When injury or illness interferes with normal processes, doctors may surgically reroute a body pathway to create a stoma, or artificial opening to the outside of the body. A stoma may be for introduction of air or nutrition or for removal of waste products. The procedure may be temporary or long-term. According to SGV Medical, “there are approximately 1 million people living in the United States with ostomies. In fact, each year there are between 75,000 and 100,000 ostomy operations performed.”
Identify the part of the body rerouted by the name of the procedure, which will typically end in "-stomy."
• Tracheostomy (also known as a tracheotomy) opens an air intake through the trachea rather than the mouth or nose. • Gastrostomy provides an opening for introduction of liquid nutrition directly into the stomach. • Jejunostomy introduces nutrition through a section of the small intestine (the jejunum or jejuneum). • Ileostomy diverts fecal matter from the ileum (the last part of the small intestine). • Colostomy collects fecal discharge from the large intestine (the colon). • Urostomy connects replaces the bladder or reroutes a ureter to an outside source of urine collection.
Loss of body function due to accident or illness triggers the need for a stoma. Physicians may address inability to swallow resulting from esophageal cancer, achalasia or injury with a gastrostomy or jejunostomy. They may bypass blockage of the nasal passages and mouth with a tracheostomy or use the opening to direct the output of a ventilating device into the patient’s lungs. Waste matter can be collected when resection of a bowel interferes with elimination.
Patients who are unable to swallow often have their nutritional needs met with a PEJ (percutaneous endoscopic jejunostomy) or PEG (percutaneous endoscopic gastrostomy). Measured amounts of liquid nutritional supplement enter the digestive system through the stoma at regular intervals, utilizing a gravity feed bag or catheter-tipped syringe connected to a catheter that attaches to the ostomy. Protect the opening with an appliance to facilitate closure between feedings. Conceal the unobtrusive stoma under clothing when not in use.
Colonoscopy, ileostomy and urostomy patients experience loss of control over the affected function. Collect feces or urine in an ostomy collection device. A typical fecal ostomy device includes a shield to protect skin from the potentially acidic contents of the bowel and a collection bag to contain the contents until the patient can dispose of them and apply a new bag. Wear the bag under clothing with little inconvenience. Minimize odor by attaching the bag firmly and changing regularly.
“You may bathe with or without your pouching system in place. If you wish to take a shower or bath with your pouch off, you can do so. Normal exposure to air or contact with soap and water will not harm the stoma, and water does not enter the opening,” advises the United Ostomy Associations of America. The actual stoma is red, moist tissue and does not require any special care beyond basic hygiene. Ostomy supplies are available from most medical supply outlets as well as online providers.
An ostomy may be a temporary detour until the patient heals from the underlying condition. Surgical reversal of the ostomy completes the course of treatment. In those situations where the reroute is permanent, ostomy care becomes a lifelong accommodation.