Ostomy Surgery: Things To Expect

Ostomy surgery is a life-saving procedure that alters the excretory pathway. Some diseases can result in the intestinal tract or bladder to stop functioning. Such a condition can lead a person requiring a surgical treatment aimed at bypassing the normal excretory pathway. The newly formed artificial pathway for waste excretion is known as an ostomy.

No matter what type of ostomy you are going to get, there are a few things that can expect before and after surgery.

Preparing for ostomy surgery

First of all, you are going to get an appointment with an ostomy care nurse before the procedure. The nurse will review the surgical procedure and will explain likely changes in the GI tract after surgery. They will also demonstrate how an ostomy pouching system works. You will be given a quick overview of skills that you are going to need to change or empty your ostomy pouch.

Based on where the diseased part of the colon or small intestine starts from, your nurse will mark the location of the stoma on your abdomen. They will make sure that the stoma location is easily accessible to you. Marking the stoma location provides your surgeon with necessary information about the type and location of the stoma.

In the next step, your surgical team will schedule a pre-operative visit. During this visit, the team will examine your condition and will explain the surgical procedure. You can discuss all of your concerns related to ostomy surgery you are going to have.

After surgery, you will need to stay at the hospital for about five days to have an initial recovery. You will be discharged from the hospital as soon as your bowel activity resumes. This resumption is marked by the output of gas and watery stool from your stoma.

Ostomy care after surgery

After surgery, your nurse will teach you the right way to use ostomy supplies to manage your stoma. By the time you will leave the hospital, you will know how to empty or change your pouch. The hospital will provide you several ostomy care supplies to let you adapt to the ostomy care regimen in the best possible way.

After leaving the hospital, you are going to have to make sure that you are not missing any of the follow-up visits, which you are going to need to pay every two weeks for the first few months. These visits will let you steer clear of, or deal with, any complications related to your GI tract, stoma, or peristomal skin.

During the first few weeks after surgery, your stoma will change shape quite frequently. Nurses suggest measuring the stoma every two weeks after surgery. After six weeks, the stoma will retain shape and size.

Many people wonder if there is any diet-related change that they have to bring in their lives after ostomy surgery. It is worth mentioning here that an ostomy doesn’t stop you from eating whatever you want to eat. There are indeed some diet changes that you are going to have to stick with during the first few weeks after surgery, but those changes are meant to keep a more vulnerable GI tract from harm’s way.

As far as the exercise is concerned, you would have to be a bit cautious about heavy lifting. You will need to start low and slow to adapt to the fitness regimen that you intend to continue after surgery. You can talk to your doctor for guidance in this regard.

Tips To Use An Ostomy Bag And Pouching System

You must learn how and when you will need to empty your pouching system to successfully manage your ostomy. This process also includes assessing and taking care of your stoma and the skin around it. You should also know what to do in case the peristomal skin looks less than healthy.

Emptying the pouch

Emptying your pouch is one of the most basic skills that you are going to have to learn after surgery. In the hospital, the nurse will teach you how to measure the amount of stool in the ostomy bag, and also how to empty the bag into a container. You can also empty the pouch into the toilet.

You may wonder when to change the pouch. You will need to empty it once it is one-third to half full. The aim should be to prevent the bag from becoming too heavy as it can undermine adhesion between the skin barrier and the peristomal skin. The frequency at which you need to empty the ostomy bag depends on the type of ostomy you have. If you have an ileostomy, you may have to empty your pouch five to six times in 24 hours. If you have a colostomy, you may need to empty your ostomy bag two to three times in 24 hours.

Changing the Ostomy Pouch

If your ostomy requires you to use closed-end ostomy bags instead of drainable bags, you are going to have to learn about how to change your ostomy pouching system. There may be several steps involved in removing and replacing an ostomy pouch. You may not be skilled enough to change the bag during the first few weeks after surgery, and it is understandable.

Again, you are going to have to learn the process of changing an ostomy bag from an ostomy care nurse. The nurse will tell you what is normal for your stoma and peristomal skin. They will also tell you about the troubleshooting process if things do not seem normal. The lessons you will get from your nurse will help you examine your stoma every time you change the pouch.

It is crucial to keep your ostomy care nurse and doctor on quick dial. You may think that you are fully aware of the process of changing the pouch because you are doing it daily, but you might never know about the occurrence of a complication that’s beyond your understanding. During that situation, an instant call to your ostomy care nurse can help you get rid of that complication.

Urostomy Types And Pouching Systems

There are two types of urostomy: the incontinent (conventional) urostomy and the continent urostomy. Your doctor will determine what type of urostomy is suitable in your case. There will be several factors involved in this scenario.

Incontinent (conventional) urostomy

The primary requirement of this type of urostomy is the making of an ileal conduit, which can also be referred to as an internal pouch. The ileal conduit is a piece of small intestine used to transport urine coming from the ureters to the stoma. This conduit is cut from the small intestine, and it is 5-6 inches in length. The remaining part of the small intestine is then connected to the large intestine.

After the stoma has been created with an ileal conduit, the surgeon detaches ureters from the bladder and connects them with the conduit. At one of the conduit is the ureters connected, and the other end serves as the stoma, which is an opening sticking to the abdominal wall.

A patient with urostomy doesn’t have any control over the urine output, so he needs to wear an ostomy pouch at all times to collect the urine evacuated by the urostomy.

Continent urostomy

A continent urostomy also involves the creation of a small pouch, but this pouch has valves to keep the urine from flowing back into the kidneys. Another valve allows the patient to keep the urine in the pouch until it needs to be removed. The patient must drain the pouch four to five times a day with the help of a thin tube called a catheter. You will learn how to drain the pouch by your doctor.

There are different types of continent urostomy.

• A Kock pouch is the most common type of diversion used in the continent urostomies. The pouch, valves, and the outlet in this diversion are made from the end of the small intestine.
• Another type of continent urine diversion is the Indiana pouch. The pouch in this diversion consists of the large intestine, while its outlet consists of a part of the small intestine.
• The ileal neobladder is another type of continent urine diversion. It consists of the small intestine.

Types of ostomy pouching systems

Urostomy Pouches are available in different sizes and types. You can choose the most appropriate ostomy bag with guidance from your ostomy care nurse. Generally, there are two types of urostomy pouches to choose from: one-piece ostomy pouches and two-piece ostomy pouches. A one-piece ostomy pouch has a bag and the skin barrier attached in the same unit. When you will need to change the pouch, you are going to have to take the barrier off too.

A two-piece ostomy pouch, on the other hand, uses the bag and the barrier as two different entities. You can take the bag off, while the barrier will stay in place.

You can pick an ostomy pouch based on your requirements. Make sure to consult with your doctor before engaging in any decision making process regarding your ostomy care regimen.