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                                                                                                       Ostomy A to Z

 

 

 

   If  you  are  new  to  the  ostomy  world,  it’s  easy  to become quickly  overwhelmed with  new  terminology when   talking  with  your  health   care   team   or  when reading about  your condition. The good news is that by becoming familiar with some key terms, you will soon begin to feel much more comfortable – and fluent – with the ostomy lingo around  you. This article will help you get  started  by  briefly  defining  various  ostomy-related terms in an easy-to-understand manner.

 

   Adhesions -  Scar   tissue   from   an   abdominal   surgery can   generate    adhesions,  which   are   fibrous   bands that  may  attach  to  the  bowel.  These  can  sometimes cause  blockages  in the  intestine,  though  this is a rare occurrence.

 

  Appliance - the  formal  term  for  an  ostomy  pouch   or ostomy bag.

 

  Colectomy = the  surgical   removal   of  the  colon   (also known  as the  large  intestine),  often  due  to cancer,  or non-cancerous conditions such as severe inflammatory bowel  disease  or ruptured  diverticulitis.  Depending on what’s necessary,  a colectomy can be a partial or a total removal of the colon.

 

  Colostomy - a type of ostomy in which  part of the colon is brought  to  the  surface  of one’s  abdomen,  through a  surgical  procedure, to  eliminate  stool.  Reasons  for a colostomy  include  cancer  of the rectum, ruptured diverticulitis,  trauma  to the bowel,  or disease  / damage to the spinal cord resulting in little   or no bowel control.

 

  Convexity - a type  of pouching system  that  is typically used for stomas that are recessed  into or flush with the abdominal surface

 

  Crohn’s Disease - one type of inflammatory bowel disease.  It affects the gastrointestinal (GI) tract anywhere from mouth  to anus  (although  the small and  large  intestines   are the most common sites). Crohn’s affects all layers of the GI tract. Symptoms can include abdominal pain, diarrhea, fever, fatigue, and weight loss. Surgery for this condition may result in one having an ostomy.

 

  Cystectomy - the surgical removal of the bladder.  A cystectomy  can  be  partial,  or,  more  commonly, total. The  most  common reason  for this  surgery  is bladder cancer.

 

  Diverticulosis/Diverticulitis - a condition of the colon in which  small  sacs  or pouches form in the  wall  of the colon,  often asymptomatic. Diverticulitis  occurs  when these small pouches become inflamed. Ruptured or perforated  diverticulitis  often requires  the creation  of a temporary  colostomy.

 

  Enterostomal Therapy  (ET) Nurse - a nurse  specializing in ostomy care. Refer to WOCN for the updated version of “ET Nurse.”

 

  Faceplate - the part of the pouching system that adheres to  the  skin  around   the  stoma.  The  faceplate   can  be separate  from a pouch  (two-piece  system), or a pouch and  faceplate  can  be one  unit (one-piece system). See also “wafer.”

 

  Familial -  Adenomatous  Polyposis  (FAP) a  hereditary disorder  that  is characterized by  the  development of multiple  polyps  (growths)  in  the  colon  that  generally begin during the teenage  years. There is a high risk for developing colon  cancer  in any of these  many  polyps over time.  Surgery to remove  the large intestine  is the typical treatment  for this disorder.

 

  Folliculitis - an  inflammation  of the  hair  follicles.  This condition  sometimes   occurs   on   one’s   skin  around his  stoma  due  to  the  physical  trauma  involved  with repeatedly  removing   ostomy   appliances  adhered  to one’s skin.  It may  also  occur  as  a  result  of frequent shaving of the skin around  the stoma, resulting in a rash or eruptions  of the skin.

 

  Flange -  a   plastic   ring   on the faceplate  (wafer) that allows   a   pouch    to   snap onto the faceplate. Some manufacturers also  refer to their wafer/faceplate as a “flange.”

