Digestive ostomies

In some cases, surgery of colon or rectal cancer may include the creation of a stoma, that is to say, the stoma of a bowel segment to abdominal skin to allow bowel movement instead of the anus, hence the term "stoma" sometimes used.
stomas

At large, an ostomy can be described as the branch (or deviation) of a natural surgical duct fails to fulfill its evacuation function due to illness or accident. When this concerns the intestine bypass, we talk about digestive stoma or ostomy. In the urinary tract, uses the term urostomy.

The word comes from the Greek stoma stoma meaning mouth, which explains, for example, the phrase "the colon is abouché abdomen," often used by doctors and nurses (eras) to describe the colostomy. Stoma is also the term used for the discharge opening in the skin (stoma).Digestive ostomies
Regarding digestive ostomies, there are:

    Colostomy or surgical anastomosis of the large intestine to the abdominal skin for a derivation of fecal matter. In this case, the materials are molded evacuated.
    The ileostomy or stoma in the abdomen of the ileum, the last part of the small intestine before the colon. Feces are liquid because they have not passed through the large intestine.
In both cases, feces are collected in a special bag that can be stuck on the stomach around the stoma (apparatus stoma).
Colostomies ileostomies as can be:

    T emporaires (or protection): they are then closed during a second surgery after three months on average, with recovery of the intestinal continuity and anal discharge.
    Final, when it becomes impossible to restore intestinal continuity and / or anal function.
In France, 100,000 patients concerned
According to data from the Association of French Entérostoma Therapists (AFET), approximately 100,000 people are infected with gastrointestinal stoma in France, mostly following surgery for colorectal cancer.
In 2008, the HAS (Health Authority) stated that among the 18,000 new cases of colon cancer reported in France every year, 30% of them will have a stoma, usually temporary (75% and colostomy ileostomy 25%). As for rectal cancer, the cumulative number of cases annually is 8 000. Again, 30% have a stoma, usually permanent.

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Stoma care practice

Because all ostomies are alike, each patient must choose with the help of the nursing staff, the equipment that best suits him. But even if the choice is the most suitable, the technical care when changing the equipment is essential to maintain its stoma - and the skin surrounding it - in good condition.

 stoma-care
During the last decade, thanks to advances in technology, specialized laboratories in ostomy appliances have developed a wide range of systems and accessories more and more efficient.Significant progress ostomy appliance
The collecting bags have long existed but the systems to maintain the pockets did not prevent leakage and odors and, therefore, their port was very restrictive for patients. In particular, the leakage of effluent (feces for digestive stomas, urine for urinary stomas) were originally very significant irritation to the skin around the stoma with frequent superinfections. Thus, the quality of life of ostomy patients was quite compromised.
The first rubber pockets were created in the 1930s and were used until the 1950s and gradually replaced by plastic bags in 1940.
But the first great advances took place in the 1980s with the appearance of synthetic protective skin that allowed a better adhesion of the equipment while protecting the skin around the stoma. It was a major advance because, even today, the skin around the stoma complications are prominent.
Currently, apparatuses for digestive stomas are also provided with a filter to reduce (or eliminate) the odor and to control the gas outlet. In addition, urostomy systems are provided with an anti-reflux valve, a plug or drain system. Overall, the equipment currently proposed prefer tightness, skin protection, comfort and discretion.Ostomy: several options for patients
These devices are suitable for different needs of patients and stoma shapes. There are two main types of collection systems:

    The adhesive pocket sticks directly to the skin. These are the systems "room". This type of system is changing everyday and the pockets are drainable or not for digestive ostomies. Note that all urostomy pouches are drainable: they need to be emptied regularly in the day.
    The bag fits to an adhesive backing adhered to the skin by a fastening system which clips or adhesive. These are the "two-piece" systems that can be flat or convex. The support may be left in place for 2 to 3 days while the pouch is to be changed daily. The latter can also be drainable bags for colostomy or ileostomy. The urostomy pouches are drainable all because they must be emptied regularly in the day.
Recently, small systems like a protective plaster and mini-pockets have emerged. They are used by patients who practice colonic irrigation instead of wearing a digestive ostomy pouch (only for left colostomies). Irrigation is a regular bowel enema with lukewarm water can evacuate the entire colon and therefore provides content to wear a pocket.

Other small and discrete devices can also be used occasionally by the holders of ostomy pouch to facilitate activities such as swimming (knowing that current pockets can be used in this type of sport because they are waterproof and impervious).
The specialized manufacturers also offer accessories for use punctually according to particular situations: pasta (to fill a fold), protective films, belts, connecting tubing and night collecting bags or leg bags for urostomies, etc.
Thus, there is no standardized equipment. Each patient with the help of his entérostoma therapist (ET) can choose the most suitable equipment according to its stoma (shape, size, location, shape of the abdomen), abilities (manual dexterity, visual ...) and preferences in order to promote autonomy and facilitate activities. As many components that contribute to the maintenance of quality of life. The devices are available in pharmacies or in specialized stores. They are reimbursed by Social Security according to the rates set by the Interministerial price of health services (TIPS).Know how to use ostomy appliances
Stoma care is primarily hygienic care, and control to change its equipment is essential to prevent leaks and keep his stoma and surrounding skin undamaged.
In the morning, quiet and empty stomach or between meals are the best times to make the change because the intestine has a minimum load to these moments. The equipment to be replaced is removed gently and then, always with gentleness, the stoma and surrounding skin should be cleaned with tap water and a neutral soap, mild and unscented (soap like Marseille) , using a washcloth, sponge or other soft material. After thorough washing, rinse thoroughly and then dry the skin around the stoma by tamponade. The own apparatus may then be applied with care, making sure that the diameter of the pocket (or the support) is adapted to the size of the stoma because it can have small changes over time.
This care is as important as the right choice of equipment and the combination of both is the best guarantee of healthy skin around the stoma, which is essential to avoid irritation and skin lesions that are the most frequent complications Ostomy.
Above all, do not hesitate to consult their doctor or the ET in case of doubt or problem.Keep a good self-image
Some laboratories and independent companies even offer a choice of more and wider underwear and lingerie, while being aesthetic, adapt to holders bellies of a stoma. And yes ! These treatments do not prevent the desire to seduce or sex. If problems in this area, please talk to your doctor or ET, who can advise you or refer you to a specialist.

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