If you’re scheduled to undergo ostomy surgery, it’s understandable that you’d have a lot of questions. One of the most common questions ostomates (i.e. those with an ostomy) have is “how painful is ostomy surgery?”

We have good news for you — while getting an ostomy marks a big change in your life, the surgery itself is normally uncomplicated and should be relatively painless. The anesthesiologist will put you under general anesthesia and often, the surgery is done laparoscopically which means the operation is performed through small incisions in the skin using highly specialized equipment and cameras., 

To ensure you’re fully prepared for your ostomy surgery, this article will help answer some of the most common ostomy questions.

What Is An Ostomy?

An ostomy refers to one of several medical surgeries that changes how body waste, such as urine and stool, exits the body, usually by means of a catheter or an ostomy pouch. 

There are many reasons why a person’s bowels are no longer able to function normally such as colorectal cancer or trauma or injury to the bowels. Because the intestinal system is essential for survival, an ostomy can present a solution.

An ostomy changes the flow of the body’s intestines away from the problem source and creates a shortcut that allows the body to continue functioning properly. 

If you think of the intestines as a highway, an ostomy would essentially be rerouting traffic away from an accident and sending the travelers to a new exit ramp. This keeps traffic flowing and enables the body to keep going. By performing an ostomy, the doctor surgically creates the off-ramp (called a stoma) for the traffic that will bypass part of the gastrointestinal process before things arrive at the damaged or malfunctioning part of your body, which could be anything from the rectum to the kidneys.

And to do that, the ostomy might involve procedures such as a colostomy, a urostomy, or an ileostomy, depending on the individual patient’s needs.

Why Is This Necessary?

Ostomy surgery has to be performed when patients suffer from a serious condition with their bowels, which means there is an issue in the upper or lower intestines that is negatively affecting the body’s gastrointestinal (GI) tract and function. Ostomy surgery is only performed for very serious gastrointestinal problems, so people experiencing constipation or brief spasms of intestinal cramps probably won’t need an ostomy, although any concerns should be communicated to your primary healthcare provider. 

An ostomy might be necessary for anyone suffering from colon or rectum cancer, injuries to either the big or small intestine, long-term bowel inflammations that result in irritation and sores in the GI tract (think ulcerative colitis or Crohn’s disease), any bowel obstruction that results in the normal flow of solids and fluids no longer functioning properly, or when pouches in the colon become inflamed or infected (also known as diverticulitis). 

What To Expect

Depending upon the individual patient’s needs, the surgery will involve removing part of the patient’s bladder or bowels that has become too damaged to recover without help. When that happens, the doctor will create an opening on the outside of the abdomen, called a stoma, that will allow waste to be removed from the body. So rather than exit the body through the rectum, the waste will bypass part of the GI tract and be removed through the stoma. 

Once passed the stoma, waste will then be collected either by the ostomy pouch, also referred to as an ostomy bag or j-pouch, on the outside of the body. Depending on the individual patient’s situation, the ostomy can be temporary or permanent. Generally, there tend to be three types of ostomies: urostomy, which involves the bladder; ileostomy, when the problem occurs in the small intestine; and colostomy, when the large intestine has a serious problem.

1. The Urostomy

When a patient’s bladder becomes diseased or defective, a urostomy can be performed to divert urine away from its normal route through the body. The surgeon will surgically remove a section from the end of the small bowel, the ileum, or the start of the large intestine, the cecum. The removed section then gets transformed into a passageway, or conduit, for the urine to leave the kidneys and get to the stoma. In some cases when the bladder has been deemed too damaged for repair, the urostomy can involve the complete removal of the bladder.

2. The Ileostomy

If the small intestine has stopped functioning properly, the path to the stoma gets created through an ileostomy. The surgeon goes to the lowest part of the small intestine and brings that part through the abdominal wall, and could involve the removal of some or all of the colon.

3. The Colostomy

When the problem has occurred in the large intestine, the doctor might recommend a colostomy. This process involves the stoma being made from the large intestine, specifically the colon or rectum.

Both the ileostomy and the colostomy will result in the loss of normal bowel movements, although location plays the deciding factor in which surgery the patient will need.

It should also be noted that, as with a urostomy, the level of work involved with an ileostomy and colostomy depends on the individual patient’s needs. If the damaged area can be treated, the work performed during an ostomy might not be permanent. Therefore, it’s important to learn as much about the procedure before it happens.

How To Prepare for Ostomy Surgery

As with any medical procedure, the patient’s first and best resource will be their doctor and surgical team. While online information can be helpful, you should ultimately direct your questions to the people who will be performing/attending your surgery. Every patient has a unique situation, and the healthcare professionals who know your unique medical situation and history will have the best answers.

While you should direct any medical questions to your doctor, there are some additional resources that might be helpful as well. Online resources such as the Better Health Ostomy Resource Center or the United Ostomy Association of America provide relevant information that is vetted by healthcare professionals for accuracy.

Prior to the surgery, your surgeon will be able to explain what the operation will involve and how the stoma will work, including where it will be physically located on your body and whether it will be temporary or permanent. The surgeon may also take this time to discuss ostomy supplies and potential risks of the surgery as well as what you can expect during the recovery period.

The surgeon and the ostomy nurse should also explain how the stoma works, the importance of getting the stoma and ostomy pouch to fit, the cost and location of ostomy supplies, whether your medical insurance will cover the surgery, lifestyle changes to diet/work/sex life, and the ability to travel and visit friends/family.

If you have questions about your ostomy surgery and want to speak to an ostomy peer coach, sign up here for a free ostomy consultation.

Organizations such as Better Health and the United Ostomy Associations of America can also provide information about quality of life, ostomy care, ostomy appliances and supplies, skin care, support groups, and other health information 

Things to Watch For

As with any medical procedure, complications may occur. Common ostomy complications can include damage to the surrounding skin and the skin barrier of the stoma, blockages or leakage, or any complications with the pouching system. 

The most important aspect to monitor after surgery will be the stoma and its pouching system. Special care should be taken in making sure they connect correctly, and the connection could change due to a hernia or the stoma narrowing.

For more information about your ostomy surgery, how to find the best ostomy products for you or questions about how your ostomy affects your diet and daily life, call us! We’re available at 415-475-8444 or www.joinbetter.com

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