Constipation Causes, How Often You Should Have a Bowel Movement, and More

What Is Constipation?

Your digestive system is remarkably efficient. In the space of a few hours, it extracts nutrients from the foods you eat and drink, processes them into the bloodstream, and prepares leftover material for disposal. That material passes through about 20 feet of intestine before being stored temporarily in the colon, where water is removed. The residue is excreted through the bowels, normally within a day or two.

Depending on your diet, age, and daily activity, regularity can mean anything from three bowel movements a day to three each week.

As fecal material sits in the colon, the harder the stool becomes and the more difficult it is to pass. A normal stool should not be either unusually hard or soft, and you shouldn’t have to strain unreasonably to pass it.

What Causes Constipation?

Our busy, modern lifestyles may be responsible for most cases of constipation: not eating enough fiber or drinking enough water, not getting enough exercise, and not taking the time to respond to an unmistakable urge to go to the bathroom. Persistent, chronic constipation may also be a symptom of more serious conditions, including inflammatory bowel disease, colorectal cancer, diabetes, Parkinson’s disease, multiple sclerosis, depression, or an underactive thyroid gland.

Continued

Bowel habits tend to vary with age and circumstances. Bottle-fed babies, for example, tend to have firmer stools and more bouts of constipation than breast-fed babies. Some children become constipated when they start school or other activities, because they are embarrassed to ask permission to use the toilet. Toddlers often become constipated during toilet training if they are unwilling or afraid to use the toilet. Being sensitive to pain, children may avoid the toilet if they have minor splits or tears in the anus from straining or other irritations. Kids can also become constipated from consuming certain foods, such as dairy products.

Older people, especially those who are more sedentary, tend to develop constipation more often.

Medications that can cause constipation include narcotics, diuretics, iron supplements, antacids, and drugs for blood pressure, seizures, and depression.

Frequent Bowel Movements: Causes, Diagnosis & Treatment

Overview

What are frequent bowel movements?

Frequent bowel movements is a condition in which a person defecates (eliminates waste from the bowel) more often than usual. There is no “normal” number of bowel movements. Many healthcare providers agree that healthy bowel movement frequency can range from three times a day to three times a week. However, your ‘normal’ pattern may be different from these numbers. To say that a person’s bowel movements have become more frequent is based on an increase in that person’s usual pattern, not on a standard definition that applies to everyone.

The two main bowel movement conditions are constipation (fewer than three bowel movements per week) and diarrhea (more than three movements of loose stools per day).

Who is affected by frequent bowel movements?

Frequent bowel movements occur in both males and females of any age.

Symptoms and Causes

What causes frequent bowel movements?

Some cases of frequent bowel movements last for a short time only and are not a cause for concern. These can be caused by digestive upset from eating spoiled, fatty or spicy food, a food that is not tolerated, or an intestinal “bug” that clears in a day or two.

Other possible causes of frequent bowel movements include an increase in physical exercise, certain medications like antibiotics or metformin, or a change in the diet (more fiber, water, fats or sugars). Bowel movements may return to the usual after the person adapts to these changes or makes modifications to his or her diet.

When the person has other symptoms to go along with the greater number of bowel movements, there may be other causes, including the following:

• Bacterial infection
• C. difficile infection (which can be serious if untreated)
• Viral infection
• Parasitic infection, such as from worms or protozoa
• Diverticulitis (the small pockets along the wall of the colon fill with stagnant fecal material and become inflamed)
• Inflammatory bowel disease (a group of disorders, including Crohn’s disease and ulcerative colitis, that cause irritation and swelling of the digestive tract)
• Pancreatitis (inflammation of the pancreas)
• Celiac disease (an autoimmune disease that causes sensitivity to gluten, a protein found in grains such as wheat, rye or barley)
• Cancer of the colon or elsewhere in the digestive tract
• Food allergies
• Gallbladder problems
• Lactose intolerance (the inability to digest lactose, the sugar primarily found in milk and dairy products)
• Irritable bowel syndrome (a disorder of the colon or lower bowel with symptoms that include abdominal pains or cramps)
• Side effects of medications (including antacids, laxatives, stool softeners)
• Foods and beverages, including certain herbs and herbal teas, alcohol and caffeine
• Use of antibiotics, which can upset normal bacteria in the gut
• Bowel obstruction
• Complications of intestinal or abdominal surgery
• Complications of cancer treatments such as chemotherapy or radiation therapy

Diagnosis and Tests

How are frequent bowel movements diagnosed?

In cases in which a cause for frequent bowel movements is not known, the doctor will ask you the following:

• The time of your last bowel movement
• How often you urinate
• The consistency of stool (watery or shaped)
• If there is blood around or in the stool
• If you have bleeding from the rectum
• If you are dizzy or have cramps, pain, fever or nausea
• What foods and drinks you consume
• If you have had any recent changes in your weight
• The medications you take
• If and when you have traveled recently

The doctor will conduct a physical examination and may order blood and stool tests, urinalysis and X-rays.

Management and Treatment

How are frequent bowel movements treated?

Mild cases of diarrhea can be treated with an over-the-counter medicine, such as Pepto-Bismol®, Imodium A-D® and Kaopectate®. These are available as liquids or tablets. Follow the instructions on the package.

Note: do not take antidiarrheal medicines if a bacterial infection or parasites are the suspected cause (symptoms include fever or bloody stools). It is important to allow bacteria or parasites to pass through the digestive system.

Living With

When should I call my doctor about frequent bowel movements?

