Bowel diversion surgery is performed when the large intestine needs to be removed or needs time to heal. This surgery allows stool and gas to safely leave the body. There are several surgical options that exist for bowel diversion including colostomy surgery. In colostomy surgery, the colon is diverted to a stoma, or opening, and stool collects in an ostomy pouch. A colostomy can be either a permanent or temporary procedure depending on the condition being treated.
Bowel Prolapse
A potential complication of colostomy surgery is bowel prolapse. According to the Cleveland Clinic, a "bowel may become narrow or prolapse, which means it gets longer". According to the American Society of Colon and Rectal Surgeons, a prolapse is most frequently seen in loop colostomy procedures and is often a temporizing procedure.
Hernia
Another potential complication of colostomy surgery is a potential hernia developing around the colostomy. According to the American Society of Colon and Rectal Surgeons, peristomal hernias are a complication that has been reported in up to 50 percent of patients that have had colostomy surgery. According to the United Ostomy Association a hernia is defined as "the protrusion of an organ or tissue through a structure which usually contains it".
Skin Irritation/Complications
Contact dermatitis is a common skin disorder that is associated with stomas and can result from an allergic reaction to the ostomy appliance itself. In other cases, skin irritation can be a result of leaking stool in which proper fitting of an ostomy pouch and improved cleansing and use of skin barriers to the area may help prevent skin irritation.
Hemorrhage
Minor hemorrhage or bleeding from the stoma is common and rarely requires the assistance of medical personnel. If excessive bleeding occurs from the stoma opening or a moderate amount of blood is found in the ostomy pouch, medical assistance should be sought. Bleeding is typically mucosal and responds from applying light pressure to the area.
Constipation/Diarrhea
Some minor changes may be needed in the diet to help avoid constipation, diarrhea or excessive flatus, or gas. Constipation is often the result of an unbalanced diet and inadequate fluid intakes. The focus should be on consuming a well-balanced diet while avoiding foods that may cause gas such as cabbage, beans, eggs, broccoli, cucumbers, onions, fish, carbonated beverages and chewing gum. Diarrhea may be an indication to seek medical assistance if it is persistent. Loose bowel movements are typically common in transverse colostomies due to the shortened length of the colon, according to the United Ostomy Association.
References
- Jackson Siegelbaum Gastroenterology: Ostomy, Colostomy, Ileostomy
- National Digestive Diseases Information Clearinghouse: Bowel Diversion Surgeries: Ileostomy, Colostomy, Ileoanal Reservoir, and Continent Ileostomy
- Cleveland Clinic: Colostomy
- Americal Society of Colon and Rectal Surgeons: Ostomies And Stomal Therapy
- United Ostomy Associations of America, Inc.: Colostomy Guide
