen, which enables you to pass out the pee through the stoma.

You will be habitual to urinate in this way and the urine will be collected outside the body in a bag or pouch called an Ostomy bag. You can empty that bag when it gets full. To avoid inconvenience at night you can use a night Ostomy bag that can hold a lot more urine.

Your Ostomy nurse can guide you in a very well manner. He or she can help you to choose the best Ostomy products for you. Initially, you will feel awkward and embarrassed using an Ostomy bag all the time, but with time you will learn to live with it.

Neobladder (Bladder reconstruction)

There are some situations in which a new bladder can be constructed, termed as a neobladder. In this procedure, a portion of the bowel is removed and is rebuilt into a balloon shape sack. This sack is then connected with the urethra at one terminal and the other terminal is connected with the ureters. This procedure does not work for everyone but it might be given as an option.

After the surgery, you will learn how to relax your pelvic muscles and tighten your abdominal muscles at the same time to empty your neobladder. This seems very difficult but doesn’t worry you will learn it shortly. There are no nerves present in the neobladder that’s why you don’t feel any urge to urinate. According to some people, they feel pressure and weight, and others feel like they need to pass out air. Your body will give indications when you need to pee.

As you know there is no nerve functioning, almost 25 % of people experience incontinence in the early stages, especially during the night when they are asleep. You can set times for urinating during the day and before going to bed. You should use incontinence pants until you can control your new bladder.

Continent urinary diversion

A continent diversion is the same as a urostomy except for an external Ostomy appliance. Despite that, the surgeon creates an internal pouch using your intestines that is used for the collection of the urine. This is very rare in the UK, less than five percentage patients undergo this procedure.

The surgeon connects one end of the internal pouch with the ureters and the other with the abdominal walls. A catheter is used for emptying the pouch. A catheter is inserted into the stoma to drain out urine. Typically, it is advised to empty the pouch four to five times throughout the day.

Sexual issues following the surgery

Erectile dysfunction is observed in men after the surgery. It is a condition when they lose the capability to acquire or maintain an erection. You can ask your surgeon he will refer you to any GP. This is not a big issue there are a lot of medicines and injections that can help you to overcome this issue shortly. There are many treatments; you just need to find the best one for you.

In women, the vagina gets narrow and shortens after the surgery. This can make it hard for them to have normal sex. There are two basic treatments. Either you can use a cream for lubrication that has natural hormones stimulating power or you can use a vaginal dilator. Don’t hesitate to ask for help.

Radiotherapy

Radiotherapy is also used for treating invasive bladder cancer. In this method, radiations are used for destroying cancerous or malignant cells. Radiotherapy for treating bladder cancer is done in three ways.

It can be a primary option for the cure of bladder cancer, it is the best option if you are so weak and your condition is very poor.

It is also used for controlling the symptoms in some situations such as palliative treatment, it is an incurable disease.

Radiotherapy session continues almost 5 days a week and for four to seven weeks. Each session is about ten to fifteen minutes long. Besides killing cancer cells it can also destroy healthy cells. It has other side effects such as:

• Diarrhea

• Inflammation in the bladder, leading to difficulty in urinating

• Vaginal shortening in women and erectile dysfunction in men

• Infertility

These side effects may lessen after a few weeks of radiotherapy, except infertility.

Sexual issues after radiotherapy

Radiotherapy can cause intimacy problems for both men and women.

Some men complain about weak erections or erectile dysfunction. And women experience vaginal dryness. It can be treated by using lubricants and medical gels.

Chemotherapy for invasive bladder cancer

Chemotherapy can be used for the treatment of invasive bladder cancer in three ways:

• It can be used before radiotherapy for shrinking the size of any present tumor

• It can be combined with radiotherapy, termed chemoradiation

• To slow down the irredeemable cancer

In chemotherapy, many chemo medicines are introduced in the body through veins. It continues for at least 28 days and lasts according to your stage and condition.

Side effects of direct chemotherapy are:

• Feeling ill

• Hair loss

• Loss of appetite

• Tiredness

These signs must diminish after the treatment. Chemotherapy can also weaken your immune system and you are an easy target for infections to attack. You should call your doctor if you experience high temperature, red skin, and a non-stop cough.

Living and persisting invasive bladder cancer

Despite the all treatments, there are a lot of chances for cancer cells to come back and attack any other part of your body. For example: lungs, abdomen, and pelvis. That’s why you need to keep a regular follow-up. Your body will be scanned every three to six months.

These follow-ups are very important to diagnose cancer at an early stage.

