Stoma Differences

There are lots of differences between the types of stoma’s people have.  They also have them for lots of different medical reasons and each has its own specific purpose and philosophy of how to live and work with them. There is a lot of confusion on the differences and the terminology is just crazy. So I want to go through and maybe clear up a few things about the placement of Stoma and what that means for the person who has it.

The first stoma we will talk about is a Colostomy. A colostomy is an operation that creates an opening for the colon, or large intestine, through the abdomen. A colostomy may be temporary or permanent If you have a colostomy and irrigate your bowels, you might not need to empty your bag for a day or two! Now it does depend on the size of the bag and I like the variety that ostomy supplies carries.  That’s pretty convenient! But if you aren’t irrigating your bowel then you may be emptying 1-3 times a day or however often you would have been going to the bathroom before your surgery. Now this is different from having an ileostomy.

Wickipedea describes this as this: “Ileostomy is a stoma constructed by bringing the end or loop of the small intestine out onto the surface of the skin, or the surgical procedure which creates this opening. Intestinal waste passes out of the ileostomy and is collected in an artificial external pouching system which is adhered to the skin” Most ileostomates will empty their bag 4-10 times per day, but some may need to empty more often if they have liquid output. I find myself emptying around seven or more times per day, but I also let my bag fill up past the 1/3 mark.   Then there is also a urostomy.

A urostomy is a surgical procedure that creates a stoma (artificial opening) for the urinary system.  There are specialty bags for each of these ostomy situations and I still would say to check out ostomy supplies to see which ones work best for your situation. A urostomy bag may need to be drained several times a day depending on the capacity. The volume of urine collected throughout the day should be closely matted with the volume of liquids you consume. 

A urostomate who drinks several liters of water should expect several liters of output in a 24h span. So now you hopefully are a little more informed about what is out there and the differences between stomas and placements!

Convexity in Ostomy Appliances

For many ostomy appliances, the convexity of it matters. This is the outward shape of the faceplate, which is like the top of the bell, that’s used to reach into the peristomal skin in order to create the best seal possible. This exists to provide the optimal seal. The stoma can have a shape that’s uneven, unusual in size, and other irregularities that make the non-convex applies ineffective. Convex ostomy bag systems curve outwards, and with that, it can press into the peristomal skin in order to protrude to the stoma long enough for the ostomy bag to attach in a firm and secure manner.

One of the key parts of ostomy care is to provide a secure and have a predictable seal. Having the convexity in place is important for achieving this. convex products are usually the preferred means for flat and retracted stomas, and will help compensate for the peristomal planes, and it helps with reducing the creases and the folds. While there are many products available with a lot of depths and shapes, there is little supporting evidence to guide the use and selection.

The origin of this is not known. There are limitations in early product availability and the need to cope with the wrongfully constricted stomas or irregular body contours that were historically addressed by the creative use of the belts, rings, and other medical adhesives. During the 80s and the 90s, there were many ostomy product manufacturers that were made to release the convex skin barriers that were made for the different systems.  There is also the new accessories such as the barrier rings and the convex skin barriers. While these are used consistently to describe the curvature of the adhesive sides of the barriers and accessories, there are still undefined descriptors.  There are no industry standards for the ability to determine the different flexibility and other aspects of this feature.  There is still research which needs to be done on this,which does leave the determination of the matching stomal protrusion and the peristomal contours to approximate the barriers of the different systems, and right now, only really the clinicians can help with showing you the correct way to have something such as this.

You might wonder what a convex pouching system is.  These are differing in how they sit around the stoma.  The flat one will sit flat around the stoma, whereas the convex ones are different, since they will curve around the skin. The outward curve will then press down on the skin, and from there, it will help push the stoma out more, and will offer a better emptying means for the pouching system.

This might be used if you need to stop the stool or leakage, offer a comfier and secure means to hold al of this in, stop skin irritation, improve the wear time, and also help save you some time and money.

You might end up suing this to help with preventing frequent leakage that’s caused by a stoma that empties either below or at the skin surface, any wrinkles and scars or creases in the skin, or if there is soft abdomen around the stoma. This will help with wearing in many cases, especially when compared to a pouching system. While this isn’t for everyone, and it might be a bit uncomfortable at first, it’s a good option for those who have trouble with the flat options for your stoma products.

What is an Ileostomy Surgery? – Types of an Ileostomy

In an ileostomy surgery, doctors detach the small intestine of a patient from the large intestine. In this operation, surgeons remove whether an entire colon and rectum or a small portion of the small intestine. The ileostomy operation could be permanent and temporary. It depends on the condition of the rectum and colon in a patient. If the procedure can preserve the colon and rectum, then the surgery will be temporary. Otherwise, an ileostomy operation is permanent.

Most of the digestion of food takes place in the small intestine. It is a six-meter-long tube. The absorption of vitamins, proteins, minerals, fats, and carbohydrates takes place in the small intestine. Any food which a small intestine cannot absorb goes into the large intestine. The undigested food which goes into the large intestine is waster matter of the body (stool and liquid).

In the ileostomy surgery process, doctors attach ileum to the wall of the abdomen and make a stoma (an artificial opening) in the lower belly wall. The stoma collects the waste of the body which discharges after the digestion process.

Causes of an Ileostomy Surgery

The following are the various causes of ileostomy surgery:

•      Ulcerative colitis (an inflammatory bowel disease).
•      Crohn’s disease (gastrointestinal tract disease).
•      Congenital bowel defects (esophageal atresia and fistula disease).
•      Uncontrolled bleeding (from the large intestine, a severe infection).
•     Any injury in the intestine (damages intestinal tract).
•     Ischemic bowel disease.
•     Carcinoma urinary bladder.
•     Spinal cord injury.