Contact your doctor if you have frequent bowel movements and any of the following symptoms:

• Bloody stools or bleeding from the rectum
• Very bad-smelling stools
• Unintended weight loss
• Severe or chronic (long-term) diarrhea
• Acute severe diarrhea after hospitalization or after taking antibiotics
• Painful, swollen or bloated abdomen
• Abdominal cramps
• Painful bowel movements
• Incontinence (an inability to control bowel movements)
• Urgent need to have a bowel movement
• Nausea
• Vomiting
• Body aches
• Fever
• Chills

Frequent Bowel Movements: Causes, Diagnosis & Treatment

Overview

What are frequent bowel movements?

Frequent bowel movements is a condition in which a person defecates (eliminates waste from the bowel) more often than usual. There is no “normal” number of bowel movements. Many healthcare providers agree that healthy bowel movement frequency can range from three times a day to three times a week. However, your ‘normal’ pattern may be different from these numbers. To say that a person’s bowel movements have become more frequent is based on an increase in that person’s usual pattern, not on a standard definition that applies to everyone.

The two main bowel movement conditions are constipation (fewer than three bowel movements per week) and diarrhea (more than three movements of loose stools per day).

Who is affected by frequent bowel movements?

Frequent bowel movements occur in both males and females of any age.

Symptoms and Causes

What causes frequent bowel movements?

Some cases of frequent bowel movements last for a short time only and are not a cause for concern. These can be caused by digestive upset from eating spoiled, fatty or spicy food, a food that is not tolerated, or an intestinal “bug” that clears in a day or two.

Other possible causes of frequent bowel movements include an increase in physical exercise, certain medications like antibiotics or metformin, or a change in the diet (more fiber, water, fats or sugars). Bowel movements may return to the usual after the person adapts to these changes or makes modifications to his or her diet.

When the person has other symptoms to go along with the greater number of bowel movements, there may be other causes, including the following:

• Bacterial infection
• C. difficile infection (which can be serious if untreated)
• Viral infection
• Parasitic infection, such as from worms or protozoa
• Diverticulitis (the small pockets along the wall of the colon fill with stagnant fecal material and become inflamed)
• Inflammatory bowel disease (a group of disorders, including Crohn’s disease and ulcerative colitis, that cause irritation and swelling of the digestive tract)
• Pancreatitis (inflammation of the pancreas)
• Celiac disease (an autoimmune disease that causes sensitivity to gluten, a protein found in grains such as wheat, rye or barley)
• Cancer of the colon or elsewhere in the digestive tract
• Food allergies
• Gallbladder problems
• Lactose intolerance (the inability to digest lactose, the sugar primarily found in milk and dairy products)
• Irritable bowel syndrome (a disorder of the colon or lower bowel with symptoms that include abdominal pains or cramps)
• Side effects of medications (including antacids, laxatives, stool softeners)
• Foods and beverages, including certain herbs and herbal teas, alcohol and caffeine
• Use of antibiotics, which can upset normal bacteria in the gut
• Bowel obstruction
• Complications of intestinal or abdominal surgery
• Complications of cancer treatments such as chemotherapy or radiation therapy

Diagnosis and Tests

How are frequent bowel movements diagnosed?

In cases in which a cause for frequent bowel movements is not known, the doctor will ask you the following:

• The time of your last bowel movement
• How often you urinate
• The consistency of stool (watery or shaped)
• If there is blood around or in the stool
• If you have bleeding from the rectum
• If you are dizzy or have cramps, pain, fever or nausea
• What foods and drinks you consume
• If you have had any recent changes in your weight
• The medications you take
• If and when you have traveled recently

The doctor will conduct a physical examination and may order blood and stool tests, urinalysis and X-rays.

Management and Treatment

How are frequent bowel movements treated?

Mild cases of diarrhea can be treated with an over-the-counter medicine, such as Pepto-Bismol®, Imodium A-D® and Kaopectate®. These are available as liquids or tablets. Follow the instructions on the package.

Note: do not take antidiarrheal medicines if a bacterial infection or parasites are the suspected cause (symptoms include fever or bloody stools). It is important to allow bacteria or parasites to pass through the digestive system.

Living With

When should I call my doctor about frequent bowel movements?

Contact your doctor if you have frequent bowel movements and any of the following symptoms:

• Bloody stools or bleeding from the rectum
• Very bad-smelling stools
• Unintended weight loss
• Severe or chronic (long-term) diarrhea
• Acute severe diarrhea after hospitalization or after taking antibiotics
• Painful, swollen or bloated abdomen
• Abdominal cramps
• Painful bowel movements
• Incontinence (an inability to control bowel movements)
• Urgent need to have a bowel movement
• Nausea
• Vomiting
• Body aches
• Fever
• Chills

Frequent Bowel Movements: Causes, Diagnosis & Treatment

Overview

What are frequent bowel movements?

Frequent bowel movements is a condition in which a person defecates (eliminates waste from the bowel) more often than usual. There is no “normal” number of bowel movements. Many healthcare providers agree that healthy bowel movement frequency can range from three times a day to three times a week. However, your ‘normal’ pattern may be different from these numbers. To say that a person’s bowel movements have become more frequent is based on an increase in that person’s usual pattern, not on a standard definition that applies to everyone.

The two main bowel movement conditions are constipation (fewer than three bowel movements per week) and diarrhea (more than three movements of loose stools per day).

Who is affected by frequent bowel movements?

Frequent bowel movements occur in both males and females of any age.

Symptoms and Causes

What causes frequent bowel movements?

Some cases of frequent bowel movements last for a short time only and are not a cause for concern. These can be caused by digestive upset from eating spoiled, fatty or spicy food, a food that is not tolerated, or an intestinal “bug” that clears in a day or two.

