Sigmoidectomy operation.

Why is an ileostomy necessary?

Ileostomy makes it possible to live!

In order to understand what an ileostomy is, you need to know about the functioning of the digestive system. Food entering the mouth goes to the stomach and stops in the small intestine. Useful vitamins and substances from food are absorbed into the body’s blood. Food that the body is unable to digest passes on and ends up in the large intestine. Undigested food, passing through the large intestine, absorbs water, resulting in a food bolus of dense and thick consistency.

This lump ends up in her end of the colon - the rectum, which ends in the anus. Through it, food debris (feces) comes out. A healthy person, whose digestive system is in order, is able to independently control the process of excretion of feces from the anus. The term ileostomy consists of concepts such as “ileum” and “stoma”. Translated, these terms mean the end part of the small intestine and the opening, that is, the mouth.

Ileostomy is necessary for patients who have suffered certain injuries to the colon, intestines, or diseases associated with the digestive system. With an ileostomy, the end of the small intestine is brought to the surface of the abdominal cavity, where it is attached, while simultaneously forming a new opening to allow the contents to be removed from the intestine. Sometimes, in order to remove food debris from the intestines, it is necessary to create a waste pathway, bypassing the colon. Most often it is created permanently and the person must learn to live with it, although an ileostomy can only be created for a while.

Surgery to close a colostomy

Many patients look forward to operations to close a colostomy, because then a person has the opportunity to live a normal life again and relieve his needs with the help of an anus located not on the stomach, but in the right place. But from the closure of the colostomy to the normalization of stool elimination processes, a long rehabilitation period will have to go through, and the functionality of the large intestine will be established.

What to expect from such an operation and when the recovery period will end can be found in the article below.

How does surgery to close a colostomy work?

A colostomy is an artificially created opening in the large intestine that allows stool to pass out. It is applied in various cases: for problems with the lower intestines, for malignant neoplasms and other factors. Colostomy can be either temporary or permanent.

The operation to close a temporary colostomy is called reconstructive surgery and is the elimination of a previously created stoma.

The operation is performed by a qualified and experienced surgeon and takes place within one hundred to one hundred and twenty minutes. In some cases, the operation lasted up to three hours.

Sometimes the elimination of a colostomy occurs in two stages, the interval between which is several days.

This operation is performed under general anesthesia, and if the patient’s heart is not able to cope with general anesthesia, then the colostomy is not closed until his heart can cope with such a load.

This method of surgical intervention consists of several stages.

If a double-barreled stoma was applied, then an incision is made between the holes; with a previously applied single-barrel colostomy, the length of the incision directly depends on the longitudinal incision of the colon.

After the incision, the section of the intestine where the ostomy was performed is removed.

With a single-barrel colostomy, the two ends of the intestine are connected, and with a double-barrel colostomy, the holes are simply sutured. When closing an end stoma, it is most often accompanied by the removal of that section of the intestine that was cut longitudinally.

It turns out that the intestines will no longer function as before. The most striking consequence of this is rapid bowel movement, which lasts from fifteen minutes to two hours from the moment of eating.

Therefore, to increase the digestibility of foods, you need to eat several times more, but for these purposes, the method of fractional meals is most often used. That is, they eat often, but in small portions.

Thus, the operation to close a double-barreled stoma is easier for both the patient and the surgeon who performs it than the closure of an end stoma with a single opening.

Then the muscle tissue is sewn together, and then the upper sutures are applied using self-absorbing threads. Lastly, the intestines are checked for leaks. Such an operation may also contain additional stages when, for example, a rectal lobe transplant is required.

Contraindications and possible complications when closing a colostomy

It is possible to restore intestinal function to the previous level only in forty percent of all cases.

After such an operation, some complications are possible, which affect both the area where the colostomy was previously placed and the functioning of the intestine, which has not functioned for a long period of time.

The most severe complications arise after the elimination of a terminal single-barreled colostomy, since such a stoma is considered permanent and is placed for the rest of life.

