ostomy

Ostomy refers to a surgical procedure that creates an opening, or stoma, from an internal organ to the outside of the abdomen to divert stool or urine into an external pouch. The stoma is usually formed from a segment of bowel or a urinary conduit and sits on the abdominal wall.

Common ostomies are ileostomy, colostomy, and urostomy. An ileostomy uses the ileum and typically drains liquid, continuous stool. A colostomy uses the colon and usually yields more formed stool. A urostomy provides a urinary diversion, often via an ileal conduit, with urine exiting through the stoma into a collection pouch. Some patients may have continent ostomies or alternative urinary reconstructions.

Ostomies can be temporary or permanent. They may be end ostomies, where the end of the intestine is brought to the surface, or loop ostomies, where a loop of bowel creates two openings. Urinary ostomies divert urine when the bladder is not used.

Care involves the use of ostomy appliances, including a skin barrier and a collection pouch. Proper skin care, correct sizing of the appliance, and regular changes help prevent leakage and irritation. Diet and hydration management, particularly with ileostomies, may be advised. Guidance from wound, ostomy, and continence specialists is commonly sought.

Common complications include skin irritation, stoma retraction or prolapse, blockage, dehydration, and parastomal hernia or stenosis. Reversal to restore normal continuity is possible for some patients but not every case. Psychosocial support and education are important aspects of ostomy care.