Ostomy - Overview
Living with Inflammatory Bowel Disease will sometimes require surgical intervention in order to manage the disease and its symptoms. Certainly the prospects of surgery alone can be overwhelming, while the addition of an ostomy, whether it be temporary or permanent, can also be met with fear and worry. Numerous supports are available for individuals who are facing ostomy surgery, including: written information, booklets and videos, Ostomy Visitor Programs, support groups, and Enterostomal Therapy Nurses; all of which will help with the adaptation process and will provide reassurance that you can live a full and productive with an ostomy.
What is an Ostomy?
An ostomy is a surgeically created opening in a part of either the small or large bowel. The bowel is brought up through the abdominal wall (through the muscle and fat layers), everted or "cuffed", and the edges of the bowel are sutured to the surrounding skin surface. The resulting "bud" of bowel is called a "stoma". It will be moist, warm and red in colour, and may either be flush with the surrounding skin (as for colostomies) or may be protruding from the skin surface (as for ileostomies). The stoma is often referred to as resembling a puckered mouth. While it may look sore, a stoma actually has no nerve endings so will not be painful to the touch. For some individuals, a loop of bowel is brought to the surface instead of the end of bowel, so a small plastic rod will be used under the stoma to support it while healing.
The rod is generally removed about four to six days after surgery with very little if any discomfort. The stoma will always have some degree of movement (peristalsis), particularly while functioning for stool. Stomas are initially swollen after surgery, but will decrease in size about six weeks following surgery. Because there are no sphincters associated with a stoma, there is no voluntary control over when the stool (bowel movements) will be passed. Since there is no control, an external appliance must be worn to collect the stool.