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Crohn's Disease Forum » Surgery » Stoma Subforum » Some basic questions


11-08-2011, 11:25 AM   #1
chrisnsteph1022
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Some basic questions

Forgive my ignorance. I don't know anyone with a bag, and I've never even had surgery for the Crohn's. I'm just curious about some things.

What exactly is a stoma? Is it the piece of intestines that sticks out?
How does it stay in place and not go back in your body, leaving a hole?
For temporary ones, what happens to the disconnected colon? Does it just sit in there, open-ended?
How does the bag attach to the stoma? Is there a clamp that goes around it, or does it just stick on? If adhesive, doesn't that hurt every time you pull it off to empty it (like ripping off a bandaid)?
If you wear snug clothing, doesn't that smush the contents of the bag out? Or back into the stoma?

I think that's all for now. I hope nothing came across offensive. I'm truly curious how these things work, in case I ever need one.
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11-08-2011, 12:44 PM   #2
Gav
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Forgive my ignorance. I don't know anyone with a bag, and I've never even had surgery for the Crohn's. I'm just curious about some things.

What exactly is a stoma? Is it the piece of intestines that sticks out?
How does it stay in place and not go back in your body, leaving a hole?
For temporary ones, what happens to the disconnected colon? Does it just sit in there, open-ended?
How does the bag attach to the stoma? Is there a clamp that goes around it, or does it just stick on? If adhesive, doesn't that hurt every time you pull it off to empty it (like ripping off a bandaid)?
If you wear snug clothing, doesn't that smush the contents of the bag out? Or back into the stoma?

I think that's all for now. I hope nothing came across offensive. I'm truly curious how these things work, in case I ever need one.
Hi Steph,

No need to apologise. You are showing no ignorance. These are valid questions for someone who hasn't had a stoma! I'll try to answer to the best of my knowledge!

1/ What exactly is a stoma? In an ileostomy, it's part of the terminal ileum that has been pulled through a hole in the stomach so stool bypasses the colon and comes out of the stoma instead. In a colostomy it's part of the colon that forms the stoma end.

2/ Is it the piece of intestines that sticks out? Yup, see above!

3/ How does it stay in place and not go back in your body, leaving a hole? The end of intestine that forms the stoma is pulled out and then turned inside out and stitched to the skin through to the intestine (if that makes sense...it's tough to describe without a picture)


4/ or temporary ones, what happens to the disconnected colon? Does it just sit in there, open-ended? Some people have loop ileo. In this case you the upper end of the colon usually comes out in the same opening as the stoma and the bag goes around both the stoma and this end, which is called the mucous fistula. Others have the operation and the surgeons leave a rectal stump behind, which is a closed section of the colon around 6" to 12" from the rectum. This can be removed later on, or in some cases, worked on with the small intestine to create a J, S or even W Pouch (ileo-anal pouch). That operation is usually one for UC and not Crohn's patients.


5/ How does the bag attach to the stoma? A hole is cut in the flange of the stoma and this sticks to the skin around the stoma

6/Is there a clamp that goes around it, or does it just stick on? If adhesive, doesn't that hurt every time you pull it off to empty it (like ripping off a bandaid)? There are plenty of different types of flanges on stomas to suit different types of skin and plenty of products to protect the skin underneath while the flange is sticking to it. I use a product to protect the skin and spray it on before I stick the bag on. I then use another spray product to help remove the stoma bag flange with ease. I do not have any pain removing it.

7/If you wear snug clothing, doesn't that smush the contents of the bag out? Or back into the stoma? Not really. I wear a tight waistband at work for support and to help muffle noise. It's never stopped the flow. Occasionally it can hold up the stool closer to the top of the bag, but it eventually finds it way down.

I hope that helps. As I said I have answered to the best of my knowledge. However, it may not be the same as other ostomists see it. I've had my 4 years but still see myself as a learner!!

Gav
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11-08-2011, 01:06 PM   #3
Nyx
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Gav pretty much covered everything I was going to say...lol
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Crohn's Diagnosis: May 2006
Current meds: none
Surgeries: Colostomy, December 2009

"Never trust a fart." Jack Nicholson, The Bucket List

Oscar is awesome! Loving my life with my stoma (with a hint of poo)!!