How to Deal with a Parastomal Hernia

Have you heard of what’s called a parastomal hernia? While not everyone who has an ostomy has this, it’s a common issue in a lot of cases. While they aren’t always dangerous, you should always seek out medical care for hernias, even if they’re not painful. They can impact the life quality, causing you discomfort and fatigue. 

Plus, it can affect your mental health too, so better to handle this now. First, let’s talk about what parastomal hernias. This is usually a bulge that’s near the stoma, and usually, it has a little bit of pain to it when touched. They’re not always going to cause pain, but they can, and it can be noticeable if you laugh, cough, or strain.  You also may feel a bit of a dragging feeling, a leaking of an ostomy bag, or struggle with putting the ne ostomy bag on. 

What Causes These 

You may wonder if you’re at risk, and what the risks for this are. Having a stoma is pretty much a risk factor for this to start. During an ostomy, doctors create the stoma with some of the intestines to help divert where the waste goes out.  This passage is usually in the lower parts of the abdomen. 

Because the process is actually serious, it can make the abdominal muscles weaken, which then causes them to move back from where your stoma is.  This area, when it’s weakened, usually is a spot where the intestines try to push through, and that creates the hernia that happens. There are other risk factors as well, and that can be chronic cough or gaining weight, since this can put you at risk for a parastomal hernia. If you life heavy, this is another risk factor for parastomal hernias, so you should most definitely be careful too. 

Tips for this 

While you can’t always prevent them, there are a few things that you can do.You can talk to your doctor or ostomy nurse about what you can do to fix this. But first, work on those core muscles. Weak abdominal muscles and abdominal cavity are what make hernias more likely. You should check with your doctor before trying out new exercises though, especially post-injury. But for many who have ostomies, they can exercise pretty regularly, so it’s good for you.

Once you’re allowed to start doing physical activity, do this slow. Your doctor may give you a few ab exercises to start with. Another way to protect this is an ostomy belt or ostomy wrap, since this can help to conceal the pouch, and also offer support for the system. When the bag gets more and more full, the weight is what causes the leaks, dragging, irritation, and also puts you at risk for hernias. This helps to support the bag’s weight too. You also can prevent this by taking care of your weight. You’ve probably heard this, and while it is a common tip for avoiding and prevention, it’s actually important for parastomal hernias. That’s because there is evidence that showcases that being overweight or obese is one of the most major causes of this.  That means, that to prevent development of this, you might want to start managing your diet and exercise. Obviously, talk to the doctor to get some tips on the best ways to go about managing your weight. And finally, be mindful when you’re lifting. Practice good form, bend at the knees and not your waist, and keep the back straight. If you feel pain in your body, you should stop, and you should ask for help too. 

Tips for living with a colostomy: Colorectal Cancer

A colostomy may be required for people with colorectal cancer and some other bowel diseases. This is a procedure in which the passage of the body waste is altered. Feces exit the body through the hole created in the abdomen. This opening is termed a stoma. A pouch adheres outside the body for the collection of feces. You can empty and change the bag when needed. Living and adapting to a colostomy is very dramatic. Having the proper knowledge can help you in a better way.

What is meant by a colon?

The colon is the part of the large intestine from the small intestine to the rectum. The small intestine is the point for the entrance of the small intestine. The colon helps in the reabsorption of water and nutrients as food moves through it. The waste material is stored for some time in the rectum before leaving the body.

There are three main parts of a colon:

• Ascending colon: It moves up to the right side of the abdomen. It is the portion where the food enters from the small intestine.

• Transverse colon: It reaches the upper part of the belly.

• Descending colon: This part moves down the left side of the abdomen to the sigmoid colon. The sigmoid colon is connected with the colon. It aids in the reabsorption of water and important nutrients and stool formation.

What is meant by Ostomy?

A surgical procedure in which a hole is created in the stomach; which allows the body waste to leave the body, without passing through the anus or urethra. There are three main types of Ostomy:

Colostomy: A part of the colon is used in stoma creation. The stool that is produced as a result is very firm.

Ileostomy: A part of the ileum is involved in Ostomy creation. It is made on the lower side of the abdomen. The feces are semi-soft and green in color.

Urostomy: It is done just for the drainage of urine, not feces from the body.

Ostomy is a procedure that enables the body to pass out waste through a newly made opening in the belly. An Ostomy may be permanent or temporary. You require wearing an Ostomy pouch outside the stoma for collecting waste material.

The type of feces that is produced as a result of colostomy depends on the location of the Ostomy. For Example:

Colostomy that is on the lower end helps in the reabsorption of more water and as a result, more solid feces are formed.

