Normal Digestive System:

Small Intestine:

Approximately 20 feet long, consisting of:

• Duodenum (first part) 10-12 inches beginning at the outlet of the stomach.
• Jejunum (second part), about 8-9 feet.
• Ileum (third part) about 12 feet, connected to the large intestine at the cecum.

Food nutrients are digested and absorbed in the small intestine as food is moved through by peristalsis.

 

Large Intestine:

Approximately 5-6 feet long, consisting of:

• Cecum – contains the ileocecal valve, which prevents reflux into the ileum; contents are highly acidic liquid.
• Ascending colon – contents are acidic liquid.
• Transverse colon – contents are less acidic liquid.
• Descending/sigmoid colon – contents become more formed.
• Rectum – formed stool.

The primary functions of the large intestine are absorption of water and electrolytes, transport of stool by peristalsis, and storage of digestive waste until it is eliminated from the body.

 

Colostomy:

A Colostomy is an opening in the large intestine (colon), through the abdominal wall. This opening is called a stoma. The stoma is actually the lining of the intestine, which is similar to the lining of your mouth and is pink and moist.

Colostomy surgery is performed for many different diseases and conditions. These include cancer of the colon, rectum or anus, inflammatory bowel disease, diverticulitis, trauma and birth defects. Colostomies can be temporary or permanent. Temporary colostomies may be necessary to protect a section of colon during healing.

The colostomy functions similarly to the natural bowel. The body’s chemistry, digestive function and ability to nourish itself are usually not altered by it. However, because there is no muscle left to control the expelling of stool or gas, a protective collection device (pouch) is necessary for management. Consistency of colostomy output will depend on where in the large intestine the stoma is constructed, diet, medication and other factors.

Some colostomy patients chose to regulate their bowel function by diet or routine irrigations of the stoma. Irrigation is similar to an enema and causes the bowel to evacuate at a given time and place.

There are three types of colostomies – ascending, transverse, and descending.

Tranverse Colostomy:

Indications: Diverticulitis. Trauma (injury). Birth Defects. Cancer/descending or sigmoid colon. Bowel obstruction. Paralysis.

Discharge: Semi-solid. Unpredictable. Contains some digestive enzymes.

Management: Skin protection. Drainable pouch. Closed-end pouch for convenience or special moments.

Descending Colostomy:

Indications: Cancer of rectum or sigmoid colon. Diverticulitis. Trauma (injury). Congenital defects. Bowel obstruction. Paralysis.

Discharge: Resembles normal bowel movements. Regulated in some persons, not in others.

Management: Natural evacuation or irrigation. Protective cover or closed-end pouch if regulated. If not regulated, use open-end drainable pouch.

Urostomy

A urostomy (urinary diversion) is one of a number of surgical procedures which divert urine away from a diseased or defective bladder.  Cancer, birth defects, spinal cord injury and interstitial cystitis are the most common diseases that lead to urostomies
These operations bring urine to the outside of the body through an opening on the abdominal wall.  This opening is called a stoma. The stoma is actually the lining of the intestine, which is similar to the lining of your mouth and is pink and moist.
There is no voluntary control of the urine therefore a collection device (pouch) is necessary for management.  The function of the kidneys is not changed by the urostomy.
The urostomy pouch is usually emptied when 1/3rd full.  Generally trips to the bathroom are not increased by the presence of a urostomy.  The pouch should be connected to a larger collection container at night to insure a good night sleep and reduce the time urine stays in the pouch.  This reduces the potential for urinary tract infections.