Types of Ileostomy

The following are the two primary types of ileostomy:

•      Conventional ileostomy surgery. 
•      Continent ileostomy surgery.
•      Surgeons remove the large bowel downstream no caudal viscus anastomoses from the ileum, which is a permanent device.

Conventional Ileostomy or Brooke Ileostomy

In conventional ileostomy surgery, doctors remove sphincter from the intestine. Because of the surgery, a patient loses the natural process of discharging feces. After the operation, patients excrete their stool through the artificial opening stoma, which is made by doctors on the lower abdomen wall. A stoma is the small opening to evacuate the urine and stool from the body. Stoma collects the waste matter of the human body in a pouch called stoma bag.

When a patient has ulcerative colitis, doctors perform conventional ileostomy. In ulcerative colitis, a patient has inflammatory bowel disease. When a person has ulcer or inflammation in a digestive tract, he needs conventional ileostomy operation. The conventional ileostomy is preferred when a patient is Crohn’s colitis. When a person has familial adenomatous polyposis and extensive colonic resection for ischemia, he may need proctocolectomy and end ileostomy.

Continent Ileostomy or Barnett Continent Intestinal Reservoir

In this type of surgery, doctors make an internal container and a valve from the lower end of the ileum. However, the stoma is outside the wall of the abdomen. The stoma collects the cavity and mucus flow from the small intestine. Surgeons insert a small narrow tube in the valve, it excretes the waste two to three times a day. The stoma covered by a simple and single band-aid.

J-Pouch

What is J-Pouch in conventional ileostomy?

There is one more option to the conventional ileostomy surgery, called J-Pouch or Ileoanal Pouch.

This is an advanced procedure of conventional ileostomy. It has better options for quick recovery and tolerance in a patient. The procedure has advance technical changes to make a patient comfortable.

Temporary Ileostomy

A temporary ileostomy is a partial dissection of the colon. In the temporary ileostomy operation, half of the colon removes, and when the remaining colon gets to heal, surgeons restore the connection of colon to the anus.

Permanent Ileostomy

Permanent ileostomy surgery occurs when a patient has chronic ulcerative colitis, bowel obstructions, colon cancer, rectal cancer, Crohn’s disease, congenital conditions, or trauma. In the permanent ileostomy, the patient will have stoma for the rest of his life.

What is a Urostomy Surgery? – Types of Urostomy

Urostomy Surgery

Urostomy is a surgical process that allows the urine to come out through an artificial opening stoma. The operation allows the urine the go pass the bladder and urethra.

Causes of Urostomy Surgery

The following are the causes of urostomy:

•  Bladder cancer.
•  Chronic inflammation.
•  Neurological bladder dysfunction.
• Malfunction of the kidney.
•  Infection in the kidney.
• Injury in the bladder or urethra.
•  Defect in the ureter or urethra.

The procedure of a Urostomy Surgery

In the urostomy operation, the doctors have to remove the ureters from the bladder. During the surgery, surgeons make an opening in the abdomen. After the operation, the stoma (opening) collects the urine. The process of the flowing of the urine does not change. It remains to evacuate through the ureter and collects in a bag which affixes to the opening (stoma). During the operation, doctors can remove the bladder, it depends on the type of disease.

Urostomy surgery is the least common type of the three primary kinds of stoma. The only purpose of the urostomy is to pass the urine from the body, through an artificial process. the urine collects in the stoma bag which attaches to the abdomen wall. In the operation, a small section of the bowel uses as a conduit (a path), sometimes the ileum (an ileum conduit). Usually, doctors put stents in situ to prevent the anastomosis between the ureter and bowel through a process called stenosis. The sensing occurs during the urostomy surgery. The urostomy operation is al usually permanent end stoma.

When it comes to appropriate appliances for the urostomy stoma. Doctors and nurses always recommend a drainable pouch. You can clean and wash the stoma bag through normal tap water. A patient should empty and clean the pouch five to six times daily. If you do not empty your stoma bag on time, it may leak and release the bad odor. The stoma pouch has a maximum capacity of 400ml, it cannot collect the liquid more than it. Therefore, it starts leaking and makes you embarrassed in public.

Types of Urostomy Surgery

The following are the three main types of urostomy surgery:

•  Ileal conduit.
•  Colon conduit.
• Ureterostomy.

Ileostomy Conduit

In the ileostomy conduit, procedure doctors resect the minor segment of the ileum and create a small opening in the belly wall called a stoma. In the operation, surgeons attach only one segment of the ileum (small intestine) to the stoma and connect the remaining portion of the small intestine by sewing to the two ureters. The surgery stops the passage between the ureter and the bladder. After the operation, urine can flow directly from the kidney and collects it into the stoma. The urine passes to the stoma through the ileal conduit which has created by the doctors. The ileal conduit only allows the urine to pass, the remaining undigested material pass through the sewed intestine.

Colon Conduit

The surgery procedure and purpose are the same in the colon conduit. The only difference is doctors create the conduit in the colon segment. In the colon conduit, surgeons have to make a larger stoma in the lower abdomen wall. Therefore, the size of the stoma pouch is larger in diameters than the ileal conduit.

Ureterostomy

In the ureterostomy operation, the doctors have to create one or two stomas in the belly wall. Surgeons have to connect each ureter to the abdomen. When a doctor links the ureters with each other internally, it is called transureteroureterostomy. One ureter creates the stoma on the outer wall of the patient. Therefore, it requires one stoma pouch which attaches to the outer stoma that collects the urine and liquid fluid. When doctors create two stomas on the outside of the abdomen, it is called bilateral ureterostomy, and it requires two stoma bags to collect the waste fluid from the body.