Other possible causes of frequent bowel movements include an increase in physical exercise, certain medications like antibiotics or metformin, or a change in the diet (more fiber, water, fats or sugars). Bowel movements may return to the usual after the person adapts to these changes or makes modifications to his or her diet.

When the person has other symptoms to go along with the greater number of bowel movements, there may be other causes, including the following:

• Bacterial infection
• C. difficile infection (which can be serious if untreated)
• Viral infection
• Parasitic infection, such as from worms or protozoa
• Diverticulitis (the small pockets along the wall of the colon fill with stagnant fecal material and become inflamed)
• Inflammatory bowel disease (a group of disorders, including Crohn’s disease and ulcerative colitis, that cause irritation and swelling of the digestive tract)
• Pancreatitis (inflammation of the pancreas)
• Celiac disease (an autoimmune disease that causes sensitivity to gluten, a protein found in grains such as wheat, rye or barley)
• Cancer of the colon or elsewhere in the digestive tract
• Food allergies
• Gallbladder problems
• Lactose intolerance (the inability to digest lactose, the sugar primarily found in milk and dairy products)
• Irritable bowel syndrome (a disorder of the colon or lower bowel with symptoms that include abdominal pains or cramps)
• Side effects of medications (including antacids, laxatives, stool softeners)
• Foods and beverages, including certain herbs and herbal teas, alcohol and caffeine
• Use of antibiotics, which can upset normal bacteria in the gut
• Bowel obstruction
• Complications of intestinal or abdominal surgery
• Complications of cancer treatments such as chemotherapy or radiation therapy

Diagnosis and Tests

How are frequent bowel movements diagnosed?

In cases in which a cause for frequent bowel movements is not known, the doctor will ask you the following:

• The time of your last bowel movement
• How often you urinate
• The consistency of stool (watery or shaped)
• If there is blood around or in the stool
• If you have bleeding from the rectum
• If you are dizzy or have cramps, pain, fever or nausea
• What foods and drinks you consume
• If you have had any recent changes in your weight
• The medications you take
• If and when you have traveled recently

The doctor will conduct a physical examination and may order blood and stool tests, urinalysis and X-rays.

Management and Treatment

How are frequent bowel movements treated?

Mild cases of diarrhea can be treated with an over-the-counter medicine, such as Pepto-Bismol®, Imodium A-D® and Kaopectate®. These are available as liquids or tablets. Follow the instructions on the package.

Note: do not take antidiarrheal medicines if a bacterial infection or parasites are the suspected cause (symptoms include fever or bloody stools). It is important to allow bacteria or parasites to pass through the digestive system.

Living With

When should I call my doctor about frequent bowel movements?

Contact your doctor if you have frequent bowel movements and any of the following symptoms:

• Bloody stools or bleeding from the rectum
• Very bad-smelling stools
• Unintended weight loss
• Severe or chronic (long-term) diarrhea
• Acute severe diarrhea after hospitalization or after taking antibiotics
• Painful, swollen or bloated abdomen
• Abdominal cramps
• Painful bowel movements
• Incontinence (an inability to control bowel movements)
• Urgent need to have a bowel movement
• Nausea
• Vomiting
• Body aches
• Fever
• Chills

Frequency, normal amounts, and when to see a doctor

A person’s bowel habits say a lot about their health and how well their body is functioning.

Even though it can be embarrassing to talk about bowel movements, they can offer valuable clues to what is going on in the body. Many people have concerns that they are pooping too many times a day, or not enough.

Here are the answers to some common poop questions that may be too embarrassing to ask.

Fast facts on pooping:

• It is hard to say what is normal, especially when it comes to frequency of bowel movements as it varies from person to person.
• Doctors look at how often someone poops and the consistency to determine if a person’s bowel habits are usual.
• Pooping is the body’s way of getting rid of waste products and the undigested food that does not get absorbed.
• Experiencing temporary changes in bowel habits or patterns is normal.

Share on PinterestA person’s bowel movement routine is unique to them, and is determined by a number of factors such as diet.

What is normal for one person may be abnormal for another. A 2010 study published in the Scandinavian Journal of Gastroenterology found that 98 percent of its participants pooped between 3 times per week to 3 times daily.

Most people have their own routine and go to the bathroom the same number of times per day and at around the same time.

Deviating significantly from the regular pattern may still be considered healthy, but it can also indicate the development of a stomach or bowel problem.

How often a person goes to the bathroom can vary a lot and depends on a range of factors including:

Fluid intake

Because the large intestine absorbs excess water, not drinking enough fluids can harden poop and make it more difficult to go. Someone who is experiencing constipation should increase their fluid intake to help keep poop soft.

Age

Constipation is often associated with getting older. Aging causes the gut to slow down, so poop does not pass through as quickly. Also, an older person is more likely to be taking medication that may interfere with their usual pooping habits.

Activity

Staying active helps the colon work better and move poop through the intestines more efficiently. When someone is experiencing constipation or slow digestion, going for a walk or run can help get things moving more regularly.

Diet

Share on PinterestA high fiber diet is likely to result in regular bowel movements. A diet lacking in fiber may lead to constipation, or other digestive problems.

What a person eats plays a significant role in how often they go to the bathroom. Fiber is an essential substance for healthy bowel movements.

Fiber is a type of carbohydrate that the small intestine cannot break down into smaller molecules. As a result, it passes to the colon as a mass of undigested food that eventually becomes poop, also known as stool. A diet that is adequate in fiber can promote regularity and prevent constipation.