 

  Hernia - occurs when the intestine “bulges” through a weak area of the abdominal muscle. When this happens next to a stoma,  it’s called a peristomal        hernia. The  presence of a  hernia  may  result  in  a  fullness  or prominence around  or behind  the  stoma.  Repairing  a hernia  requires  a surgical procedure

 

   Ileostomy -  an  ostomy  in  which  the  end  of the  small intestine   (ileum),   through   a   surgical   procedure,  is brought  to the  surface  of one’s abdomen to eliminate bodily  waste.  Reasons  for  having  an  ileostomy  may include   severe  cases  of  inflammatory   bowel  disease (i.e., Crohn’s Disease  of the colon  or ulcerative  colitis), or as a method  to provide  a temporary  diversion  of the bowel while it heals from a surgical procedure.

 

  Inflammatory Bowel Disease (IBD) - a general term used to describe chronic inflammation (consisting of redness, swelling,  and ulceration)  in the digestive tract. The two major  forms of IBD are Crohn’s disease  (inflammation anywhere in the digestive tract affecting all layers of the GI tract) and ulcerative  colitis (inflammation  only in the colon affecting the innermost  layer of the GI tract).

 

  Irrigation - a  procedure that  people   with  colostomies undertake to  regulate  their  bowel  movements. Water is instilled  through  the  stoma,  which  then  triggers the colon  to empty  its contents.  This process  is much  like taking an enema.  It’s typically  performed  every day or every other day. After irrigating regularly for about  two months,  the person  with a colostomy  may not need  to wear an appliance any longer, as the colon  is “trained” to only eliminate  during irrigation.

 

  J-Pouch - a surgical  procedure that involves  removal  of the colon  and creation  of an internal  reservoir (shaped like  a  “j”) made  out  of the  end  portion  of  

the  small intestine. People with a j-pouch eliminate their feces the regular way through the anus, though with much greater frequency. It’s  most  commonly   an  option  for  people with ulcerative  colitis that is not responsive  to medical therapy or those with familial polyposis.

 

  Kock Pouch - a surgical procedure that involves removal of  the   colon   and   creation   of  a  continent  internal reservoir  made  from the  end  of the  small  intestine.  A valve is made  and  attached to a stoma  that is sutured to and  is flush with the abdominal surface. An ostomy appliance is not used. A catheter (drainage tube) empties the reservoir several times per day. A gauze  dressing is generally worn over the opening.

 

  Laparoscopic  Surgery = a  surgical   procedure  where several small incisions (.5 to 1.5 centimeters) are made at various points on the abdomen. A harmless gas is injected into  the  abdominal cavity  to  create  a  large  working space  that  the  surgeon  views  through  a tiny,  inserted camera. Surgical  instruments  are  inserted  through  the small  incisions,  which  the  surgeon  manipulates while viewing the surgery on a video monitor.

 

  Obstruction - a blockage  in the  intestine.  Obstructions can  result  from a variety  of causes,  including  fibrous foods,  cancerous growth,  scar  tissue  /  adhesions,  or severely inflamed lining of the intestine. Symptoms typically include abdominal pain, nausea, vomiting, or inability to pass gas or stool. Hospitalization often ensues to address the cause of the obstruction.

 

  One-piece  Pouching System - consists of a pouch  that is already  bound  to a faceplate  (i.e.,  the  skin barrier  or wafer that sticks to your skin).

 

  Ostomy - a surgical  creation  of an  abdominal opening that allows the elimination of either feces or urine.

 

  Ostomate - a person  who  has an ostomy.  Another  term sometimes  used is ostomist (mostly in the UK).

 

  Patch Test - a  method   of  determining whether   one  is allergic or sensitive to an ostomy product,  such as a tape or adhesive  barrier. It’s done by placing a small amount of the  product  on  the  side  of the  abdomen opposite the stoma. If the skin becomes irritated within a day or two, then  one  likely has an allergy or a sensitivity  to the  product  and should avoid using that product.

 

  Peristomal Skin - the skin around your stoma.   Having  healthy   peristomal skin is important  for quality  of life for those with ostomies.

