THE THREE TYPES OF STOMA
When people I know ask me what I do for a living, I tell them I’m now finishing an enterostomal therapy course “Entewhat?” is what everyone asks me. I can’t help but grin as I know I will have to explain what it is again. If you’ve read any of the previous articles, you know why enterostomal therapy nurses are useful.
After that, I need to explain what an ostomy is. Even in 2015, some health professionals don’t know what it is. I’d be lying if I said that ostomy was discussed extensively during my nursing training. We don’t talk enough about it! God knows we do see ostomies when we work. I still remember my first day at the CLSC, when I had to change an ostomy appliance for the first time…Cold sweat was rolling on my forehead. I was so stressed because I wasn’t sure if I was doing the right thing at all. That is why I will talk about the three types of ostomy in this article.
According to the Régie de l’assurance maladie du Québec, there were 12 292 people living with a permanent stoma in 2013. There is also a bunch of other people living with a temporary stoma who were not counted. Is this for life or not? It really depends on your disease and what is best for you. Ileostomy, colostomy and urostomy are three possible choices, depending on the disease. “But what’s an ostomy? Are you going to tell us?” Actually, the word ostomy comes from the Greek word stoma, which means “mouth”. Surgeons perform an “opening” when stools or urine cannot be eliminated by natural means. Various diseases and complications may lead to an ostomy. Ileostomy and colostomy are possible solutions when a patient suffers from inflammatory bowel diseases, cancer, diverticulitis, mechanical bowel obstruction, refractory incontinence […](St-Cyr & Gilbert, 2011). These are $100 words that are worth a lot of points in Scrabble!
An ileostomy is an opening performed in the ileon, which is part of the small bowel. Stools have the same texture as oatmeal, and come out intermittently. It’s possible to produce from 800 ml to 1000 ml of stools per day, as water is usually absorbed by the colon. This is why patients need an adequate water intake. Colostomy can be located in different places, depending on where the disease is: in the caecum (caecostomy), the ascending colon (ascending colostomy), the transverse colon (transverse colostomy), the descending colon (descending colostomy), and the sigmoid colon (sigmoid colostomy). The closer the stoma is to the end of the colon, the more the stools are formed. Some people with a stoma have the same bowel habits they had before their surgery. Their stoma works at the same time and the same number of times as when their bowel was functioning properly.
Urostomy can be an option for patients suffering from bladder cancer, cystitis, neurogenic bladder… (St-Cyr & Gilbert, 2011). Urostomy is an opening meant to let urine pass through. It is collected in a bag, as it cannot be collected by the bladder anymore. This type of stoma works constantly, as the bladder cannot retain the urine made by the kidneys. It is important to drink a lot of water and be able to recognize signs of urinary tract infections. In my next article, I will explain the different surgeries used to make an ostomy. That way, you will understand how it works. Until then, I hope I answered your questions, calmed your fears, or made you learn something new. Please note that I am available to answer your questions and I will gladly answer them.
St-Cyr, D. & Gilbert, D. (2011). Les stomies: partie 1, Perspective infirmière, septembre-octobre, p. 23-28.