An ostomy is an opening from the gastrointestinal or urinary tract to the body wall that a surgeon creates to allow elimination of either urine or stool. An ostomy can be temporary or permanent, depending on the indication for the surgery. Generally an ostomy empties automatically into a bag on the abdominal wall. The patient can then dispose of the waste when convenient.
Diverticulitis
Diverticulitis affects the colon. As the colon ages, small outpouchings known as diverticula form along the colon wall. These diverticula can become infected, resulting in diverticulitis. Usually this condition can be treated with antibiotics and possibly elective surgery. However, in some cases, the infection cannot be controlled and emergency surgery needs to be performed. A segment of the colon is removed but the presence of active infection makes reconnecting the colon immediately risky. Therefore, a colon ostomy, known as a colostomy, is created temporarily while the infection subsides. This colostomy can be reversed in approximately six to 12 weeks.
Rectal Cancer
Rectal cancer involves approximately the last 12 inches of the large intestine. Depending on the distance between the cancer and the anus and on the cancer treatment regimen, an ostomy may be required. Cancers that are closer to the anus or those treated with radiation are more likely to require an ostomy of some sort. Generally, if it is to be temporary, a small intestine ostomy, called an ileostomy, is created, though a colostomy may also be done. A permanent ostomy for rectal cancer is almost always a colostomy.
Inflammatory Bowel Disease
Inflammatory bowel disease is a pair of intestinal disorders characterized by chronic inflammation of the large and sometimes the small intestine. The first disorder, Crohns' disease, involves both large and small intestines. It less commonly leads to the creation of an ostomy, though it can vary case by case. Ulcerative colitis is limited to the large intestine and rectum only. The surgical treatment involves the removal of the whole colon and possible reconstruction of the rectum. If the rectum is reconstructed, a temporary ileostomy may be required. If it is not, then a permanent ileostomy is created.
Bladder Cancer
Bladder cancer may require the excision of the entire bladder, with different options for channeling the urinary flow. One option is to implant the ducts that connect the kidney and bladder, called the ureters, into an isolated segment of intestine. This segment is then opened to the abdominal wall, forming an ostomy called a urostomy.
