What causes ostomy

What Causes an Ostomy?

An ostomy is a surgical procedure that creates an opening, called a stoma, on the surface of the abdomen. This stoma allows waste products from the digestive or urinary system to be diverted out of the body into a collection pouch worn externally. The need for an ostomy arises when a portion of the bowel (intestine) or urinary tract is diseased, damaged, or needs to be removed or bypassed. This diversion is a life-saving measure that allows the affected part of the body to heal or to manage chronic conditions.

Common Medical Conditions Leading to Ostomies

Inflammatory Bowel Disease (IBD)

Inflammatory Bowel Disease is a group of chronic inflammatory conditions affecting the digestive tract. The two main types are Crohn's disease and ulcerative colitis. In severe cases, inflammation, ulceration, or blockages can render a portion of the bowel non-functional. Surgery may be required to remove the diseased segment, and an ostomy is often created to divert waste away from the remaining bowel or the surgical site, allowing it to rest and heal. For some individuals with IBD, an ostomy may be temporary, while for others, it can be permanent.

Bowel Cancer

Colorectal cancer, or bowel cancer, is a frequent reason for ostomy surgery. If a tumor is located in the colon or rectum, surgery to remove the cancerous section is often the primary treatment. Depending on the location and extent of the cancer, the surgeon may need to create an ostomy to divert stool. For example, if the rectum is removed, a colostomy (an ostomy of the colon) is typically necessary. In some instances, the ostomy might be temporary to allow healing after a difficult surgery or radiation therapy, while in others, it may be permanent if the bowel cannot be reconnected.

Diverticulitis

Diverticulitis occurs when small pouches, called diverticula, that form in the wall of the colon become inflamed or infected. In severe or recurrent cases, diverticulitis can lead to complications such as abscesses, perforation (a hole in the bowel), or obstruction. If these complications occur, surgery may be necessary to remove the affected part of the colon. An ostomy is often created during this surgery to divert fecal matter away from the inflamed or damaged area, promoting healing and preventing further complications. This ostomy may be temporary to allow the bowel to heal before being reconnected.

Bowel Obstruction

A bowel obstruction occurs when the passage of contents through the small or large intestine is blocked. This blockage can be caused by various factors, including adhesions (scar tissue from previous surgeries), hernias, tumors, or inflammatory conditions. If the obstruction is severe or cannot be resolved non-surgically, surgery may be required to remove the blockage or the affected bowel segment. In such cases, an ostomy may be created to divert waste, especially if the bowel has been significantly damaged or rejoining the bowel is not immediately feasible.

Trauma and Injury

Accidents, such as severe blunt force trauma to the abdomen or penetrating injuries (like gunshot or stab wounds), can cause significant damage to the intestines or other abdominal organs. If the bowel is perforated, ruptured, or severely damaged, surgical intervention is necessary. An ostomy might be created to divert waste and allow the damaged bowel to heal. These ostomies are often temporary, intended to be reversed once the individual has recovered from the initial injury and the bowel is deemed healthy enough for reconnection.

Other Causes

Beyond these common conditions, ostomies can also be necessary due to:

• Congenital Abnormalities: Some babies are born with conditions affecting their digestive or urinary systems that require an ostomy at birth, such as imperforate anus or gastroschisis.
• Benign Tumors: Non-cancerous growths in the bowel that cause obstruction or require removal can sometimes lead to an ostomy.
• Fistulas: An abnormal connection (fistula) between two organs or between an organ and the skin can sometimes necessitate an ostomy to divert waste and allow the fistula to heal.
• Infections: Severe abdominal infections, like peritonitis or abscesses, that compromise bowel integrity might require ostomy surgery.
• Radiation Enteritis: Damage to the bowel from radiation therapy, often used to treat pelvic cancers, can cause inflammation, strictures, or fistulas leading to an ostomy.

Types of Ostomies

The type of ostomy created depends on which part of the bowel is used and whether it is temporary or permanent:

• Colostomy: An ostomy of the colon (large intestine).
• Ileostomy: An ostomy of the ileum (the final section of the small intestine).
• Urostomy (Ileal Conduit): A diversion of the urinary system, often created when the bladder is removed or bypassed.

The decision to create an ostomy is carefully considered by medical professionals, weighing the benefits against the potential challenges. While living with an ostomy requires adjustments, many individuals lead full and active lives with proper management and support.