Common complications and how to care for the colostomy

The article is professionally consulted by Master, Doctor Duong Xuan Loc - Gastroenterologist - General Surgery Department - Vinmec Danang International General Hospital

Although ostomy is often meant to be temporary, many ostomy are created to improve quality of life. However, complications of colostomy often cause significant deterioration in quality of life and affect the patient's communication and daily life.

1.1 The colostomy is blocked Cause:
The hole is too narrow in the abdominal wall The anterior part of the colostomy is still damaged, causing narrowing of the lumen of the colonic canal. The colostomy twists a lot during surgery or due to care. The stoma was brought out by the wrong way Hernia of the abdominal wall (obstruction) next to the stoma Treatment: Surgery to redo the stoma, the remedy depends on the damage causing the intestinal obstruction.
1.2 Inflammation of the skin around the stoma The skin around the stoma is inflamed, red, and painful. Usually occurs in the ileostomy type.
Cause:
Feces from the ileum often have a high proportion of water and fluid. Using a bad patch bag, cutting the adhesive base is too wide, causing leakage of waste fluid into the surrounding skin or the patch bag, the glue base. Treatment:
Paste the appropriate bag to limit intestinal leakage around. Skin care: Wash with neutral soap, dry, apply zinc oxide ointment daily. Antibiotics if the infection is severe.

1.3 Abscess around the colostomy Cause:
Due to significant infection during colostomy Due to infection due to post-operative care. Treatment:
Cut sutures, separate part of the colostomy mouth from the edge of the skin to drain pus, change the dressing daily. Anti-infective antibiotics. 1.4 Ulcerative colostomy Cause:
The segment of colon introduced as an ostomy is ischemic due to torsion or inappropriate selection of blood vessels. Some cases can be caused by cancer, causing mesenteric embolism to feed the colon to make an ostomy. follow up more. Repeat surgery, if an ostomy torsion is suspected or if the necrosis extends beyond the fascia of the abdominal wall. 1.5 The colostomy is retracted into the abdominal cavity Cause:
The part of the colon makes the stoma too tight, difficult to fix. Fixing the colon to the abdominal wall is not technically correct Necrosis of the stoma Treatment:
Replacing the colostomy Close the colostomy if possible 1.6 Hernia next to the stoma Cause:
The opening is too wide in the abdominal wall The fixation of the colon wall to the abdominal wall is not correct Treatment:
Stitch narrowing the opening in the abdominal wall Sewing to fix the colon wall to the abdominal wall Close the colostomy if possible

1.7 Prolapse of the colostomy Cause: Usually occurs in the colostomy loop, double barrel, common in children. The colostomy usually lengthens, and occurs suddenly.
Treatment:
Rework the colostomy, do the terminal type. Cut the adhesive sole, the suitable patch Close the colostomy, if it is time to close. 1.8 Bleeding colostomy Cause: There are coagulation diseases that are not checked before surgery; blood clotting disorders due to drug use. Or new coagulation disorders appear on the background of cancer.
Treatment: Sewing to stop bleeding carefully. Use hemostatic drugs.

When recovering from surgery, the patient will need to clean the colostomy bag at regular intervals several times a day. Do not allow the anal sac to be more than half full.
The amount of stool or gas from the digestive tract that enters the bag will depend on the type of anus and the diet, so the patient will definitely not be able to control the amount of stool and gas entering the bag. The diet needs to be systematically consulted and guided so that the patient can take care of the anal sac more actively.
The ostomy bag includes an open or removable bag and a sealed or disposable bag. Some new generation bags are designed with a deodorizing filter and air vent, but the price is quite high. This prevents the bag from popping out of the belly, or breaking when the bag is overstretched.
In addition, the skin around the stoma should be cleaned and kept dry to avoid infection. The border of the anal opening is always pinkish red, sometimes there may be some bleeding, which is common and does not usually last but can recur.

The colostomy significantly affects the daily life of the patient. However, when doing artificial anus will be calculated to be as suitable as possible. The patient can choose to dress normally as before the colostomy. The ostomy bag is designed to fit under clothing and has an air barrier to prevent odors. Odors only come out when the patient removes the bag for cleaning.
At the same time, the patient can conduct activities like daily life. People with an ostomy still continue to work, play sports, and exercise reasonably so as not to injure the colostomy.