A colostomy is a procedure generally performed to stop an infection, overcome a blockage, or prevent further damage to the large intestine. This procedure can be temporary or permanent.
Colostomy procedure is done by dissecting the large intestine, then making openings or holes in the abdominal wall to be connected with the lower end of the large intestine that is still functioning. Part of the large intestine will be sewn attached to a hole in the abdominal wall. Dirt inside the large intestine will then come out through the hole, to a bag that is installed on the outside of the hole. This bag can be emptied or thrown away after it is full.
Purpose of Colostomy Procedure
Colostomy aims to help remove the contents of the digestive tract, in various conditions where the large intestine is damaged due to injury or disease, such as cancer. In colon cancer or colorectal cancer, the part of the intestine that is close to the rectum and affected by the cancer will be removed first, so that the anus is no longer a sewerage. Colostomy for this condition is permanent.
Besides cancer, some conditions that may also require permanent colostomy are:
- Blockage or injury to the large intestine area.
- Inflammatory bowel diseases, such as Crohn's disease and ulcerative colitis.
- Colorectal polyps.
- Perforation or tear in the large intestine and anus.
- Severe infections of the large intestine, for example diverkulitis.
While the temporary colostomy aims to divert impurities from the intestine or lower digestive tract, so that handling the problem areas is easier. Temporary colostomies are usually performed on children with birth defects in the anus and large intestine, as in Hirschsprung's disease.
In operations involving the large intestine, a temporary colostomy may also be made so that the newly operated large intestine area can heal. Usually, the recovery period lasts for 12 weeks, but can vary from person to person.
Types of Colostomy and the Risks
In general, there are two kinds of colostomy procedures, namely permanent colostomies and temporary ones. The procedure can be done by conventional surgery (laparotomy) or through laparoscopic surgery.
Permanent colostomy is done if there is severe damage to the large intestine so that some intestines can no longer function normally, or if there is permanent damage that cannot be repaired. While a temporary colostomy is done to help the recovery of the large intestine that is problematic but can still be repaired, so that the affected part is not passed through the feces until it recovers and functions as usual.
Like general surgery, a colostomy procedure is also at risk of causing several complications. The risks of colostomy surgery that can occur include:
- Bleeding.
- Infection.
- Organ damage around the colostomy site.
- The formation of scar tissue that blocks the large intestine.
- Hernia.
- The reopening of the surgical wound.
Post Colostomy Surgery
After undergoing colostomy surgery, you may be in the hospital for 3-7 days, or longer if the colostomy is performed as an emergency measure. Before leaving, the nurse will show you how to treat colostomy holes and pouches. In addition, there are several things that need to be considered for independent treatment after undergoing a colostomy, including:
- How to install, dry, and replace bags that are installed in holes in the abdominal wall made through a colostomy (ostomy pouch) procedure. Some types of bags can be used for three to seven days, but there are also types of bags that need to be replaced every day.
- You should immediately replace this bag when dirt starts to seep or hit the surrounding skin. You are advised to replace the bag when the dirt in the bag has reached one third of the bag capacity.
- Keep the colostomy hole and the surrounding skin clean. You can clean the skin using a cloth soaked with warm water and soap, rinse thoroughly, then dry it. Use a mild soap, no oil, perfume or deodorant.
- Watch for changes in shape, size, and odor when you are cleaning the skin or changing colostomy bags. Also note the possibility of allergic reactions that can be caused by bag material. Normally, the hole where the large intestine attaches to the belly is pink or pink, and is damp for several weeks after the swelling subsides.
- Don't forget to always wash your hands before doing the wound care procedure and also afterwards to avoid the risk of infection.
Colostomies that are infected or have complications can be marked by changes in the shape, color, odor, and size of the hole. Can also be accompanied by nausea or vomiting that is prolonged, fever, and bleeding in the hole. Contact your doctor immediately if you experience any of these symptoms or if there are other unusual complaints.
You can discuss and consult with your doctor about post-colostomy care, as well as daily activities that may require special attention or tricks, so that the recovery process can go well.
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