11-08-2011, 01:41 PM   #4
chrisnsteph1022
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That was very helpful! Thank you!
11-08-2011, 01:48 PM   #5
Misty-Eyed
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Oo how funny. I was just looking at the following page last night which explains it well and also has diagrams so you can see what Gav expertly explained above!

http://www.coloplast.co.uk/ostomycar...stomyiscreated
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'You can't change the past but you can ruin the present by worrying about the future.'

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Panproctocolectomy and terminal end ileostomy October 2011.
11-08-2011, 02:09 PM   #6
Terriernut
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Great questions, and great answers!!
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DX Crohns Feb 2011, symtoms 1997, 2009 and then WHAM! Emergency surgery for perforated sigmoid, fistula through fallopian tube, septic and near dead: Colostomy-Stan was born 22/12/10. Another parastomal hernia, his name is Ollie and he is MONSTER size!
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11-08-2011, 02:12 PM   #7
chrisnsteph1022
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So does the ileum eventually heal into the skin? Or are there always stitches there, holding it in place? When/if it's reversed, what happens to that big hole in your abdomen?
11-08-2011, 02:17 PM   #8
Terriernut
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Yes, it heals nicely. The skin around the stoma can get irritated easily, so it's important to take good care of it. Oh, no, the stiches are removed after a couple of weeks.

The folks I've seen that have had reversals have a round little scar, not too bad I might add.

Misty
11-08-2011, 02:18 PM   #9
Misty-Eyed
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Yeah it heals into the skin. I asked the stoma nurse because I was curious too. Apparently back in the very early days of stomas, they didn't turn the end of the intestine back on itself and sew it up, they just had the end of the intestine sticking out of the skin. The intestine actually used to close up and obviously was a major problem. Turning it back on itself like they do now prevents this problem completely! Ah modern medicine!

I think they just sew it all back up again. The hole isn't actually that big. Mine is only about an inch in diameter.
11-08-2011, 02:29 PM   #10
chrisnsteph1022
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Thanks for answering my silly questions. I've always wondered, but didn't want to sound stupid or offend. The pictures in the other thread have been very helpful. To be honest, I don't think I'd deal well mentally if I ever needed a stoma, but it does help to be more informed. I like to know all the details.
11-08-2011, 02:29 PM   #11
Terriernut
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Oh, something important to add (sorry, blonde moment) is that the nerves are cut. Therefore the stoma doesnt 'hurt' as such. Not that it doesnt have feelings...Stan gets his feelings hurt frequently. But its more the surrounding tissue that can hurt, not necessarily the actual stoma.
11-08-2011, 02:34 PM   #12
Terriernut
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Thanks for answering my silly questions. I've always wondered, but didn't want to sound stupid or offend. The pictures in the other thread have been very helpful. To be honest, I don't think I'd deal well mentally if I ever needed a stoma, but it does help to be more informed. I like to know all the details.
There ARE no silly questions! It doesnt offend at all! Usually by the time you need a stoma, its either an emergency (like mine and Cindy's) or it's after everything has been exhausted. And I have to say, when you reach that point, a stoma is a lifesafer and a godsend. Sometimes I wonder why it isnt offered before it comes to that point. Temporary stomas are really a lifesaver and a huge help to so many. Permanent stomas as well, truly give lives back. And if it wasnt for 'Stan' I'd be dead, truly. You will know if you get to that point. I hope you dont ever have to. But if you do....thank goodness for this great group of folks here! If it wasnt for them, I dont know what I'd have done!
Misty
11-08-2011, 09:26 PM   #13
Misty-Eyed
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Yeah I agree with Misty. I'd rather people ask because there's such a taboo around 'having a bag' and the more people know, the better.

I remember back in the day when I saw Kello's photos. Does anyone know what happened to her, by the way?? And I remember thinking the same and that having a stoma was a really scary thing. But in all honesty it's just another one of those thing that we deal with as it's happening. The life of a Crohnie isn't easy by any means, we have to take drugs with horrible side effects, go to the loo loads, have sore bums, mental break downs. But if we know something is going to make us feel better then we are going to do it. Because we are strong and quite frankly we want our lives back!

I also think you'd be stronger than you realise. Most people are
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