If a colostomy is near the rectum feces are completely formed.

Ostomy on the transverse and ascending colon, the stool produced as a result is looser and watery because less water is reabsorbed.

Stoma Surgery

In most cases, surgery is performed right after the diagnosis. These surgeries can be performed to remove colon cancer to a large extent. If the colon is very much affected then it needs to be removed completely. A colostomy can be permanent or temporary. You will have a meeting with your healthcare expert and surgeon before the surgery.

You need to clean the bowl thoroughly before the surgery.

Before surgery, you will be introduced to an enterostomal therapy (ET) nurse. He or she will help you to look after your stoma properly.

After the surgery, you need to take medicines and painkillers for healing. You need to stay in hospital for few days after the surgery. Your ET will absorb and check your stoma regularly. Your Ostomy nurse will answer all your questions.

Stoma Care

When you are allowed to leave the hospital and go home your nurse will visit you daily and help you to take care of your stoma. You need to follow the following things:

• How to clean and take care of your parastomal skin

• How to avoid infection

• Observe changes in stoma

• Which medicines to take and how to take them

How to change the flange?

You must dry and clean your stoma properly before attaching the flange or skin barrier. This is how a flange can adhere for a long time. You can use a hairdryer or wait until the skin dries completely. You may need to change the flange after the exercise or any physical activity.

Living with the pouch

Having an Ostomy is very depressing. It may be hard for some people to think about the Ostomy bag they need to carry with them all the time. But you need not worry. You can easily conceal your Ostomy bag. No one can guess that you are having an Ostomy until you decide to tell them. You can choose the people whom you want to tell about your condition. For instance, you need to inform at the workplace that you can’t lift heavyweights.

You can wear loss-fitting clothes that can help you to conceal the stoma in a better way. You should be always careful when children and pets are around so that they can't jump onto the sight of your bag.

You should always keep extra Ostomy supplies with you while traveling. Also, eat the food items carefully. Foods can cause gas and bloat.

You can control odor by using different solid and liquid products. Some products can be placed in the pouch and some can be eaten along with water.

Dietary changes

You should be careful while consuming food items. Some foods can cause odor and gas while some can change the consistency of stool and bowel movements. A mixture of carbon, methane, and hydrogen is the reason for causing gas in the abdomen. You can limit the foods that can cause gas. These food items are:

• Bananas

• Asparagus

• Broccoli

• Capsicum

• Cabbage

• Drinks (carbonated)

• Carrots

• Foods with lactose

• Onions

• Whole grains

• Bran

Trailing your stool

The timing of stool can depend on the type of your colostomy. Constipation is one of the problems for patients with colostomy. Always keep a record of the stool. Check the consistency. You can use juices, fruits, and veggies for releasing constipation.

Colostomy Treatment

The colostomy is a procedure that involves cutting off the colon and protrude it to the outside through the abdominal wall to form an artificial opening. The colostomy bag helps collect your faeces until the colon can heal or corrective surgery is performed. The attachment of a colostomy is commonly done temporarily, but the procedure can be conducted permanently in certain situations.If you undergo a temporal colostomy, the final stage of stitching the bowel back together will happen at eight to twelve weeks.

There are several underlying reasons why an individual may consider having a colostomy. One of the many reasons that one may need the procedure conducted is having inflammatory bowel conditions. If the muscles that control your bowel movements are cut off during the surgical procedures, you will have difficulties controlling your bowels. Therefore you will have to perform a colostomy to allow your bowel contents to empty in the colostomy bag.

How to conduct Colostomy Surgery

A colostomy is carried out by creating a small cut through the abdomen wall to one side of the central opening. The upper cut end of the bowel is carried out over this opening and the edges are sewn to the edges of the opening. The lower cut end may be stitched inside or brought out.

The bowel waste products will empty via the colostomy and be collected in a waterproof bag positioned above the stoma. The colostomy bag is made of a unique waterproof material that is adhesive and sticks to the areas without using adhesive tape.

After the Colostomy procedure is done, you may experience some abdominal pains. During this period, it’s crucial to be in direct contact with a stoma nurse who is professionally trained to helps patients have a smooth recovery. The nurse also offers dietary guidelines to lessen bowel problems to make sure the stoma remains healthy.

Dieting Advice

Immediately after the colostomy procedure is done, you are advised to observe your eating behaviors. It is always advisable to stick to a low residue diet to give more time for your bowel to recover. After some time, you can go back to your regular eating habits. However, some patients may be advised to avoid fibrous food or foods with tough outer skin to avoid causing a blockage in the bowel.

