WHAT IS AN OSTOMY
An ostomy is necessary when the bowel or bladder no longer functions effectively because of diseases such as bowel and bladder cancer, Crohn’s Disease and Colitis. As a result, life saving surgery must be performed to divert bodily wastes from normal paths through openings in the abdominal wall. The waste is collected and disposed of through drainable pouching systems.
Types of Ostomies
Colostomy: (colon and ostomy) a surgical procedure where a part of the large intestine or colon is removed with the result that the rectum is no longer functional. An opening is surgically created in the abdomen and the end portion of the colon is brought through the opening to the surface of the abdomen. The part of the colon or bowel that protrudes is called a stoma. A person with a colostomy has no control over bowel movements, so a pouch will need to be worn over the stoma to collect the stool. The stoma may be located on the right side of the abdomen (ascending colostomy) in the center (transverse colostomy) or on the left side (descending or sigmoid colostomy). A temporary colostomy is created in cases where it is necessary for the diseased portion of the colon to be allowed to heal while the functional colon continues to work. Sometimes this is called a double barrel ostomy.
Ileostomy: (ileum and ostomy) a surgical procedure where the entire large intestine is removed and the end of the small intestine or ileum is brought through an opening to the surface of the abdomen. The part of the ileum that protrudes is called a stoma. A person with an ileostomy has no control over bowel movements, so a pouch has to be worn over the stoma to collect the stool. If the rectum is also diseased, it is removed. Sometimes, however, the rectum is left in place in the event that a re-connection is planned or possible in the future (see below: Ileonal Reservoir).
Urostomy or ileal conduit or urinary diversion: these stomas are simply different names for the same thing. This surgical procedure involves the removal of the diseased bladder, and the formation of a stoma to divert urine into an external pouch worn on the surface of the abdomen. The surgeon takes a 6 to 8 inch piece of the small intestine (ileum) to form a conduit for the urine. The ileum, where the short length was removed, is then reconnected. The short length of the small Intestine is now reassigned to act as a “tube” or conduit to carry urine instead of feces. One end of this conduit is sewn closed and the other end is brought out to the surface of the abdomen to form the stoma. The ureters from the kidneys are grafted on to this conduit to carry the urine to the outside of the body and into the pouch.
Continent Ileostomy: a surgical procedure where the patient has lost the entire large intestine or colon and the end of the small intestine is surgically fashioned into an internal pouch where stool collects. This internal pouch, besides being connected to the small intestine is also connected to the surface of the abdomen where surgically created one-way valves on the stoma prevent the stool from leaving the pouch. Therefore, in order to empty the pouch, one must use a special plastic tube or catheter several times a day to drain the pouch. No external pouch is needed but a small absorbent pad or cover is needed over the stoma.
Continent Urostomy: As in the case of a continent ileostomy, a portion of the small intestine is cut out and fashioned into an internal pouch to replace the bladder which has already been removed. This pouch is now the new bladder. The ureters from the kidney are grafted onto this new bladder that will store urine. Special one-way valves are surgically constructed at the end of the internal pouch to prevent the urine from leaking out. As in the case of a continent ileostomy, a special catheter is used several times a day to empty the urine. No external pouch is required but a small absorbent pad or cover is required over the stoma.
Ileonal Reservoir: This surgical procedure involves the formation of a large internal pouch (similar to a continent ileostomy), except that the end of the pouch is surgically re-connected to the rectum to allow for normal controlled bowel movements. The frequency of bowel movements is greatly increased, but no external pouches or absorbent pads are necessary.
More information is available on the website of the Ottawa Ostomy Support Group at www.ottawaostomy.ca.
WHAT IS A STOMA?
A stoma is the opening created by ostomy surgery. It is located on the abdomen and is a dark pink colour. For most stomas, a pouch is worn over the stoma to collect the stool or urine.
For some people it is possible to have a continent diversion as an alternative to a conventional ostomy. This eliminates the need for a pouch.
A HANDBOOK FOR NEW OSTOMY PATIENTS
We would like to acknowledge and thank the Vancouver Chapter of the Ostomy Canada Society for writing and compiling this handbook for new ostomy patients. The Handbook has been slightly revised to reflect the details of the Ontario Assistive Devices Program. The Handbook is a universally useful resource for new ostomates who need detailed information on all aspects of the issue.
The Handbook is available on the Ostomy Toronto website or by clicking on http:/www.ostomytoronto.com/handbook.asp.
The following links provide useful information on the primary sources of financial support and assistance for ostomates.
Federal Disability Tax Credit
A trifold brochure has been printed and is available through Ostomy Canada and the Canadian Association for Enterostomal therapy. These brochures are part of a strategy to inform the medical community, pharmacies, patients and the general public about how people living with an ostomy can qualify for the Canadian Disability Tax Credit. Click on https://www.ostomycanada.ca/dtc/.
Ontario Assistive Devices Program
The Ontario Assistive Devices Program (ADP) helps cover the cost of specialized supplies such as those used with ostomies. For immediate access to the program details please click on https://www.ontario.ca/page/assistive-devices-program/.
Additional Useful Information
Ostomy Canada has a library of information that is invaluable for ostomates, ranging from topics such as types of ostomies, ostomy products, brochures and magazines. Click on https://www.ostomycanada.ca/information/ostomy-101/.
United Ostomy Associations of America is a very useful information source providing answers on issues such as sexuality, ostomy skin care, diet and nutrition, types of ostomies and product information. To access click on https://www.ostomy.org.[/vc_column_text][/vc_column][/vc_row]