When closing any type of colostomy, the following complications arise:

• prolapse of the rectum from the anus;
• intestinal perforation or rupture in the area of ​​the operation;
• intestinal obstruction in the operated area associated with the accumulation of large amounts of feces;
• infectious-inflammatory or purulent processes in the place where the colostomy was previously located.

Colostomy has a certain number of contraindications:

• atrophy or damage to the sphincter muscles;
• removal of more than thirty percent of the intestine when applying a stoma, in addition to removal from the rectum;
• long course of chemotherapy for cancer;
• atrophy or more than fifty percent damage to the villous epithelium, since this may result in fecal stagnation, which often leads to sepsis.

Recovery in the postoperative period

The rehabilitation period after surgery to close a colostomy is usually several months. And all possible complications often arise when at this moment the patient does not follow all the doctor’s recommendations, or are not followed in full.

When the recovery and rehabilitation period ends is decided only by the attending physician based on diagnostic studies of the intestines.

The most important thing in the postoperative period is to follow a diet and maintain a healthy lifestyle with a strict daily routine.

The diet program during the recovery period looks something like this:

• 3-5 days after surgery only drips with the necessary medications;
• from the fifth to the twelfth day you can only eat liquid porridge with added sugar;
• from the twelfth to the twenty-first day, it is allowed to gradually introduce other foods into the diet, with the exception of raw fruits and vegetables;
• Only after three months have passed since the operation can you start eating apple peels, corn, raw cabbage, legumes, fried and spicy foods.

Summing up

The operation to close a colostomy is one of the stages of reconstructive surgical intervention, in which the temporary artificially created anal opening located on the anterior part of the abdominal wall is eliminated.

One of the main conditions for carrying out such an operation is the absence of obstructions in the intestine along its entire length to the anus.

Also important is the recovery rehabilitation period after such an intervention, which is characterized by a strict daily routine and a strict dietary program for a long time.

Surgery to close a colostomy

updated:

June 26, 2018

Types of ileostomy and their differences

Ileosteloma occurs:

• Single-barrel according to Brook;
• Valve (reservoir) for the cooker;
• Loop according to Thornball;
• Separate double barrel.

Single-barrel ileosteloma involves the end of the ileum being brought to the surface of the skin. In this case, only through the single opening of the stoma does the contents exit the intestine. Usually this type of ileosteloma is done on a permanent basis.

Loop ileosteloma according to Turnbull is performed as follows. An incision is made on the anterior wall of the abdominal cavity and a loop of the small intestine is removed through it, which is fixed there. After this, the anterior wall is dissected, and this type of stoma turns into a double-barreled stoma. Such surgical intervention is required when the patient has severe inflammatory and tumor diseases, in which the patient is unable to perform a bowel movement on his own.

Read: Types of esophageal diseases: characteristic symptoms and treatment

Kock valve-type ileostomy is performed for patients who have undergone coloproctectomy. After a very complex operation, when the patient’s condition improves slightly, a special reservoir is formed from the intestine before making an ileostomy. The ileostomy is then compressed using a muscle cuff, and a catheter is used to empty the reservoir twice a day.

With a separate double-barreled ileosteloma, the small intestine is crossed, and its ends are brought out into separate openings. This method of surgical intervention allows you to easily determine the location of the afferent and efferent loops of the intestine when their anastomosis is required.

How is the operation performed?

It is necessary to carefully care for the skin around the ileostomy

Before the operation, it is necessary to accurately indicate the intended location of the stoma, since a large amount of caustic content comes out of the ileostomy. The end of the intestine is brought out through the abdomen to the surface. In this case, the intestine should not be at the same level with the skin, but protrude somewhat beyond its limits.

This way your clothes won't get dirty when you have a bowel movement. There are no scars with this operation. In order for the surgical intervention to take place without complications and surprises, the patient must be examined for the presence of scars and other pathologies of the skin, since they not only complicate the operation but force one to look for alternative locations for the stoma, which may not be very beneficial for the patient.