Travelling with Your Colostomy

The colostomy procedure should not hinder you from either travel locally or internationally. You only need to plan as the Colostomy Association has come up with valuable guidelines on traveling with a stoma. Below are some of the tips.

Ensure to carry with you enough Supplies’ change in climate may lead your Colostomy bag to be changed more regularly than usual.

Pack your ostomy supplies in personal hand luggage. This is to ensure you are on the safe side in case your suitcase is misplaced; at least you will have your ostomy supplies.

Always carry bottled water. The water will keep you hydrated and help you keep away from stomach upset.

What should you know about bowel resection?

Bowel resection is a medical procedure that is used for the removal of the whole or some specific parts of the small and large bowel (intestines). Some conditions such as blockages, inflammations, intestinal bleeding, and infections demand bowel resection. It is also used for eradicating the great polyps or tumors formed in the intestine to prevent cancer. The length of the intestine that is to be removed is decided upon the medical reports of the patient. Some other options are ileostomy or colostomy. This s the formation of an opening in the abdomen, that allows the waste to leave the body.

What your surgeon can ask you?

• Your surgeon will enquire about your current medication. He or she will decide whether you need to stop them or not and when you need to stop taking them. He will guide you about the drugs you should take on the day of your surgery.

• The surgeon might give you an antibiotic thirty minutes before the surgery through the mouth or using your arm. This will avoid any kind of bacterial infection. You must foretell your surgeon if you are allergic to any specific antibiotic.

• You may be asked to start taking blood-thinning drugs. These drugs help to keep the blood thin and avoid blood clotting in veins. You will be asked about any blood clotting or bleeding history.

• You should tell your doctor about your medical issues such ad diabetes, bleeding issues, heart or kidney disorders.

• You may be asked if you ever had any abdominal surgery before.

• In case you are female then share with your doctor if you feel like you are expecting (pregnant).

How can you prepare for the surgery?

Your surgeon will guide you about the basic preparations before the surgery. You must arrange a person who could drive you home.

Dietary guidelines: You are advised to consume foods that will help in the cleansing and emptying of the bowel. You should take simple liquids such as gelatin, sugar-free fruit juices, simple soups.

You must not eat foods with high fibers and that is difficult to digest. For example Cereals, nuts m beans, fried foods, bread.

You should start drinking a lot of water.

Some tests such as x-rays, CT scans, ultrasounds, and colonoscopy may be needed before the surgery.

What should you do one day before the surgery?

You must drink eight to ten cups of water during the daytime.

You should use an enema or any laxatives mixed with water to clear your bowel thoroughly.

In case of diabetes, consult with your doctor about the diet, before the surgery. If you are using any medicines he will also guide you about them.

What can happen during the surgery?

You will be given general anesthesia so that you can’t feel any pain. The surgeon will cut (incision) in the abdomen. He will use some specific tools for separating the diseased bowel from the healthy one. He will cut and bind many blood vessels. Then he will remove the complete bowel or some of its parts. At last, he will stitch the healthy and remaining parts together.

The tissues of your bowel will be transferred to the laboratory for testing. Lymph nodes can also be removed. The surgeon might use drains to remove the pus and the fluids. In the end, he will cover your wound with tape and bandages after stitching it.

What should you expect after the surgery?

You will be shifted to the restroom and once you are awake you will be taken to your hospital room. You will remain under observation for avoiding any complications. A healthcare expert will remove the bandage to have a look at your wound.

You will be allowed to walk with support, after the surgery.

Your PCP may advise some medicine to avoid nausea and pain. Blood-thinning drugs are also recommended to avoid blood clotting. Some medicines are allowed for avoiding constipation.

There are some chances that you might get into a condition termed postoperative ileus. This indicates that the bowel is not functioning normally after the surgery. It involves:

• Nausea

• Vomit

• No gas

• No bowel movements

• Abdominal pain

• Bloating

This condition may be there for few days. This issue may be solved by walking around with the help of care providers, this may ease the bowel movement. You need to consume only fluids and take medicines. You may also require a nasogastric tube (NG). This tube passes through the nose into the throat and is used for the passage of food.

You will be allowed to eat when you start hearing your bowel movements. In the case of ileostomy and colostomy, you are not allowed to eat solid foods for many days following surgery.

What are some common risks of bowel resection?

It might lead to some other issues that will demand more surgeries. It can damage your:

• Stomach

• Liver

• Nerves

• Blood vessels

• Intestines

There might be excessive bleeding and contents of the bowel may leak down in the abdomen. You can also get an infection right after the surgery. There may a blood clot that can be fatal.