Medical history

Some medical conditions and medications can affect bowel health and cause a person to poop more or less often than usual. Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, and even a basic stomach flu virus, can change how often a person has to poop.

Hormones

Some hormones, such as progesterone and estrogen, can affect how often a woman goes to the bathroom. For example, some women report pooping much more frequently in the days leading up to and at the start of their period.

Social factors

Some people have difficulty pooping in a public bathroom, at work, or when other people are nearby. This can cause someone to “hold it in” longer than necessary.

Over time, the body is not able to respond as quickly to signs that it needs to poop, which can cause someone to feel constipated or uncomfortable.

Healthy bowel habits mean that someone is pooping regularly and that the poop is soft and easy to pass. Regular bowel movements allow the colon to empty without pain or discomfort.

Poop that is watery or loose indicates that it is moving through the colon very quickly, usually as a result of irritation, such as from an infection or another source of inflammation.

Having chronic diarrhea (the term for increased and liquid poop) can lead to dehydration or electrolyte imbalances. Diarrhea can also lead to nutrient deficits because the intestine is not able to absorb them when poop is moving through so quickly.

Poop that is small and pellet-like is also abnormal and is usually a sign of constipation or incomplete bowel emptying. This type of poop can be hard or difficult to pass and may even lead to other complications, such as hemorrhoids or stool impaction.

Share on PinterestUsually, a change in pooping habits will resolve itself within a couple of weeks. However, if it doesn’t, or changes are accompanied by concerning symptoms, medical attention should be sought.

Usually, irregular changes in a person’s pooping habits resolve within a short amount of time and are no cause for concern. However, a doctor should assess someone if their bowel changes last longer than 1 to 2 weeks, or there are other concerning symptoms, such as:

• blood in the poop
• black poop
• new onset of “pencil-thin” poop
• weight loss or fever that accompanies diarrhea or constipation
• severe abdominal pain
• vomiting blood or a substance that looks like coffee grounds

If someone typically poops frequently during the day, and the poop has a soft, easy to pass consistency and regular appearance, then people should not be concerned.

However, if the poop is too watery or loose, then there may be some health risks associated with fluid and electrolyte loss that comes with diarrhea.

Anyone who is is concerned about their health should talk to their doctor. The doctor can evaluate the concerns and help to determine what, if any, changes the person needs to make.

One easy intervention is to make some simple dietary changes. Eating a well-balanced diet with adequate fiber and taking in more fluids is an easy way to be more regular, as is being more physically active each day.

Bowel and poop habits are very personal; they can vary dramatically from person to person. Generally speaking, most people poop between 3 times a week and 3 times a day, but it is also important to be aware of poop consistency and regularity.

Whenever a person’s bowel habits change significantly, they should visit their doctor for an evaluation.

Frequency, normal amounts, and when to see a doctor

A person’s bowel habits say a lot about their health and how well their body is functioning.

Even though it can be embarrassing to talk about bowel movements, they can offer valuable clues to what is going on in the body. Many people have concerns that they are pooping too many times a day, or not enough.

Here are the answers to some common poop questions that may be too embarrassing to ask.

Fast facts on pooping:

• It is hard to say what is normal, especially when it comes to frequency of bowel movements as it varies from person to person.
• Doctors look at how often someone poops and the consistency to determine if a person’s bowel habits are usual.
• Pooping is the body’s way of getting rid of waste products and the undigested food that does not get absorbed.
• Experiencing temporary changes in bowel habits or patterns is normal.

Share on PinterestA person’s bowel movement routine is unique to them, and is determined by a number of factors such as diet.

What is normal for one person may be abnormal for another. A 2010 study published in the Scandinavian Journal of Gastroenterology found that 98 percent of its participants pooped between 3 times per week to 3 times daily.

Most people have their own routine and go to the bathroom the same number of times per day and at around the same time.

Deviating significantly from the regular pattern may still be considered healthy, but it can also indicate the development of a stomach or bowel problem.

How often a person goes to the bathroom can vary a lot and depends on a range of factors including:

Fluid intake

Because the large intestine absorbs excess water, not drinking enough fluids can harden poop and make it more difficult to go. Someone who is experiencing constipation should increase their fluid intake to help keep poop soft.

Age

Constipation is often associated with getting older. Aging causes the gut to slow down, so poop does not pass through as quickly. Also, an older person is more likely to be taking medication that may interfere with their usual pooping habits.

Activity

Staying active helps the colon work better and move poop through the intestines more efficiently. When someone is experiencing constipation or slow digestion, going for a walk or run can help get things moving more regularly.

Diet

Share on PinterestA high fiber diet is likely to result in regular bowel movements. A diet lacking in fiber may lead to constipation, or other digestive problems.

What a person eats plays a significant role in how often they go to the bathroom. Fiber is an essential substance for healthy bowel movements.

Fiber is a type of carbohydrate that the small intestine cannot break down into smaller molecules. As a result, it passes to the colon as a mass of undigested food that eventually becomes poop, also known as stool. A diet that is adequate in fiber can promote regularity and prevent constipation.

Medical history

Some medical conditions and medications can affect bowel health and cause a person to poop more or less often than usual. Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, and even a basic stomach flu virus, can change how often a person has to poop.

Hormones

Some hormones, such as progesterone and estrogen, can affect how often a woman goes to the bathroom. For example, some women report pooping much more frequently in the days leading up to and at the start of their period.

Social factors

Some people have difficulty pooping in a public bathroom, at work, or when other people are nearby. This can cause someone to “hold it in” longer than necessary.

Over time, the body is not able to respond as quickly to signs that it needs to poop, which can cause someone to feel constipated or uncomfortable.