 

  Pouch - an ostomy appliance consists  of a skin barrier  or wafer, and a pouch,  either as  separate products used together, or manufactured as a one-piece

system. The pouch collects the effluent from the stoma, serving  as  a  reservoir  until the pouch  is emptied  by the wearer.

 

  Pouchitis - the  inflammation of an internal pouch  made from  small  intestinal   tissue

(such   as   the   j-pouch   or   Kock Pouch).  Pouchitis  it treated  with either       probiotics       (beneficial bacteria)     or     antibiotics     plus increased fluid intake and prompt emptying  of the full internal  pouch. Pouchitis is the most common long- term    complication   of   ileal-anal reservoir surgery.

 

  Prolapse - occurs when the stoma no longer  adheres   correctly  to  where it  comes   out  of  the  abdomen  as the   bowel   everts   itself  outward. This results in the stoma protruding significantly further out than the normal    one-quarter   to   one-half inch. This complication is most commonly    seen    with   transverse loop  colostomies. Surgery may  be necessary  to correct this problem.

 

  Short Bowel Syndrome - a malabsorption disorder,      which means that there is not enough small intestine or not enough functional small intestine to adequately absorb fluids and  nutrients  from the foods and beverages you eat and drink. Some define it as having more than 50 percent  of your small bowel removed,  while others point out that the functionality  of the remaining small bowel is the key determinant.

 

  Skin Barriers Products - such as pastes and powders, that some people with ostomies use to protect  the skin around  their stoma before attaching their   appliance. The faceplate or the wafer of an appliance is also considered to be  a skin barrier as it protects  the skin from contact with the stoma’s effluent.

 

  Stoma - the  part  of an  ostomy  that is visible on the exterior of one’s abdomen where body waste exits the body.  It is bright red  and ideally protrudes     approximately one-quarter to one-half  inch  above the skin surface, although some stomas  are  flat or “flush” with  the skin  surface.  The  size  of  a  stoma will  decrease after  surgery  as  the swelling goes down.

 

  Tail Closure/Tail Clip/Tail Spout - seals the bottom of a drainable ostomy pouch  used for a colostomy or an ileostomy. Sometimes a tail closure  is a separate  plastic  clamp that is attached to the pouch.  Other pouches have a folding/Velcro® system that keeps contents from coming  out from the bottom  of the pouch.  A tail  spout  is the  closure mechanism  found  on  the  bottom of urostomy pouches that can be opened for emptying  and  then closed to prevent leakage of urine.

 

  Two-Piece Pouching System - consists of a separate pouch and  faceplate or wafer (i.e., the barrier that sticks to your skin)  that comprise the ostomy  appliance. Different  styles of pouchs   can  be  attached to  the faceplate  without  having to remove the faceplate  adhered to your skin. Using a two-piece   system also allows for more frequent pouch- only  changes  or alternate  methods of cleaning  out the pouch  contents while the wafer stays in place.

 

  Ulcerative Colitis - one form of inflammatory  bowel  disease.  It targets   the   colon   (also  know   as the large intestine) and affects its innermost lining. Symptoms can include  abdominal pain, fatigue, weight loss, and bloody diarrhea. Surgery for this condition may result in one having an ostomy.

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  Urostomy - the  surgical creation of an opening in the abdomen that allows  the elimination of urine. It’s usually  performed  on  people who have had their bladder removed because of cancer,  or in people with spinal cord injuries  who  no longer can control  their bladder  function.

 

  Wafer - a barrier  or faceplate. It has adhesive   on  one  side  to  stick  on your skin around your stoma. The other side is designed to have a pouch

  attached to it.

 

  Wound, Ostomy and Continence Nurses Society (WOCN) - a professional, international nursing society of more than 4,200 health care professionals who are experts  in the care  of patients  with wound, ostomy, and continence issues. WOC nursing is the sole nursing   specialty    in   the   United States that focuses on nursing management of patients with an ostomy.

 

 

 

 

 

 

 

 

 

 

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