The optimal and best place for a stoma is considered to be the area of ​​intersection of the pectineal line and the rectus abdominis muscles. It is advisable to exclude places near which bones and ribs are located from the selection of proposed sites for surgery.

The place where the stoma will be located is indicated so that during the operation it is not possible to use a special template for this and a plate.

When it is discovered that the patient has been operated on in the past or has intra-abdominal inflammation, it is advisable to determine additional locations of the stoma in addition to the main stoma site. In this way, complications such as intestinal edema and reduction in the size of the mesentery can be avoided. The patient's abdominal cavity is marked by the professional surgeon performing the operation or his assistant using a permanent marker.

A single-barrel ileostomy is done when it is necessary to remove two intestines - the colon and rectum. This surgical intervention is necessary for people suffering from Crohn's disease and ulcerative colitis of a nonspecific course. It is very rarely applied to patients who have intestinal bleeding, polyposis, severe constipation, or cancer.

What can a patient expect after surgery?

Complications after surgical intervention in the abdominal cavity - ileostomy, which a patient can expect, are usually divided into three periods:

1. before the operation;
2. early postoperative;
3. late postoperative.

With an ileostomy, the patient has loose stools, so leakage can be expected. Various defects of the skin, their unevenness or incorrect incision can lead to the development of stenosis. If the narrowing is small, barely noticeable, then it can be corrected and expanded, but if on the contrary, then additional surgery will be required.

Colostomy bag

Through the development of stenosis, the patient may experience unpleasant complications, including intestinal ischemia and relapse of Crohn's disease. It is possible that some time after surgery the patient will experience dilatation of the ileostomy, prolapse of the stoma, or a hernia.

Read: Bloody Diarrhea: Signs of Bleeding, Risk Factors and Treatment Measures

Within two months after the operation, the hole where the stoma is located narrows, and accordingly, it decreases in size. This process lasts about eight months. Therefore, the patient needs to carefully monitor all changes that occur and take care of the stoma accordingly.

During this period, the patient is closely monitored by an ostomy physician. At the appointment, he carefully examines the stoma itself and the skin around it. If the patient notices skin leaks, stomas, allergic reactions, or feels irritation, he needs to consult a doctor who will prescribe the appropriate treatment.

If the patient cannot independently select a protective plate with the appropriate hole, it is better to consult a doctor. Just in case, you need to remember that the correct size of the hole is one that does not exceed half the size of the stoma mouth. To avoid skin irritation and smudges, you need to lubricate the places where the plates are attached, there are scars from scars, and lubricate the skin folds with a paste that contains pectin. In case of fungal rash on the skin, antifungal powder must be applied before putting on the plate.

What is a stoma?

The term “ stoma ” (ostomy, Greek) refers to a surgically created opening connecting the lumen of an internal organ to the surface of the body. There are different types of ostomies, which are named after the organs on which they are placed.

Since our site is dedicated to the topic of intestinal and urinary stomas, all definitions will be associated in the future only with these types of stomas.

A stoma is an opening of the intestine, surgically formed after removal of all or part of the intestine or bladder, brought to the anterior abdominal wall, intended to drain the contents of the intestine or urine.

The stoma does not have a closure apparatus, so ostomy patients do not feel the urge and cannot control the process of emptying. The stoma is devoid of painful nerve endings, so pain is not felt. Pain, burning or itching that occurs may be associated with irritation of the skin around the stoma or increased intestinal peristalsis (work).

The need for an ostomy occurs when the bowel or bladder is unable to function. This may be due to a birth defect, illness, or injury.

An intestinal stoma is often called an unnatural anus, since bowel movement does not occur through the natural anus, but through an opening formed on the anterior abdominal wall.

Stomas can be classified according to the following parameters:

An ostomy can be temporary or permanent. A temporary stoma can be imposed if it is not possible to achieve good preparation of the intestine for surgery (if intestinal patency is impaired due to a tumor or adhesions). Also, a temporary stoma may be required to limit the passage of intestinal contents through the intestine so that the surgical site is not injured by feces. Usually, after the temporary stoma is closed, bowel function returns to its previous level.

