Ostomy Information
Types of Ostomies
An ostomy is the surgically created opening in the abdominal wall that
allows for the discharge of waste material. A stoma is the
end of
the small or large intestine that protrudes through the abdominal wall.
The following are the most common types of ostomies.
Colostomy
A colostomy is a surgical procedure where a portion of the colon or the
rectum is removed. The remaining section of the
colon is then brought to the abdominal wall to a surgically created
opening called a stoma.
Temporary Colostomy
Sometimes a temporary colostomy is employed to allow the lower section
of the colon to rest or heal. There will be one or two
openings, when a second opening is created it discharges mucus.
Sigmoid (Descending) Colostomy
One of the most common types of ostomies, the end of the descending or
sigmoid colon is brought to the surface of the abdomen. The
location of the stoma is usually on the lower left side of the abdomen.
Transverse Colostomy
A surgical one or two openings are created in the transverse colon
(middle section of the large intestines), the location of the openings
are the upper abdomen in the middle or right side.
Loop Colostomy
A loop colostomy is created in the transverse colon; the single stoma
has two openings. One opening is for the discharging of
stool, the other is only for mucus.
Ascending Colostomy
The ascending colon is the first section of the large intestine
beginning at the cecum in the lower right side of the abdominal cavity
and continues up the right side to the transverse
colon. The opening is made in
the ascending colon of this rarely performed procedure.
Ileostomy
For an ileostomy the surgically created opening is made at the small
instestines, usually at the end of the ileum. The intestine
is brought through the abdominal wall forming a stoma.
Ileostomies can be temporary or permanent. They may also
involve the removal of all or part of the colon.
Ileoanal Reservoir (J-Pouch)
Sometimes called a restorative proctocolectomy or ileoanal
pull-through, an ileal pouch anal anastomosis (IPAA) preserves part of
the anus. This allows the patient to continue to
have normal bowel movements. The surgeon removes only the
inside of the rectum leaving the outer muscles of the anus.
A pouch is created from the end of the ileum which is then attached to
the inside of the anus. Waste accumulates in the pouch and is
passed through the anus in the normal manner.
Bowel movements are more watery and more frequent (six on average per
day) but the patient will not have to wear a permanent external pouch.
Continent Ileostomy (Kock Pouch)
In this variation of an ileostomy, a reservoir pouch is created inside
the abdomen using a portion of the terminal ileum.
A valve is crafted in the pouch and a stoma is brought through the
abdominal wall. The pouch is drained several times
a day by the insertion of a tube or catheter. This
procedure is generally been replaced by the ileoanal reservoir.
Urostomy
A urostomy is a surgical procedure that diverts urine from the
bladder. A section at the end of the small intestines or at
the beginning of the colon is surgically removed and relocated creating
a passageway for urine to flow from the kidneys to the outside of the
body. If necessary, it may include the removal of a
diseased bladder.
Continent Urostomy
An alternative to the conventional urostomy, a reservoir is created
inside the abdomen using a section of either the small or large
intestines. A valve is constructed in the reservoir
and a stoma is brought through the abdominal wall. The
reservoir is emptied several times a day by inserting a tube or
catheter.
Orthotopic Neobladder
A replacement bladder is created from a section of the intestine and is
connected to the urethra allowing the passage of urine through the
normal channel. Technically not an ostomy because there is no stoma
created.