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.

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.