What is an ostomy?
The word "ostomy" is derived from Greek and means
a surgically created opening connecting an internal organ
to the surface of the body. Different kinds of ostomies
are named for the organ involved. The most common types
of ostomies in intestinal surgery are an "ileostomy"
(connecting the small intestine to the skin) and a "colostomy"
(connecting the large intestine to the skin).
An ostomy may be temporary or permanent. A temporary ostomy
may be required if the intestinal tract can't be properly
prepared for surgery because of blockage by disease or scar
tissue. A temporary ostomy may also be created to allow
a disease process or operative site to heal without irritation
by the passage of stool. Temporary ostomies can usually
be reversed with minimal or no loss of intestinal function.
A permanent ostomy may be required when disease, or its
treatment, impairs normal intestinal function, or when the
muscles that control the rectum do not work properly or
require removal. The most common causes of these conditions
are low rectal cancer and inflammatory bowel disease.
Figure 1: An ostomy connects either the small or
the large intestine to the surface of the body.
How will I control my movements?
Once your ostomy has been created, your surgeon or an enterostomal
therapist or "ET nurse" (a nurse who specializes
in ostomy care) will teach you to apply and wear a pouch
called an ostomy appliance. The pouch is made of a special
form of plastic which is held to the body with an adhesive
skin barrier. Many sizes and styles of ostomy pouches are
available. The pouch is disposable and is emptied or changed
as needed. The system is quite secure; "accidents"
are not common, and the pouches are odor-free. The frequency
of your bowel movements will vary, depending on the type
of ostomy you have, your diet, and your bowel habits prior
to surgery. If the ostomy is a colostomy, irrigation techniques
may be learned which allow for increased control over the
timing of bowel movements.
Figure 2: An ostomy appliance is a plastic pouch,
held to the body with an adhesive skin barrier, that provides
secure and odor-free control of bowel movements.
Will my physical activities be limited?
The answer to this question is usually an emphatic NO! You
may have friends or acquaintances who have an ostomy of
which you are unaware. Public figures, prominent entertainers,
and even professional athletes have ostomies that do not
significantly limit their activities. All your usual activities,
including active sports, may be resumed once healing from
surgery is complete.
Will an ostomy affect my sex life?
Most patients with ostomies resume their usual sexual activity.
In men, removal of the lower rectum for cancer may result
in sexual dysfunction due to injury to nerves that pass
close to the rectum. This is unrelated to the ostomy. Many
people with ostomies worry about how their sexual partner
will think of them because of their appliance. This perceived
change in one's body image can be overcome by a strong relationship,
time and patience. Support groups are also available in
many cities. If the surgical procedure will require removal
of the rectum, you may wish to discuss sexual function with
your colon and rectal surgeon or an ET nurse prior to surgery.
It is often comforting and reassuring for a patient who
is facing a permanent ostomy to visit with another person
who has already been through the surgery and adjusted to
his or her ostomy. Such visits can often be coordinated
by your surgeon or ET nurse.
If circumstances dictate the need for an ostomy, it is
likely that you will return to a fulfilling lifestyle. With
the skill and support of a colon and rectal surgeon and
ET nurse, one can cope with either a temporary or permanent
ostomy and resume a normal life.
