Post-Colostomy Care: What Happens

do they sew up your anus after a colostomy

Post-Colostomy Care: What Happens

A colostomy is a life-changing surgical procedure that creates an opening in the abdominal wall, known as a stoma, for the elimination of waste. This operation may be necessary due to various conditions affecting the lower digestive tract, such as cancer, injury, or chronic diseases like Crohn’s disease. The journey following a colostomy, particularly the post-operative care and adjustment to daily life, is crucial for the patient’s recovery and quality of life. Understanding what happens after the surgery, including how to manage the stoma and potential complications, is essential for anyone undergoing or considering a colostomy.

The Colostomy Procedure Explained

Types of Colostomy: Temporary vs. Permanent

  • Temporary Colostomy: This type is often performed to bypass a part of the colon that needs to heal or rest. After the underlying issue is resolved, a subsequent operation, known as “stoma reversal,” may be conducted to reattach the bowel. The Long-term Outlook After Colostomy provides insights into what patients can expect after such procedures.
  • Permanent Colostomy: In cases where it’s not possible to rejoin the ends of the bowel (due to the removal of a large portion of the colon or rectum, for example), the colostomy becomes a permanent solution. This decision is often made to preserve the patient’s life and improve their overall well-being, despite the significant lifestyle changes it entails.

The Surgical Process: How It’s Done and What to Expect

The colostomy procedure involves making an incision in the abdomen and bringing an end of the colon out through this opening to form a stoma. The surgery can vary in complexity and duration, depending on the patient’s specific condition and the type of colostomy being performed. Post-surgery, patients will need to learn how to care for their stoma, including how to change the colostomy bag, which collects waste. This learning process is supported by healthcare professionals, particularly stoma nurses, who provide invaluable guidance and support.

Post-Operative Changes

Adjusting to Life with a Stoma

Adjusting to life after a colostomy involves both physical and emotional changes. Patients must learn to manage their stoma care effectively, which includes monitoring the stoma’s appearance, ensuring proper hygiene, and managing the colostomy bag. Emotional support is also crucial, as the adjustment can affect self-esteem and body image. Resources and support groups, such as those found on the UOAA Discussion Board, can offer comfort and advice from individuals who have gone through similar experiences.

The Role of the Stoma Nurse in Patient Education and Support

Stoma nurses play a pivotal role in the post-operative care of colostomy patients. They provide education on how to care for the stoma and manage the colostomy bag, offer advice on diet and lifestyle adjustments, and support emotional well-being. Their expertise is crucial in preventing complications such as skin irritation around the stoma and ensuring the patient’s smooth transition to their new normal. The relationship between the patient and their stoma nurse is often a key factor in the successful management of life post-colostomy.

Managing Rectal Discharge

After a colostomy, some patients may experience rectal discharge due to the remaining part of the colon continuing to produce mucus. This situation is particularly common in cases where the anus remains intact. Managing this discharge effectively is important to prevent discomfort and potential skin irritation. Techniques include:

Regularly Sitting on the Toilet to Encourage the Passage of Mucus

  • Routine: Establishing a regular schedule for sitting on the toilet can help manage mucus discharge. This routine can mimic the natural bowel movement schedule you had before the colostomy. It encourages the body to expel mucus regularly, reducing buildup and discomfort.
  • Technique: While seated, you can gently bear down as if having a bowel movement. This action can help expel the mucus naturally without straining, which is important to avoid creating new health issues.

Using Glycerine Suppositories to Ease the Expulsion of Mucus

  • How They Work: Glycerine suppositories are a gentle, effective way to stimulate the rectum to expel mucus. They work by irritating the lining of the rectum, encouraging it to contract and expel its contents, including mucus.
  • Application: Suppositories should be used according to the instructions on the packaging or as directed by a healthcare provider. It’s usually recommended to insert a suppository after being seated on the toilet for a few minutes to allow the body’s natural urge to expel mucus to commence first.

Keeping a Food Diary to Identify Any Foods That Might Increase Mucus Production

  • Monitoring Diet: The relationship between diet and mucus production is highly individual. Some people may find that certain foods increase mucus production, while others do not notice any difference.
  • Food Diary: Keeping a detailed food diary can help identify any correlations between what you eat and the amount of mucus produced. Note everything you eat and monitor your mucus discharge, looking for patterns over time.
  • Adjustments: If you identify foods that seem to increase mucus production, consider reducing your intake or eliminating these foods from your diet to see if there is an improvement.

For a deeper understanding of these complications and their management, the Understanding Colostomy Complications page offers valuable information.

Post-Colostomy Care and Complications

The Question of Anus Closure

One of the more delicate aspects of post-colostomy care involves addressing whether the anus will be closed off, a procedure known as anus closure or anal closure. This decision is influenced by several factors, including the reason for the colostomy, the presence of disease in the remaining rectum or anus, and the patient’s overall health and preferences.

