Ostomies

Ostomies are surgically created openings in the abdomen that allow waste to exit the body through a stoma, an opening on the skin. The most common types are colostomies, ileostomies and urostomies. A colostomy uses part of the large intestine (colon) to form the stoma, with stool typically more formed than in an ileostomy. An ileostomy uses the ileum, the end of the small intestine, and stool is usually liquid and can be more frequent. A urostomy diverts urine, usually after bladder removal, with urine exiting through a stoma into a collection bag. Ostomies can be temporary or permanent, depending on the underlying condition and whether the bowel or urinary tract can be reconnected.

Indications include colorectal cancer, inflammatory bowel diseases such as ulcerative colitis or Crohn's disease, diverticulitis, trauma, and bladder cancer or neurogenic bladder requiring diversion. The procedure involves bringing the end of the bowel or urinary conduit to the abdominal skin to form a stoma, after which a pouching system is worn to collect waste.

Care is provided by specialized ostomy nurses who educate on stoma assessment, skin protection, and pouch changes. The surrounding skin should be clean and dry, and the bag is typically emptied when needed and changed at intervals advised by professionals. Possible complications include skin irritation, stoma retraction or prolapse, blockage, dehydration (especially with ileostomies), and parastomal hernias.

Living with an ostomy often requires dietary adjustments, hydration, and psychosocial support. Some ostomies are reversible with subsequent surgery, but others are permanent. With proper care, most people adapt well and maintain an active, normal lifestyle.