Healthy bowel habits mean that someone is pooping regularly and that the poop is soft and easy to pass. Regular bowel movements allow the colon to empty without pain or discomfort.

Poop that is watery or loose indicates that it is moving through the colon very quickly, usually as a result of irritation, such as from an infection or another source of inflammation.

Having chronic diarrhea (the term for increased and liquid poop) can lead to dehydration or electrolyte imbalances. Diarrhea can also lead to nutrient deficits because the intestine is not able to absorb them when poop is moving through so quickly.

Poop that is small and pellet-like is also abnormal and is usually a sign of constipation or incomplete bowel emptying. This type of poop can be hard or difficult to pass and may even lead to other complications, such as hemorrhoids or stool impaction.

Share on PinterestUsually, a change in pooping habits will resolve itself within a couple of weeks. However, if it doesn’t, or changes are accompanied by concerning symptoms, medical attention should be sought.

Usually, irregular changes in a person’s pooping habits resolve within a short amount of time and are no cause for concern. However, a doctor should assess someone if their bowel changes last longer than 1 to 2 weeks, or there are other concerning symptoms, such as:

• blood in the poop
• black poop
• new onset of “pencil-thin” poop
• weight loss or fever that accompanies diarrhea or constipation
• severe abdominal pain
• vomiting blood or a substance that looks like coffee grounds

If someone typically poops frequently during the day, and the poop has a soft, easy to pass consistency and regular appearance, then people should not be concerned.

However, if the poop is too watery or loose, then there may be some health risks associated with fluid and electrolyte loss that comes with diarrhea.

Anyone who is is concerned about their health should talk to their doctor. The doctor can evaluate the concerns and help to determine what, if any, changes the person needs to make.

One easy intervention is to make some simple dietary changes. Eating a well-balanced diet with adequate fiber and taking in more fluids is an easy way to be more regular, as is being more physically active each day.

Bowel and poop habits are very personal; they can vary dramatically from person to person. Generally speaking, most people poop between 3 times a week and 3 times a day, but it is also important to be aware of poop consistency and regularity.

Whenever a person’s bowel habits change significantly, they should visit their doctor for an evaluation.

Frequency, normal amounts, and when to see a doctor

A person’s bowel habits say a lot about their health and how well their body is functioning.

Even though it can be embarrassing to talk about bowel movements, they can offer valuable clues to what is going on in the body. Many people have concerns that they are pooping too many times a day, or not enough.

Here are the answers to some common poop questions that may be too embarrassing to ask.

Fast facts on pooping:

• It is hard to say what is normal, especially when it comes to frequency of bowel movements as it varies from person to person.
• Doctors look at how often someone poops and the consistency to determine if a person’s bowel habits are usual.
• Pooping is the body’s way of getting rid of waste products and the undigested food that does not get absorbed.
• Experiencing temporary changes in bowel habits or patterns is normal.

Share on PinterestA person’s bowel movement routine is unique to them, and is determined by a number of factors such as diet.

What is normal for one person may be abnormal for another. A 2010 study published in the Scandinavian Journal of Gastroenterology found that 98 percent of its participants pooped between 3 times per week to 3 times daily.

Most people have their own routine and go to the bathroom the same number of times per day and at around the same time.

Deviating significantly from the regular pattern may still be considered healthy, but it can also indicate the development of a stomach or bowel problem.

How often a person goes to the bathroom can vary a lot and depends on a range of factors including:

Fluid intake

Because the large intestine absorbs excess water, not drinking enough fluids can harden poop and make it more difficult to go. Someone who is experiencing constipation should increase their fluid intake to help keep poop soft.

Age

Constipation is often associated with getting older. Aging causes the gut to slow down, so poop does not pass through as quickly. Also, an older person is more likely to be taking medication that may interfere with their usual pooping habits.

Activity

Staying active helps the colon work better and move poop through the intestines more efficiently. When someone is experiencing constipation or slow digestion, going for a walk or run can help get things moving more regularly.

Diet

Share on PinterestA high fiber diet is likely to result in regular bowel movements. A diet lacking in fiber may lead to constipation, or other digestive problems.

What a person eats plays a significant role in how often they go to the bathroom. Fiber is an essential substance for healthy bowel movements.

Fiber is a type of carbohydrate that the small intestine cannot break down into smaller molecules. As a result, it passes to the colon as a mass of undigested food that eventually becomes poop, also known as stool. A diet that is adequate in fiber can promote regularity and prevent constipation.

Medical history

Some medical conditions and medications can affect bowel health and cause a person to poop more or less often than usual. Inflammatory bowel diseases, such as Crohn’s disease or ulcerative colitis, and even a basic stomach flu virus, can change how often a person has to poop.

Hormones

Some hormones, such as progesterone and estrogen, can affect how often a woman goes to the bathroom. For example, some women report pooping much more frequently in the days leading up to and at the start of their period.

Social factors

Some people have difficulty pooping in a public bathroom, at work, or when other people are nearby. This can cause someone to “hold it in” longer than necessary.

Over time, the body is not able to respond as quickly to signs that it needs to poop, which can cause someone to feel constipated or uncomfortable.

Healthy bowel habits mean that someone is pooping regularly and that the poop is soft and easy to pass. Regular bowel movements allow the colon to empty without pain or discomfort.

Poop that is watery or loose indicates that it is moving through the colon very quickly, usually as a result of irritation, such as from an infection or another source of inflammation.

Having chronic diarrhea (the term for increased and liquid poop) can lead to dehydration or electrolyte imbalances. Diarrhea can also lead to nutrient deficits because the intestine is not able to absorb them when poop is moving through so quickly.

