What are the types of Ostomy?
The term ostomy originates from the Latin word ‘Ostium’ which means ‘an opening’. Ostomy is a surgical procedure to construct an opening on the abdominal wall which allows an alternative route for the urine and feces to be eliminated by the body. This opening is known as ‘stoma’ which is derived from the greek word for ‘mouth’ and bears a resemblance to the mucous membrane of the mouth. There is no valve or muscle present to control the expulsion of waste from the stoma hence the passage of the waste from the stoma cannot be controlled.
The indications for performing an ostomy include Crohn’s disease, colorectal cancer, ovarian cancer, ulcerative colitis, colonic polyps, chronic IBS (irritable bowel syndrome), extensive surgery, spinal cord deformity, neuromuscular disorders, trauma or obstruction. The advancements in medical technology and expertise of surgeons have greatly minimized the complications associated to ostomy resulting in improved prognosis.
The surgeon will decide on performing an ostomy only after reviewing the case history, physical examination and tests relevant to the procedure. The patient is usually asked to fast hours before the ostomy procedure is due to cleanse the bowel. Ostomy is performed under general anaesthesia and a stay in the recovery room is recommended post surgery. The patient is explained how to manage the ostomy and continue living a normal life after the procedure. In the present day and age, the support and sensitivity of people towards ostomy procedures has grown tremendously. Efforts are being made to eradicate the stigma around the procedure by the formation of ostomy associations and self-help support groups worldwide for people having recently undergone an ostomy procedure. Various ostomy management products are now available to maintain the ostomy. Ostomy is of three types – ileostomy, urostomy and colostomy.
Ileostomy is a surgical ostomy that creates an opening in the ileum to bypass the large intestine. An ileostomy is indicated in cases of Crohn’s disease, colorectal cancer, ovarian cancer, ulcerative colitis etc. An ileostomy might be temporary or permanent. Regular X-rays and follow ups are required to make sure the anastomosis have healed. The ileostomy procedure is of two types – end Ileostomy and loop ileostomy
- End Ileostomy – In an end ileostomy, the colon and rectum are surgically removed and the end of the ileum is brought out through the stoma
- Temporary/Loop Ileostomy – In loop ileostomy, the rectum and colon are not removed but a loop from the small intestine is brought out through the small intestine
Caring for an Ileostomy involves changing the ileostomy pouch regularly and following the guidelines provided by the hospital post the surgery. A person with an ileostomy can comfortably do most tasks they were able to prior to the procedure and continue living a normal life.
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Urostomy is the surgical procedure for urinary diversion that directs the urine to leave the body after a surgical removal of diseased or damaged part of the urinary tract. Urostomy is indicated after extensive surgery, spinal cord deformity, neuromuscular disorders or obstruction. The two main types of urostomy are:
- Ileal Conduit – In this type of urostomy a short segment of the end of intestine is used to create the stoma while the other end is connected to the ureters allowing for a urine passage through the newly formed ileal conduit into the stoma where it is collected by an ostomy bag
- Ureterostomy – In this type of urostomy, the urteters are directly connected to the abdominal wall to create a stoma. The flow of urine is not controlled hence an ostomy bag has to be placed at the stoma to collect the urine
Colostomy is a surgery where the end of the large intestine is diverted to an opening in the abdominal wall to create a “stoma” where a pouch to collect feces can be attached. A colostomy may be performed in cases of an injury, blockage, Crohn’s disease, colorectal cancer, colonic polyps, chronic IBS, ulcerative colitis and diverticulitis. A colostomy may be temporary or permanent. By diverting the bodily waste, the intestine can be allowed to heal its irritated and inflamed areas and once healing is complete the colostomy can be removed to restore the normal functioning. In case a part of intestine cannot be recovered or is permanently injured, a permanent colostomy may be necessary.
Types of Colostomy
- Sigmoid colostomy – It is done to divert the waste from the bottom portion of the large intestine. The stool produced after sigmoid colostomy is more solid when compared to other types of colostomies
- Transverse colostomy – The transverse colon passes through the top of the abdomen. Transverse stool is usually softer as water has not been completely absorbed from it. Transverse colostomy is further divided into loop colostomy, single barrel colostomy and double barrel colostomy
- Descending colostomy – The descending colon passes through the left side of the abdomen. The stool produced after a descending colostomy is firmer because the stool has passed through the functioning parts of the colon and extra water has been absorbed by the body
- Ascending colostomy – The ascending colon is located from the starting of the intestine and passes from the right side of the intestine. In this type of colostomy a small part of the intestine remains functional which increases the liquid content in the stool
Living with an Ostomy
With more awareness, the stigma associated to ostomy is getting eradicated. People have started to understand that an ostomy is just as normal as any other surgery. There are a number of ostomy supplies like ostomy barriers, ostomy pouches, ostomy belts, barrier pastes, wipes, tapes and tape removers which allow an ostomy to be concealed, comfortable and odour free. The complications associated with the procedure can easily be managed by doctors making this a safe procedure that greatly improves prognosis and quality of life. After the procedure, the patients in most cases can continue with the activities, social life and professional life they have had before having undergone the surgery. It does not act as an obstacle to travelling, socializing, working, playing sports and practicing hobbies. Ostomy in itself shouldn’t be seen as a disability, when in fact it is something that allows people to lead normal lives. It’s natural to be anxious about getting an ostomy done but life with ostomy is as normal as life with any other surgery once a person is accustomed to the routine management of an ostomy bag.