An ostomy can be permanent or temporary. A permanent stoma cannot be eliminated during further treatment of the patient, since the intestinal obturator apparatus is missing or irreversibly damaged, or there is no possibility to quickly restore the continuity of the intestine.

Stomas can be single-barrel (that is, one intestinal trunk is removed through an opening in the anterior abdominal wall) or double-barrel. Moreover, the latter are divided into loop stomas (that is, two trunks are in close proximity to each other and are brought out into one hole) and separate double-barreled stomas, when there are two openings on the anterior abdominal wall at some distance from each other. In this case, when using stoma care products, colostomy bags should not overlap each other (even if the distance between stomas is very small). With such stomas, one trunk is active, and bowel movements occur through it. A colostomy bag is glued to the active barrel. Another trunk may be needed to remove mucus or for medical procedures. It can be covered with a mini-cap (a closed bag of minimal capacity) or a gauze napkin.

Depending on the section of intestine brought to the anterior abdominal wall, the following types of intestinal stomas are distinguished: colostomy (for removal of the large intestine) and ileostomy (for removal of the small intestine).
Colostomy
Depending on the site of application, there are several types of colostomy: cecostoma, ascendostomy, transversostomy, descendostomy, sigmostoma.
With a colostomy, bowel movements usually occur 2-3 times a day, the stool is formed (with a sigmostoma) or semi-formed (with other types of stoma). Ileostomy
With ileostomy, bowel movements occur very often, almost constantly, the stool is liquid and acrid.
A common problem with an ileostomy is diarrhea, which can lead to dehydration and loss of electrolytes, minerals and vitamins. Therefore, it is very important to consume plenty of fluids. Urostomy
A urostomy is formed when it is necessary to remove the bladder. Urine diversion is performed through a selected section of the intestine, to the upper end of which the ureters are sutured, and the lower end is brought out onto the anterior abdominal wall. Urine output is constant and uncontrollable. With a urostomy, there is a constant flow of urine through the stoma.

How does a stoma change?

The size and shape of the stoma may vary. After surgery, the stoma is usually swollen, bleeds a little, and is bright red in color. Over time, the postoperative wound heals, the swelling subsides, the size of the stoma decreases, and its color becomes red-pink.

After 4–6 weeks, the stoma will be fully formed. Don't be alarmed if you notice that your stoma has gotten a little bigger or smaller. This occurs as a result of contraction or expansion of the wall of the excreted intestine.

However, you should regularly monitor the size of your stoma. The size of your stoma should be determined weekly for the first 6 to 8 weeks after surgery, and then monthly for the first year. In the future, it is recommended to determine the size of the stoma every six months.

Measuring the stoma is necessary for the correct selection of stool/urine receivers.

Complications of stoma and their prevention

Often, ostomy patients have to deal with various types of complications associated with the presence and functioning of an intestinal or ureteral stoma on the abdominal wall. These complications cause serious concern for patients, so we will dwell on them in more detail.

Skin irritation in the area of ​​the stoma (periostomy dermatitis) Dermatitis is observed quite often and is a consequence of mechanical irritation (frequent changes of colostomy bags, careless treatment of the skin), or chemical exposure to intestinal discharge or urine (leakage under the plate, poorly fitted, leaky colostomy bag). Its manifestations: redness, blisters, cracks, weeping, oozing ulcers on the skin near the stoma. Skin irritation causes itching, burning, and sometimes severe pain. An allergic skin reaction to devices and stoma care products is possible; if it is very pronounced, you should stop using adhesive bags for a while. In such cases, the question of choosing the type of colostomy bag should be decided by the doctor. Often the cause of skin complications is simply insufficient skin care in the stoma area. In case of skin irritation around the stoma, consultation with a proctologist, dentist and dermatologist is necessary.

Bleeding from the stoma In most cases, it is caused by damage to the intestinal mucosa due to careless stoma care or the use of rough materials. The edge of a tight hole in the plate or the rigid flange of a colostomy bag can also injure the intestine and cause bleeding. Bleeding usually stops spontaneously. But if it is prolonged and abundant, you need to consult a doctor.