Poop that is small and pellet-like is also abnormal and is usually a sign of constipation or incomplete bowel emptying. This type of poop can be hard or difficult to pass and may even lead to other complications, such as hemorrhoids or stool impaction.

Share on PinterestUsually, a change in pooping habits will resolve itself within a couple of weeks. However, if it doesn’t, or changes are accompanied by concerning symptoms, medical attention should be sought.

Usually, irregular changes in a person’s pooping habits resolve within a short amount of time and are no cause for concern. However, a doctor should assess someone if their bowel changes last longer than 1 to 2 weeks, or there are other concerning symptoms, such as:

• blood in the poop
• black poop
• new onset of “pencil-thin” poop
• weight loss or fever that accompanies diarrhea or constipation
• severe abdominal pain
• vomiting blood or a substance that looks like coffee grounds

If someone typically poops frequently during the day, and the poop has a soft, easy to pass consistency and regular appearance, then people should not be concerned.

However, if the poop is too watery or loose, then there may be some health risks associated with fluid and electrolyte loss that comes with diarrhea.

Anyone who is is concerned about their health should talk to their doctor. The doctor can evaluate the concerns and help to determine what, if any, changes the person needs to make.

One easy intervention is to make some simple dietary changes. Eating a well-balanced diet with adequate fiber and taking in more fluids is an easy way to be more regular, as is being more physically active each day.

Bowel and poop habits are very personal; they can vary dramatically from person to person. Generally speaking, most people poop between 3 times a week and 3 times a day, but it is also important to be aware of poop consistency and regularity.

Whenever a person’s bowel habits change significantly, they should visit their doctor for an evaluation.

90,000 Intestinal stoma care and rehabilitation training

On the basis of the coloproctological service of the Grand Medica medical center, there is an office for ostomy patients (registration by phone 8 (3843) 99-40-40) where certified coloproctology specialists select patients for restorative operations, ostomy.

What is an intestinal stoma?

In the course of a particular operation on the intestine, the surgeon sometimes needs to form an intestinal stoma – the withdrawal of the intestine to the surface of the anterior abdominal wall.Most often, the large intestine is excreted and a colostomy is formed, much less often the final section of the small intestine is excreted, then we are talking about an ileostomy.

Why can’t you do without a stoma?

Is it forever or for a while? Your surgeon will answer these questions. In any case, we can say that the stoma is imposed only for health reasons, when without this it is simply impossible to save the patient’s life. There are several diseases that lead to the need to perform such an operation.Whether the stoma is temporary or permanent, depends largely on this underlying disease, as well as on many other factors: the person’s age, concomitant diseases, complications after surgery. You can get a clear answer about the possibility of eliminating the stoma from your operating surgeon.

How will the stoma function? What kind of chair will I have?

In any case, the intestinal stoma should be considered as a normal anus, but located in a different place, on the abdomen, and devoid of sphincters, and hence the function of holding.Also, you will not feel the urge to defecate: feces and gases will pass spontaneously, you will not be able to control this. However, having received the necessary advice on care and modern colostomy bags, you will cope with the peculiarities of personal hygiene and everyday life. Modern colostomy bags will compensate for the functions lost after the operation, the contents of the intestine – feces and gases – will be reliably isolated in a sealed collection bag, which you will empty or throw away yourself. These colostomy bags are compact, invisible under clothes.The consistency and frequency of the patient’s stool depends on which part of the intestine is removed. In people with sigmostoma, stool is usually almost normal – decorated, once a day. With ileostomy, stools are thin, acrid and frequent. Also, the nature of the stool depends on the nutrition and psycho-emotional state of the person. Stress or certain foods can cause you digestive upset, just like before your surgery.

How can I cope with leaving?

The period of recovery and adaptation is quite long, several weeks.During this time, each person experiences a range of different feelings: pain, anxiety, despondency, depression are gradually giving way to hope and joy. All these feelings require recognition and attention from both the person himself and his loved ones. With the help of doctors, medical personnel, your loved ones, you will be able to learn how to take care of yourself on your own – after all, it is not so difficult. Do not dare to give yourself up, say that life is over. It is not true! You will be able to return to your usual way of life, to work, outdoor activities, sports, etc.

Will I be disabled?

The concept of a disabled person is very subjective. A stoma may not change anything in your usual lifestyle that you led before the operation. It is necessary to master new skills in hygienic self-care. You need to be aware of reality, but not dramatize it. If you lose heart, stop noticing good things, do not respond to the help offered to you, you will undoubtedly become disabled. Believe me, a lot is only in your hands and in your power. Some ostomy people do not apply for disability, because they do not consider themselves disabled, they work, and they lead a very active lifestyle.Many, especially the elderly, people usually receive the 2nd group of disability. Everyone decides this question for himself.

Where to replace the colostomy bag? In what position?

If living conditions permit, you can change the colostomy bag in the bathroom, and there you can also use the ostomy toilet. It is preferable to be in a standing position in front of a mirror so that you can clearly see the stoma. If it is difficult for you to stand, you can change the colostomy bag while sitting or lying down.A small mirror can be used.

What needs to be prepared for the ostomy toilet and colostomy bag replacement?

• napkins (for example, “konvakea”, “niltak” cleaning napkins and “konvakea”, “siless” napkins are protected

• dry wipes

• scissors, preferably with curved ends, manicure type

• pencil or pen

• new colostomy bag

• sealing paste, medicinal (similar in consistency to glue, close tightly, store at room temperature)

Should ostomy patients follow a diet?

