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Ostomy Management
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Over 100,000 ostomy procedures are performed each year to allow for the elimination of bodily waste (Doty, 2019), with approximately 750,000 to one million people currently living with an ostomy in the U.S. (United Ostomy Associations of America, 2017).
Ostomy Types
The three most common types of ostomies are ileostomy, colostomy, and urostomy.
Fecal Ostomies (Francone, 2020)
Colostomies and ileostomies are surgical procedures performed to bypass or remove injured or diseased bowel. This creates a temporary or permanent fecal diversion where a portion of the bowel is pulled through an incision in the abdominal wall creating an ostomy or stoma.
Fecal ostomies may be used to manage medical conditions such as congenital anomalies, colon obstruction, cancer, diverticulitis, trauma to the intestinal tract, or inflammatory bowel disease.
- Ileostomy: performed when it is necessary to remove or bypass the entire colon or rectum, or to protect a distal colorectal, coloanal, or ileoanal anastomosis. It is made from the ileum and has one opening for fecal elimination (Doty, 2019). Ileostomies always require a pouch system to collect liquid effluent which is high in digestive enzymes.
- Colostomy: performed when it is necessary to bypass or remove the distal colon, rectum or anus. It is constructed from the ascending, transverse, descending or sigmoid colon.
Urostomy
Urostomies are created to bypass the bladder by diverting the normal flow of urine from the kidneys and ureters. Ureters are implanted into a small segment of ileum (called an ileal conduit) and pulled through the abdominal wall as a stoma. This procedure may be used to treat bladder cancer, neurologic dysfunction of the bladder, birth defects, chronic bladder inflammation, radiation injuries, or spinal cord injury.