Narrowing (stenosis) The stoma should be passable and the index finger should be free to pass through. The narrowing is usually caused by inflammation in the stoma area in the early postoperative period. If the narrowing reaches a degree that interferes with bowel emptying, surgery must be performed to widen the opening. If your stoma is narrowed, you should not take laxatives without consulting a surgeon!

Stoma retraction (retraction) This is a retraction of the intestinal wall below the skin level, circular or partial. The presence of a funnel-shaped depression significantly complicates the care of the stoma and requires the use of special two-component colostomy bags with a convex (concave) plate and additional care products (special pastes for leveling the surface of the skin and protecting it). If these measures are ineffective, surgical treatment is undertaken.

Prolapse of the stoma (prolapse) A small (3-4 cm) prolapse of the mucous membrane occurs quite often, but, as a rule, is not accompanied by a violation of the patient’s condition and the function of the stoma. Complete loss of all layers of the intestinal wall disrupts the function of bowel movement, makes it difficult to care for the stoma, and can lead to strangulation of the intestine. The prolapse increases with standing, coughing, and physical activity. In a supine position it is sometimes reduced; In most cases, the prolapsed intestine can be set back by hand. In case of repeated or persistent loss, you must consult a doctor, and if you are pinched, immediately!

Hypergranulation in the stoma area Sometimes polyp-like growths form at the border between the skin and the mucous membrane, which bleed easily. They are usually small, a few millimeters in diameter. Whitish, bleeding blisters may appear on the mucous membrane. In all such cases, you should consult a doctor. The problems, complications and their prevention in patients with urinary tract stomas (urostomies) are similar to those faced by patients with intestinal stomas.

Hernia in the area of ​​stoma A hernia in the area of ​​stoma (parastomal hernia) is a protrusion of internal organs around the stoma due to weakness of the muscle layer of the abdominal wall at the site of the stoma. This is a common complication of colostomy; with ileostomy it is less common. The risk of a hernia increases with obesity, as well as prolonged coughing. Patients even with a small hernia may experience pain, constipation, and difficulty using colostomy bags.

A parastomal hernia can become strangulated; in such cases, treatment is only surgical. To prevent this complication, during the first time after surgery (2-3 months), patients wear a specially selected elastic bandage. The bandage is used for parastomal hernia and intestinal prolapse if surgical treatment is impossible due to concomitant diseases.

Rules for using the bandage:

1. The bandage is put on while lying down.
2. The bandage is placed over the colostomy bag.
3. Cutting holes in the bandage in the projection of the stoma is absolutely unacceptable.

Diet and proper foods for ileostomy

The menu of a patient who has undergone an ileostomy is practically no different from the diet of a healthy person. The main thing is that the food is varied and nutritious, containing foods rich in microelements and vitamins. Each patient must independently determine which foods are best for him and which are best avoided or consumed in moderation. At the same time, you need to remember that the faster the patient decides on suitable food products, the easier it will be for him in the future, he will be able to avoid unpleasant and uncomfortable situations.

You need to learn to identify among the variety of food products those that cause diarrhea, constipation, and severe gas formation in the intestines. People who have undergone an ostomy should remember that it is better to eat at least three times a day, and meals should be taken at the same time. Food should be chewed thoroughly. The more liquid food and non-carbonated drinks are present in the diet, the better for the patient. Corn, nuts, various types of mushrooms and similar products are difficult to digest by the intestines, so it is advisable to exclude them from the diet or consume them on rare occasions.

Since people who have had an ileostomy have a slightly different digestive tract, food does not enter the large intestine, and they risk becoming dehydrated.

To avoid this, they must drink as much fluid as possible, at least three liters per day. If some are worried that as a result of drinking a large amount of liquid, the amount of discharge from the ilestomy will significantly increase. This is not so, the volume of discharge does not depend on the liquid consumed, but rather on the large amount of food consumed, which contains foods that can cause fermentation and fiber that is difficult to digest by the digestive tract.

