Sigmoidal Colostomy

Introduction

The most frequent form of colostomy is a sigmoid colostomy. It’s created in the sigmoid colon, only a few inches below a descending colostomy. Because the colon is more active, it may produce solid stool on a more regular basis.

A double-barrel or single-barrel colostomy can be used for both the descending and sigmoid colostomies. The single-barrel colostomy, also known as an end colostomy, is more frequent. End colostomy stomas are either stitched flush with the skin or turned back on themselves (like the turned-down top of a sock).

Characteristics:

• The faeces is harder, almost paste-like. It doesn’t include nearly as many of the unpleasant digestive enzymes.
• Stool output may occur as a reflex at predictable intervals. After a specific volume of faeces has accumulated in the intestine above the colostomy, bowel movement will occur. There may be a gap of two or three days between moves.
• Because there is no muscle to keep the faeces back, spilling may occur between movements. To avoid mishaps, many individuals utilize a lightweight, disposable pouch.
• Some people will instinctively feel the desire to evacuate their bowels (reflex). Others may require modest stimulation such as juice, coffee, food, a little laxative, or irrigation.

Bowel’s movements

A bowel movement through a colostomy occurs in the same way as a regular bowel movement occurs through the anus. The colostomy, unlike the anal hole, does not contain nerves or a sphincter muscle to assist stop feces from passing through.

• You must wear a pouch to gather everything that comes through, whether or not it is intended. Many lightweight pouches are difficult to see through clothing. They adhere to the skin surrounding the colostomy and can be worn all day or only as needed.
• Certain meals eaten at specific times might cause the bowel to move at a time that is most convenient for them. Some people solely utilize this approach to maintain a regular bowel movement schedule, while others combine it with irrigated bowel movements.

Constipation or loose stool:

Many individuals believe that you should have a bowel movement at least once a day. This differs from person to person. Some people have two or three bowel motions each day, while others have one every two or three days or even less often. It may take some time for you to figure out what is typical for you following surgery.

Some descending and sigmoid colostomies can be trained to move regularly, while others cannot. Only individuals who had regular bowel motions before being unwell are likely to undergo training, whether with or without stimulation. It may be difficult, if not impossible, to have regular, predictable colostomy function if your bowel motions were erratic in the past.

Some disorders that cause patients with colostomies to experience spells of constipation or loose feces include spastic colon, irritable bowel, and some forms of dyspepsia.

Reversing a colostomy

If your colostomy is going to be closed, the surgeon may discuss intentions to “take it down” or “reverse it” in a few weeks or months, but the doctor may not mention it at all. It’s ideal to discuss these issues with your surgeon before you leave the hospital so you know what the plans are and when you’ll see him again. If you’re at home and haven’t received instructions, contact the doctor’s office or clinic to learn what the doctor wants you to do. It is your responsibility to keep in touch with the doctor.

• When considering colostomy closure, many factors must be considered, including:
• Why did you require a colostomy?
• Whether you’re up to it, see if you can handle additional surgery.
• Your well-being

Pouching system:

Choosing the right pouching system or appliance for you is a highly personal decision. It’s important to chat with an ostomy nurse or someone with knowledge in this field before trying out your first pouching device. After surgery, there should be someone in the hospital who can help you get started with equipment and instructions.

Make sure you’re sent to a Wound Ostomy Continence Nurse (WOCN or WOC nurse, also known as an ostomy nurse), a clinic, an ostomy manufacturer, or a chapter of the United Ostomy Associations of America as you prepare to leave the hospital. Even if you have to go out of town to obtain such assistance, it is beneficial since you want to get off to a solid start and avoid making mistakes.

When looking for the pouching method that will work best for you, there are several factors to consider. The length of the stoma, abdominal firmness and form, stoma placement, scars and folds surrounding the stoma, as well as your height and weight, must all be taken into account. Stomas around the hipbone, waistline, groin, or scars may require special adjustments. Custom-made items are available from certain businesses to meet the needs of unique scenarios.

• A decent pouching system should include the following features:
• Stay safe with a leak-proof seal that may last up to three days.
• Protect the skin surrounding the stoma by being odor-resistant.
• Wear virtually imperceptible clothes.
• It should be simple to put on and take off.
• If you want to wash or bathe with the pouch on, go ahead.

Types of pouches:

Pouches are available in a variety of designs and sizes, and an ostomy nurse will assist you in selecting the ideal one for your needs and lifestyle. They all feature a collecting bag to collect stool drainage from the stoma and an adhesive barrier to protect the surrounding skin (called a flange, skin barrier, or wafer). There are two types of systems on the market:

Both the pouch and the skin barrier are connected to the same unit in one-piece pouches. The barrier is also eliminated when the pouch is removed.

A skin barrier separates from a pouch in a two-piece system. The barrier remains in place after the pouch is removed.

Some pouching methods have a bottom that can be unzipped for convenient emptying.

Stomach cap:

The skin barrier or pouch wafer opening must be large enough to accommodate your stoma. The gap between the stoma and the aperture should be no more than 1/8 inch. You may need to cut a hole in the pouch for your stoma, or the wafer may be pre-sized and cut, depending on the pouch design. Because the wafer is meant to shield adjacent skin from stoma output while still being soft on the skin, the hole size is critical.

Keep in mind that the size of a stoma might alter if it swells or for other reasons. For example, your stoma may be enlarged for 6 to 8 weeks after surgery. The stoma should be measured once a week throughout this time. In pouch boxes, a measurement card may be supplied.