No, but each person should define for himself some individual rules of nutrition and follow them in one way or another.

Recommended:

• Eat at least 3 times a day

• Eat at the same time every day, ie. regularly.

• Always chew food thoroughly.

• Drink enough liquid, at least 1.5 liters per day.

So, ostomy people do not need to follow a special diet, if there is no special medical indication for this. They, like all people, should eat a varied and healthy diet.Healthy foods include low-fat, high-fiber foods. However, approach this definition carefully. Too much fiber in food can lead to strong gas and loose stools. Do not seek to change the functioning of the stoma by frequently changing food, as this can lead to a continuous release of feces and gas.

Different foods affect stool for each person individually, and it is difficult to define a single rule for everyone. The peels of nuts, fruits and vegetables contain coarse fibrous tissue that cannot be digested, and this is easily identified by the contents of the stool, especially in the case of an ileostomy.The accumulation of coarse fibers in the intestine leads to discomfort. Chewing thoroughly while eating, eating cooked vegetables will help eliminate these problems.

CONSTITUTION in most cases is caused more likely by a general imbalance in nutrition, a lack of fiber, than by some particular food. It is necessary to increase the amount of fiber in food: vegetables, fruits, bran bread, prunes. You also need to drink at least 2-3 liters of fluid per day.

GASES are largely formed as a result of the fermentation of undigested residues of fibrous food tissue containing nitrogen, under the influence of bacteria that make up the microbial flora of the intestine.Everyone is well aware of the result of eating peas or lentils. Some ostomy patients report a decrease in gas production due to a reduction in the diet of onions, cabbage, radishes and, in some cases, cucumbers.

DIARRHEA can be caused by some fruits, vegetables, too spicy food, beer. Spicy food should be eaten carefully and in limited quantities with plain rice, pasta. On all issues of the functioning of the stoma, in case of problems, you should consult with doctors who will help solve these problems, taking into account your individual characteristics.

ILEOSTOM. In any case, liquid, enzyme-rich contents are constantly supplied through the ileostomy throughout the day. It is necessary to consume a sufficient amount of liquid, at least 2.5-3 liters per day. It is best to avoid fruits and vegetables rich in indigestible fiber containing nitrogen (peas, cabbage, legumes), which can cause bloating. You can recommend fractional multiple meals in small portions throughout the day.

KOLOSTOMA. It is necessary to take into account the individually existing tendency to constipation or diarrhea and regulate the stool, giving preference to certain products.Stool-strengthening foods: rice, white bread, pasta, jelly, butter, etc. Laxative foods: fruits, vegetables rich in fiber, prunes, figs, juices, dairy products, beer, etc.

Make an appointment with the proctologist by phone 8 (3843) 99-40-40 or leave a request on the website. 90,077 90,000 “Stoma gave me freedom.” How to live if the intestines are removed

December 7, 2018

Photo author, Linda Blacker

There is probably no such topic about sex and human relationships that YouTube blogger Hannah Vuitton could not talk about, including such a delicate one for many question how sex is disabled.26-year-old Hannah is a frank, well-read woman, cheerful and not afraid of taboo topics.

This year she underwent severe emergency surgery to remove part of her intestines.

The stoma – the hole made by the surgeons in her abdomen – means that Hannah is now doomed to live with a fecal drainage bag she calls “Mona.”

After surgery, Hannah started a blog about how to love her body again. Hannah posted a picture of herself in her underwear showing her stoma, her scars and her drainage bag.

On her BBC blog and podcast, Hannah chatters lightly with two more experienced ostomy and drainage bag owners – BBC host, So Bad Ass author Sam Clisby and fitness model Blake Beckford.

Photo by Linda Blacker

Caption

Hannah Vuitton and her “Mona”

Thousands of people in the UK are living with an ostomy and drainage bag after bowel surgery. There are many indications for such operations, including bowel cancer, Crohn’s disease and ulcerative colitis.

So here’s what you didn’t know about living with a stoma, including phantom pain and opportunities for sex.

What is an ileostomy bag?

An ileostomy is a surgical procedure that pulls the ileum out through the anterior abdominal wall to create an artificial opening (stoma) through which intestinal contents can be removed without passing through the colon.

The excrement enters a special bag, which is then emptied in the toilet.

Hannah says the stoma looks red, soft and moist. It has no nerve endings, you won’t feel anything if you touch it, she says.

Hannah, Sam, and Blake developed ulcerative colitis, a disease in which the colon and rectum become inflamed and ulcers appear on the surface of the colon.

“I often forget about the stoma and the bag until I have to go to the toilet.” Hannah says. “I only feel it if there is gas. Then the bag starts to creak, and if the stool is liquid, I feel like it’s in it.” the contents are dangling. “

Photo author, Blake Beckford

Photo caption,

Blake Beckford and his stoma. He says this operation gave him his freedom

Is it difficult to care for the ostomy?

“It takes all the attention at first,” Sam shares. “You need to master this process. How to care for your stoma, how to change the bag, how to empty it. Now it’s part of my daily life. I go to the shower, change the bag.”

Hannah, Sam and Blake are also forced to get up in the middle of the night to empty the drainage bags or they could leak.

Can I eat normally?

“My family is from India. When I was in the hospital, the nurse told me that I would never be able to eat curry again. I was then ready to pull the IVs out of my hands. That nurse was wrong. You just need to eat a variety of foods. And there is nothing something that I can’t eat right now, “says Sam.

Although when Sam ate beets for the first time after the operation, she was scared: “I thought I was bleeding internally.”

Having a stoma means that food is not digested to the same extent as in a healthy stomach.