Read: Why does bleeding from the anus occur? What to do?

Other unpleasant consequences of ileostomy

You can live a normal life with an ileostomy!

One of the unpleasant consequences of this surgical intervention is considered to be a liquid discharge. According to statistics, normally about 400 ml of the entire contents are released from the ileostomy in just one day. Therefore, the patient must always monitor personal hygiene and have a sealed colostomy bag available. In addition, it is necessary to carefully care for the skin around the stoma to avoid irritation and allergic reactions.

At first it will be difficult and unusual to do this, but gradually the patient will acquire the necessary skills and will be able to cope with the task easily and very quickly. If there is too much discharge, you need to reduce the consumption of cabbage, beets, apples, pears, dried fruits, plums, and other foods containing fiber in your diet. Replace them with boiled rice, jelly and yoghurt.

If the patient experiences increased gas production, the amount of gas in the bag can be reduced. For this purpose, special bags with filters are used, with the help of which excess gases can be removed from the bag. The filters are equipped with deodorizers, so the unpleasant odor can be masked. Also, to reduce the formation of gases in the ileostomy, it is necessary to avoid carbonated drinks, beer, and foods that cause fermentation.

Discomfort and inconvenience can be caused by the specific odor released by the contents of the ileum. Some foods especially enhance the unpleasant odor, such as pickles and various marinades, onions, garlic, even herbs - parsley and dill. Products that contain large amounts of protein, especially canned fish and eggs, emit an unusually foul smell. You can avoid such troubles by refusing to consume these products. You can also use specially designed deodorants for the colostomy bag.

Today there are also special products that turn the liquid contents of the ileostomy into a gel.

Despite the fact that the patient who has undergone an ileostomy will experience some unpleasant situations at first, he will feel inconvenience and discomfort among others, this does not mean the end of a normal life. Cases of such operations are not isolated; many do not even suspect that they are communicating with a person who has undergone such a complex operation. And all only because the patient not only accepted this turn of life, he learned to live in a new way and made sure that his flaw was invisible to others.

Types of stomas What is a colostomy, ileostomy, urostomy, see the video:

Read along with this article:

• Colonostomy: types and lifestyle after surgery
• Digestive processes that occur in the small intestine
• Intestinal anastomosis: features, preparation, purpose
• Human small intestine: anatomy, functions and process...
• Human intestine: intestinal length, general information, features...
• Manometry – examination of the esophagus and stomach
• Anatomy of the colon and its main functions
• Irrigoscopy as a method of intestinal examination. General information
• Anatomy of the human intestine: what's what

Features of the operation to close a colostomy and possible complications

Any patient perceives the closure of a colostomy with joy, because he has a chance, although not immediately, to send his needs through the anus, located at the end of the rectum, and not on the stomach, and to do this at his own request.

However, to achieve the long-awaited normalization of stool, you need to go a long way to restore the functioning of the large intestine.

How is the operation to close a colostomy performed and when will the period of life associated with many inconveniences, called life after a colostomy, end?

Colostomy surgery

Unlike an ileostomy, a colostomy is an opening for removing feces from the large intestine.

A colostomy has some advantages over an ileostomy:

1. Although uncontrollable, the urge to defecate is an opportunity to mentally prepare in a few minutes.
2. The feces are practically formed - the skin around the stoma is subject to less irritation.
3. The course of the operation to apply a colostomy, just like the course of the operation to close it, consists of fewer stages.
4. The diet is not so strict.
5. The recovery period takes 2-3 times less time than if a stoma for the small intestine is closed.

