In some intestinal surgeries, the surgeon needs to make a stoma. This procedure is done by making a hole in the abdominal wall to remove intestinal contents, without passing through the anus.
The meaning of stoma itself is actually a hole in the body. In some conditions, it is necessary to make a hole in the abdominal wall to remove feces or stool. Thus, the stool is not removed through the anus.
Stoma surgery on the abdomen can be temporary or permanent, depending on the reason or purpose of making it. This procedure is only performed by surgeons who are specially trained to carry out gastrointestinal operations.
What are the types of stoma in the stomach?
There are 2 types of abdominal stoma-making operations that surgeons often do, namely ileostomy and colostomy. The following is the explanation:
Ileostomy
Ileostomy is an operation to make a stoma in the abdominal wall which is connected to the end of the small intestine (ileum). This action is most often done in inflammatory bowel disease or anal cancer.
Stomas made on ileostomy can be permanent or temporary. Stomas are permanent if the surgeon removes the entire large intestine and anus. But in ileostomy, making temporary stomas is more often done than permanent stomas.
A temporary stoma in the ileum is made to give the colon or inflamed anus rest time After recovering, the surgeon will reconnect the ileum with the large intestine or anus, so the stool flow returns to normal.
Colostomy
Colostomy is the making of stomas in the abdominal wall which are connected to the large intestine. Just like ileostomy, a colostomy can be done to make a stoma that is temporary or permanent. Stomas are permanent when the surgeon removes or cuts the lower part of the large intestine and closes the anus.
While the temporary stoma of the large intestine, is done to rest the part of the large intestine and rectum that is disturbed, for a certain period. After the large intestine or rectum is healed, the surgeon will reconnect the large intestine so that stool can pass through the rectum normally.
Colostomy is commonly performed in colon cancer, diverticulitis, and fecal incontinence.
What is the correct treatment for stoma?
After the operation to make a stoma in the stomach, the surgeon will attach a special bag to the stoma, to collect the stool that comes out. Before the patient is allowed to go home, the doctor or nurse will teach you how to stick, dry, replace the stoma bag, and treat the stoma and surrounding skin.
Poor stoma care can cause complications in the form of skin irritation, especially in patients undergoing ileostomy. This condition will make the skin become blisters and sores, making it vulnerable to infection. Therefore, it is important to know how to properly care for stoma pouches.
The duration of use of a stoma bag
Stoma bags consist of 2 parts, namely wafers and stool-holding plastic bags. Wafers are part of a barrier attached to the skin of the stomach, to protect it from dirt. When it's full, the plastic bag can be removed or replaced without the need to replace the wafer.
The wafer can be replaced if the stool starts to enter between the wafer and the skin, or every 3 days to 1 week. The duration of wafer use depends on several things, namely:
- How well the wafer fits the skin
- Skin condition around the stoma
- Physical activity of the patient
In addition to the stoma bag consisting of 2 parts, there are also stoma bags with wafers and storage bags in one. For this type of bag, the wafer will also be replaced when the container is replaced.
Steps to replace the stoma bag
There are several things that need to be done when replacing a stoma bag, namely:
- Clean the mucus that comes out of the stoma.
- Clean the skin around the stoma with warm water and washcloth.
- Rinse skin thoroughly.
- Dry the skin around the stoma.
The skin can be cleaned with soap. However, choose soap that does not contain fragrance and oil, because it can cause irritation and make the bag difficult to stick to the skin.
When replacing a stoma bag, you need to check the condition of the stoma. Call your doctor immediately if the stoma changes in size (significantly shrinks or enlarges), changes in shape (protruding out), or discoloration (pale, bluish or blackened).
In addition, you also need to check for bleeding from the stoma and signs of skin irritation around the stoma, such as redness or blisters. If you experience these things, contact your doctor immediately.
The operation to make a stoma in the abdomen aims to divert the outlet of the contents of the intestine, namely feces or stool, from the anus to the abdominal wall. The hole made in the abdominal wall is at risk of causing irritation and infection of the skin. Therefore, correct and painstaking care is needed to prevent these complications.
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