Dealing with bowel surgery
Thousands of people every week have surgery on their bowels. Some involve a single operation and just a couple of days in hospital. Even if you need more, help is at hand.
Why might I need bowel surgery?
Your bowel is largely divided into the small bowel (also known as the ileum) and the large bowel (the colon). Most bowel cancers and polyps, as well as diverticulitis, affect the large bowel. Inflammatory bowel diseases are autoimmune conditions, in which your body's immune system, which usually fights off disease, mistakenly recognises part of your body as an enemy. They include ulcerative colitis, which affects our colon, and Crohn's disease, which can affect your large and/or small bowel. All these conditions might mean you need surgery. If possible, the surgeon will reconnect the ends of your bowel during the surgery, but sometimes this may not be possible and you will need a stoma.
The lowdown on stomas
'Ostomy' is the Greek word for 'opening', and after some kinds of bowel surgery you will need to have the bowel opening diverted from your bottom (rectum and anus) to an opening on the stomach wall, called a stoma. You will be shown how to fit pouches to collect the waste. Most of these operations are temporary, giving part of your bowel time to rest or recover. After at least a couple of months you may be able to have further surgery to rejoin the two ends of the bowel.
A colostomy is an opening from the large bowel (colon). It's a common procedure - about 60,000 people in the UK have a colostomy - but only about one in 10 of these is permanent. It's usually done for colon cancer, but may be needed if you have inflammation or infection in the large bowel.
An ileostomy is an opening from the small intestine - the contents of your gut are diverted before they reach the large intestine. It is carried out for some kinds of bowel cancer and sometimes for inflammatory bowel conditions such as Crohn's disease or ulcerative colitis. About 9,000 people in the UK have an ileostomy operation each year.
What are the problems with stomas?
After the usual time you need to recover from major surgery, you'll need to know how to deal with possible problems arising. If the area around your stoma gets red, hot and painful, see your GP in case you have an infection. Other common issues include leakage from your stoma or the pouch attached to it, and skin irritation around the area your pouch is attached to. Your stoma nurse should be able to help with these.
Coming to terms with your stoma
It's natural to feel self-conscious when you first have a stoma. Lots of people feel anxious about leaking and smell, and about how their loved one will feel about this new 'addition to their body', as one of my patients calls it. Your GP and stoma nurse will know exactly how you feel, and will be happy to chat to you and your partner.
Your stoma nurse - an invaluable ally
If you have a colostomy or ileostomy, you'll have support from a very special nurse - a stoma specialist nurse. She can advise you about your stoma, including:
- What to expect in terms of recovery time and early teething problems with your stoma
- The practicalities of stoma bags and the equipment that might help minimise the disruption to your lifeHow to change your bags
- How to cope with bathing and even swimming (yes, you can!)
- What to do if you run into problems.
But one of the most important roles of your stoma nurse specialist is to support you in your journey back to a normal life. Because while your stoma will take some getting used to and you will need to do a bit more planning ahead, there is no reason why your life needs to be restricted.
With thanks to 'My Weekly' magazine where this article was originally published.