The course of the operation to close a colostomy consists of the following stages:

1. With a double-barreled stoma, an incision is made between two holes, and with a single-barrel stoma, the length of the incision depends on the length of the longitudinal incision of the colon, which was made before the colostomy.
2. The section of intestine where the ostomy was performed is removed.
3. With double-barrel, the holes are sutured, and with single-barrel, the functioning ends of the intestine are connected. As a rule, the closure of an end stoma (single-barrel type) is carried out with the removal of a section of the intestine that was cut longitudinally, plus 10-15% beyond this length, and this is already a resection of the intestine, that is, the intestine will not function as before the ostomy. The consequences are expressed in rapid bowel movements from 15 minutes to 2 hours after eating. Accordingly, in order to increase the absorption of nutrients, you need to either eat several times more, or switch to high-calorie and frequent meals 5 times a day or more. Therefore, the procedure for closing a double-barreled stoma is easier for the surgeon and the patient than the operation for closing a single-hole stoma.
4. The muscle tissue is carefully sewn together and the top suture is applied. Sutures are applied with self-absorbing threads such as catgut.
5. The degree of tightness of the intestinal section is checked.

The operation may include additional steps, such as transplanting a section of the rectum or another section of the large intestine if a suitable donor is available.

The operation to remove a colostomy lasts on average 100-120 minutes, and in some cases up to 3 hours.

Despite the fact that reconstructive surgery is entrusted only to professionals, due to the physiological characteristics of the body of some patients, for example, heart problems, colostomy and stoma elimination, it can be carried out in 2 stages with a break of several days. If the patient cannot withstand the effects of general anesthesia, the colostomy is not closed until the heart can cope with the required load.

Complications and contraindications

It is possible to completely restore the former functionality of the intestines in 40% of cases. Often, after closing a colostomy, complications may arise both in the area of ​​the stoma where the surgical actions were performed, and in the functioning of the intestine after a long period. The main complications arise when removing a single-barrel (end colostomy, since this type is not temporary.)

When removing both single-barrel and double-barrel stoma, the following complications may occur:

• Perforation or rupture of the intestine in the stoma area.
• Rectal prolapse.
• Suppuration or inflammation in the area of ​​the former stoma.
• The occurrence of obstruction in the ostomy area due to the accumulation of feces in the area of ​​the sutures.

You cannot do a colostomy:

• if the sphincter muscles have atrophied or been damaged;
• after a long course of chemotherapy;
• if the villous epithelium is atrophied or damaged by more than 50%, fecal stagnation with subsequent sepsis is possible;
• if during the stoma more than 30% of the intestinal tract was removed, except for the output from the rectum.

Recovery

As a rule, the complications described above arise when restorative procedures are not properly performed in the postoperative period, which can last from several weeks to several months.

The end date of the postoperative rehabilitation complex can only be announced by the attending physician after diagnosing the intestinal condition.

Postoperative rehabilitation includes an appropriate diet and a strict daily routine.

The diet looks like this:

• the first 3-5 days after surgery - droppers with the necessary substances;
• 5-12 days – liquid porridge with sugar;
• 12-21 days – foods, except raw vegetables and fruits, are gradually introduced into the diet;
• raw cabbage, apple peels, fried and spicy foods, as well as legumes and corn should not be consumed for 90 days or longer after surgery.

Diet goals

After an operation to close an intestinal stoma, proper dietary nutrition is aimed at restoring and normalizing stool, ensuring the uninterrupted functioning of the digestive system.

Products approved for consumption prevent constipation, the formation and accumulation of excessive amounts of gas. After surgery, the diet promotes proper excretion of feces and smooth functioning of the digestive system.

Principles of nutrition

After closing an intestinal stoma, proper nutrition can significantly speed up the patient’s recovery process and prevent complications.

Dietary nutrition has the following principles:

• refusal to consume a number of prohibited foods;
• chewing thoroughly ;
• fractional meals - in small portions up to 5 times a day;
• a larger volume of food should be consumed for breakfast, lunch, and light dinner;
• compliance with the drinking regime - up to 1.5 liters of plain water per day;
• refusal of salt.

The greatest dietary restrictions occur in the period after surgery. When the functioning of the digestive system is fully restored, the list of permitted products will gradually expand. A return to the usual diet with minor restrictions is possible 1.5-2 months after the closure of the intestinal stoma.