Enterostomy
Procedure
Definition
Enterostomy is surgery to create an opening into the intestine through the belly wall. It allows the intestine contents to drain. It may also be done to insert a feeding tube.
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Reasons for Procedure
This surgery is done when a new opening is needed to empty the bowels.
It may also be needed when food can no longer enter the mouth or stomach. A feeding tube is inserted in the opening to provide nutrients.
Possible Complications
Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:
- Excess bleeding
- Problems from anesthesia, such as wheezing or sore throat
- Blood clots
- Damage to other organs or structures
- Infection or skin irritation around the stoma
- Diarrhea
- Intestinal blockage
- Hernia at the incision site
- Feeding tube blockages or leaks
Things that may raise the risk of problems are:
What to Expect
Problems To Look Out For
Call your doctor if you are not getting better or you have:
- Signs of infection, such as fever or chills
- Redness, swelling, excess bleeding, or discharge from the incision or stoma
- Lasting nausea or vomiting
- Pain that you cannot control with medicine
- Pain or swelling in the feet, calves, or legs
- Problems passing urine or stool, including bleeding
If you think you have an emergency, call for medical help right away.
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging
- Cleaning out the colon
Prior to Procedure
The surgical team may meet with you to talk about:
- Anesthesia options
- Any allergies you may have
- Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
- Fasting before surgery, such as avoiding food or drink after midnight the night before
- Whether you need a ride to and from surgery
- Tests that will need to be done before surgery, such as imaging
- Cleaning out the colon
Anesthesia
The doctor will give general anesthesia. You will be asleep.
Description of the Procedure
- An intestinal sac is made inside the belly. The sac is to collect stool. It will lead to an opening in the outer belly called a stoma. From the stoma, the sac will be emptied through a tube.
- The intestine is attached to a stoma in the outer belly. The stoma allows stool to leave the intestine. It collects in a pouch called an ostomy bag.
- To place a feeding tube, the doctor will make an opening in the small intestine. The tube will be placed through this opening. It will be held in place with stitches. The tube will then be brought through the outer belly. It will also be held in place with stitches.
These procedures may be done as an:
- Open procedure—uses a longer incision in the belly
- Laparoscopic procedure—uses many small incisions
How Long Will It Take?
About 30 to 45 minutes. It may take longer if other repairs need to be made.
Will It Hurt?
Pain and swelling are common in the first week. Medicine and home care help.
Average Hospital Stay
The usual length of stay is 2 to 4 days. You may need to stay longer if there are any problems.
Post-procedure Care
At the Hospital
After the procedure, the staff may:
- Give you medicines to control pain or nausea
- Teach you how to care for your stoma and ostomy
During your stay, the hospital staff will take steps to lower your risk of infection, such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chance of infection such as:
- Washing your hands often and reminding and reminding visitors and staff to do the same
- Reminding staff to wear gloves or masks
- Not letting others touch your incisions
At Home
Recovery may take 1 to 2 months. Physical activity will be limited during this time.
Family Doctor—American Academy of Family Physicians
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
Family Doctor—American Academy of Family Physicians
National Institute of Diabetes and Digestive and Kidney Diseases
CANADIAN RESOURCES:
Canadian Association of Gastroenterology
Canadian Digestive Health Foundation
References
- Colorectal surgery considerations. EBSCO DynaMed website. Available at: https://www.dynamed.com/procedure/colorectal-surgery-considerations.
- What is an ileostomy? American Cancer Society website. Available at: https://www.cancer.org/treatment/treatments-and-side-effects/physical-side-effects/ostomies/ileostomy/what-is-ileostomy.html.
- Xian, H. and Zhang, Y. A descriptive, cross-sectional study among Chinese patients to identify factors that affect psychosocial adjustment to an enterostomy. Ostomy Wound Manage. 2018; 64 (7): 8-17.
Contributors
- Marcin Chwistek, MD
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