Surgeon Antonio Couceiro Lopes clarifies the main doubts about the disease and its effects on the patient’s life
The stomies are derivations of the digestive tract to the skin. When indicated, they can be temporary or definitive and performed at any time of the digestive system, from esophagus, passing through the small intestine, to the, also called colon.
Definitive colostomy (large intestine externalization to the abdomen wall) is a surgical procedure performed when there is no possibility of restoring natural intestinal transit. Although it may represent an initial challenge for the patient, it provides symptom relief and can significantly improve quality of life. In this article, we address your main indications, essential care and emotional impacts.
1. Indications and benefits of definitive colostomy
Definitive colostomy is indicated when there is a need to permanently divert intestinal transit, either due to malignant diseases, severe inflammatory or irreversible lesions in the colon. The main conditions include:
- Advanced colorectal cancer, especially in cases involving total resection of the anus and rectum and/or the impossibility of safe anastomosis.
- Intestinal inflammatory diseases at an advanced stage or without the possibility of clinical control, such as ulcerative retocolitis and Crohn’s disease, when there are complications such as toxic megacolon or intestinal drilling.
- Severe abdominal trauma, in which the reconstruction of intestinal transit is unfeasible due to the extent of the lesions.
- Congenital malformations, such as imperforated anus and Hirschsprung syndrome, which can make natural evacuation unfeasible.
Although definitive colostomy is an irreversible procedure, it can significantly improve quality of life, reducing pain, preventing serious infections and providing more control over intestinal functions.
2. Care and adaptation to the use of the colostomy bag
Adapting to the use of the colostomy bag requires changes in routine and special attention to some essential care.
- Hygiene and Bag Maintenance: Change the bag regularly to avoid leaks and infections.
- Keep the skin around the stoma clean and dry using protective barriers to prevent dermatitis.
- Food and intestinal control: Avoid foods that cause gases or constipation, such as beans, cruciferous vegetables and fat red meat.
- Increase the intake of soluble and liquid fibers to maintain the proper consistency of evacuations.
Adaptation to routine and active life
- Wear comfortable clothes that do not press the bag.
- Explore accessories such as support straps for greater discretion and safety.
3. Psychological aspects and patient support
The emotional impact of definitive colostomy can be significant, requiring adaptation proper support.
- Self -esteem and acceptance: Change in body image can affect self -esteem and acceptance of the new lifestyle. Strategies such as psychological counseling and group support can assist in this process.
- Psychological and social support: Emotional support, both professional and familiar, is essential to avoid disorders such as anxiety and depression.
- Social Life and Intimacy: Maintaining an active and satisfactory social life can be an initial challenge, but open dialogue with partners and friends, as well as the use of resources as more discreet bags, can facilitate this adaptation.
Conclusion
Definitive colostomy is a procedure that can be very challenging for the patient and is therefore only indicated when there is no other safe or viable option. Despite the initial challenges, it is possible to lead an active and healthy life. Education on daily care, psychological support and the exchange of experiences with other patients are fundamental to adaptation. With proper follow -up, it is possible to recover self -confidence and maintain a full and satisfactory routine.
Antonio Couceiro Lopes (CRM 100656 SP | RQE 26013)
Digestive Surgeon
