RCS 6080 Medical and Psychosocial Aspects

of Rehabilitation Counseling

Ostomy Surgeries

Ostomy Surgeries

Numerous medical conditions, including congenital defects, trauma, inflammatory bowel disease (IBD),and bowel and bladder cancer, can be treated by ostomy surgeries

These surgeries close the normal route of elimination of bodily wastes and create a new opening (stoma)

Ostomy Surgeries

GI Stomas Jejunostomy Ileostomy Cecostomy Colostomy

Colostomy

Colostomy: A surgically created opening in the abdominal wall through which digested food passes. Temporary colostomy Permanent colostomy

Reasons for surgery: Cancer, diverticultis trauma, imperforate anus

Vocational impact – restrict heavy lifting

Ileostomy

A surgically created opening in the abdominal wall through which digested food passes. The Ileum (the lowest part of the small intestine) is brought through the abdominal wall to form a stoma. A Ileostomy is performed when a disease or injured colon cannot be treated successfully.

Vocational implication – restrict heavy lifting.

Jejunostomy

Can be used for either feeding or removal of stool, depending on if the stoma is at the beginning or end of the Jejunum. Feeding: A tube is placed into the jejunum versus

the stomach (gastrostomy). People with a jejunostomy can eat and drink by mouth. The device is an “insurance” mechanism for nutrition. It can be temporary or permanent.

Stool removal: in certain instances a jejunostomy is conducted similarly to the Ileostomy. Again, this usually temporary.

Cecostomy

A tube that goes through the skin into the beginning of the large intestine to help remove gas or feces by injecting a solution (antegrade enema) that flushes the gas and stool out of the rectum.

Can be temporary or permanent.

Urinary Stomas

When a urinary stoma is created, the urine does not go to the bladder. The urine is rerouted through an opening on the abdomen (stoma) created by a surgeon.

Vesicostomy:An opening in the bladder created to connect the bladder to an opening on the lower abdomen.

Ureterostomy: The ureter (or ureters) is attached to the skin’s surface through a small opening in the abdomen.

Ileal conduit: A small section of the ileum (small intestine) is used to create a passage for the urine to exit the body. This section of the small intestine, called a conduit, is attached to the abdominal wall to create a stoma. The urine flows from the kidneys, through the ureters, and out the stoma

Psychosocial/Vocational implications

Vocational Implications Ostomy surgery itself does not present obstacles to

most vocational functioning – underlying disease process may influence RTW

Changes in body image Economic costs of living with an ostomy can be

considerable when complications from the stoma or disease process develop

Provide information and education to the person in a manner that relays a message of acceptance

Additional Resources and Information from the Web

United Ostomy Association (www.uoa.org) International Ostomy Association (www.

ostomyinternational.org) World Ostomy Resource (www.powerup

.com.au/~takkenb/OstomySites.htm) Crohn’s Colitis Foundation of America (www.

ccfa.org) Oley Foundation (www.oley.org)