  • Circumstances Leading to Anus Closure: In cases where the rectum has been removed or is no longer functional due to disease, closing the anus may be considered. This procedure, known as perineal closure, involves surgically closing the anal opening to prevent discharge and infection, providing a more manageable and hygienic situation for the patient.
  • Psychological and Physical Considerations: The decision to close the anus is not taken lightly. Physically, it marks the finality of the colostomy being a permanent condition. Psychologically, it can affect a patient’s self-image and sense of normalcy. Support from healthcare providers, counseling, and connecting with others who have undergone similar experiences can be invaluable during this time.

Complications and How to Address Them

Post-colostomy, patients may face various complications related to their stoma or the surgery itself. Recognizing and addressing these complications early is crucial for maintaining health and comfort.

Parastomal Hernia

A parastomal hernia occurs when the intestine bulges through the abdominal muscles around the stoma, causing a noticeable lump. This complication can affect the fit and function of the colostomy bag, leading to discomfort and potential skin issues.

  • Prevention and Management:
    • Wearing a support garment, like a belt or specially designed underwear, can help reduce the risk of hernia development.
    • Maintaining a healthy weight and avoiding heavy lifting are also key preventive measures.
    • In some cases, surgery may be required to repair the hernia, although there’s a risk of recurrence.

Stoma Blockage

Stoma blockage is a serious complication that can occur if food or other material obstructs the stoma. Symptoms include reduced output, abdominal pain, and swelling.

  • Signs and Immediate Actions:
    • Noticing a decrease in stoma output or experiencing nausea could indicate a blockage.
    • Patients are advised to drink warm fluids and massage the abdomen gently to try and dislodge the blockage.
    • If symptoms persist, immediate medical attention is necessary to prevent further complications.

Skin Irritation Around the Stoma

Skin irritation, or peristomal skin complications, are common among colostomy patients. The skin around the stoma can become red, sore, or infected due to leakage or the adhesive on colostomy bags.

  • Care and Prevention:
    • Ensuring the colostomy bag fits properly is crucial to preventing leaks and skin irritation.
    • Regular cleaning of the stoma area with mild soap and water, and applying a barrier cream, can protect the skin.
    • Changing the colostomy bag as recommended and checking for any signs of irritation or allergy to the bag’s materials can help maintain skin health.

Addressing Other Complications

Several other complications may arise, each requiring specific attention and care:

  • Stomal Fistula: A small channel or hole that develops in the skin next to the stoma, which may require specialized bags or appliances to manage.
  • Stoma Retraction: Occurs when the stoma sinks below the skin level, potentially leading to leakage issues. Different pouching systems or surgery might be necessary.
  • Stoma Prolapse: When the stoma protrudes excessively from the skin, it may require adjustments in the colostomy bag or surgical intervention.
  • Stomal Stricture: Narrowing of the stoma due to scarring, sometimes necessitating further surgery to ensure proper function.
  • Leakage: Digestive waste leaking from the stoma onto the skin or within the abdomen can cause discomfort and skin issues, requiring adjustments in the colostomy bag or further surgical procedures.
  • Stomal Ischemia: Reduced blood flow to the stoma, potentially requiring surgical intervention to correct and ensure the stoma’s viability.

Managing these complications effectively involves a combination of self-care, regular follow-ups with healthcare providers, and sometimes, additional surgical interventions. The role of the stoma care team, including stoma nurses, is invaluable in providing the necessary support, education, and interventions to address these challenges.

FAQs Section

Can you still pass stool normally after a colostomy?

After a colostomy, the stool will no longer pass through the rectum and anus in the traditional manner. Instead, waste exits the body through the stoma into a colostomy bag attached to the abdomen. This change requires adjustments in how one manages bowel movements.

Is it possible for a colostomy to be reversed?

Yes, some colostomies are temporary and can be reversed if the underlying condition of the bowel has healed sufficiently. The possibility of reversal depends on the specific medical circumstances, the portion of the bowel affected, and the patient’s overall health.

How do you care for the skin around the stoma?

Caring for the skin around the stoma is crucial to prevent irritation and infection. Key steps include:

  • Cleaning the skin with mild soap and water during bag changes.
  • Ensuring the skin is completely dry before applying a new bag.
  • Using skin barrier products to protect the skin from stool and adhesive.

What are the signs of a parastomal hernia, and what should I do if I suspect I have one?

Signs of a parastomal hernia include bulging around the stoma, discomfort, and difficulty securing the colostomy bag properly. If you suspect a hernia, consult your healthcare provider for evaluation and management, which may include wearing a support belt or, in some cases, surgical repair.

Can I shower or bathe with a colostomy bag?

Yes, you can shower or bathe with or without a colostomy bag. Water will not harm the stoma, and many bags are designed to be water-resistant. However, if you choose to remove the bag, ensure the stoma area is cleaned gently and thoroughly dried afterward.

Conclusion

Navigating life after a colostomy involves a significant adjustment period, both physically and emotionally. However, with the right information, support, and care, individuals living with a colostomy can lead full, active lives. Understanding how to manage the stoma, prevent complications, and integrate the changes into daily life are key components of successful post-colostomy care. Resources such as healthcare professionals, support groups, and educational materials play an invaluable role in this journey. Remember, it’s important to communicate openly with your medical team and reach out for support whenever needed. With time and patience, adapting to life with a colostomy becomes a manageable part of your routine, allowing you to continue engaging in the activities you enjoy.