Hannah finds it “exciting but disgusting” to watch digested food pass through the stoma and into the bag.

Does the drainage bag smell?

Hannah says that feces only smell when it is outside the drainage bag, for example when it has to be emptied. The bag itself does not emit any odors.

“If you smell something, it’s 100% not me, because I have filters in my bag,” Hannah says.

Sam adds menthol mouthwash to the bag to neutralize odor.

Author of the photo, Sam Cleasby

Caption,

Having a stoma does not mean radical restrictions on food, says Sam Cleasby

What about sex? Can these people do it?

“Hell, yes, of course,” says Sam.

“During sex you won’t be able to remove your drainage bag,” explains Hannah. “For me, it was a kind of psychological barrier: a feeling of insecurity in myself and my body and the need to overcome all this.From a practical point of view, the bag doesn’t affect anything. “

But it’s not that simple for everyone.

” I have a gay friend, “Sam says. – His rectum and anus were removed, everything is sewn up from top to bottom. And it, yes, changed his sex life. “

Hannah has a rectum, but she doesn’t know exactly what condition it is in.

” I don’t know how long it is, how strong it is, “she says. “You see, anal sex is not only for homosexuals, it is for everyone, and so I don’t know yet what to do with this side of sexual life.”

What is phantom rectum?

“People who have lost a limb still seem to feel it or pain in it, phantom pains,” Sam says. “It’s the same with the rectum. As if the brain does not yet know that it is not there.”

“In the beginning, I felt it all the time. And I discussed with the nanny my desire to defecate. She said that next time I should go and sit in the toilet for it to pass,” adds Hannah.

What about the most awkward moment?

It happened to Sam this year in San Francisco.Suddenly, she felt a burning sensation in the stoma – this meant that the stoma was leaking. Sam found a toilet at a nearby supermarket.

“There was a long line, and when I finally went into the booth, I was all in this, from chest to knees,” she recalls. “I took off my leggings and T-shirt and left the toilet in a bra and cotton dress, all in tears, and slowly walked along this line, “she recalls.

“There are times when you feel these kinds of events in public as a real disaster, but now I can even laugh at what happened,” says Sam.

Hannah says she has a special “Can’t Wait” card issued by Crohn’s and Colitis UK, which supports people with ulcerative colitis and Crohn’s disease. She does not need to spend time on long explanations, she can simply show the map in a cafe or in a store.

Photo author, Blacke Beckford

Photo caption,

Blake Beckford

Are stomas always uncomfortable?

“The stoma gave me my real life,” says Blake. “Because life with ulcerative colitis was horrible.With him, everything hurts you, you feel overwhelmed. I got to the point where I couldn’t go outside so that nothing happened to me. “

For Hannah, stoma did not become a symbol of freedom. She was diagnosed at the age of 7, the inflammatory process caused a lot of trouble. From 15 to 25 years old, the disease was in remission, but came back last year.

“It all happened suddenly and completely unsettled me. I spent a month in the hospital and had to urgently undergo an operation. I don’t feel like the ostomy has brought my life back to me.I would like to return everything that was before. But when I say that, I’m not ashamed, “Hannah says.

90,000 Intestinal stomas

What is a stoma

Stoma
(στομα – Greek) is an artificially created anastomosis (message) between the lumen of any hollow organ (trachea, stomach, ureter, etc.) and the surface of human skin.

What is an intestinal stoma

Intestinal stoma
(εντερικό στόμιο – Greek.) is an artificially created anastomosis (communication) between one or another part of the human intestine and the surface of the skin.

There are several types of intestinal stomas. If the stoma is formed from a loop of the small intestine, then its name will correspond to the section of the small intestine on which it is formed: a stoma formed from a loop of the jejunum is called a jejunostomy, from a loop of the ileum – an ileostomy.

When a stoma is formed from any part of the large intestine, it is called a colostomy – this is the general name for all artificial anastomies of the large intestine.

In addition, the name of the stoma may indicate the section of the colon that was used to form it. So, from the cecum (caecum – lat.) A cecostoma can be formed, from the ascending colon (colonascendens – lat.) – an ascendostomy, from the transverse colon (colontransversum – lat.) A transverse colon can be formed, from the descending colon (colondescendens – lat. .) form a descendostomy, and from the sigmoid colon (colonsygmoideum – lat.) form a sigmoidostomy. The most common stomas are formed on the most mobile part of the colon – on the loop of the transverse colon.

When and why are intestinal stomas formed

The range of diseases and conditions in which it is necessary to form the intestinal stoma is quite wide. Among the diseases, colorectal cancer can be distinguished: rectal cancer or colon cancer complicated by intestinal obstruction, severe and complicated forms of ulcerative colitis, Crohn’s disease, complicated forms of acute diverticulitis, in the surgical treatment of multiple knife and gunshot wounds of the intestine.

Many patients with intestinal neoplastic diseases are admitted to the hospital in serious condition, often with complicated forms of the disease. These patients undergo urgent operations, which are completed with the formation of an intestinal stoma. As a rule, the creation of a stoma allows (in this situation) to prepare the patient for more complex and radical treatment.

In other cases, when performing a certain kind of elective surgery, for example, with a low anterior resection of the rectum for rectal cancer, the formation of a stoma is a necessary condition to reduce the risk of failure of the newly formed connection between two fragments of the intestine and, accordingly, is a preventive measure the occurrence of intra-abdominal abscesses and peritonitis – serious surgical complications that can arise as a result of the failure of the interintestinal anastomosis.

Is an intestinal stoma permanently established?

A stoma can be temporary or permanent.

Temporary stoma

A temporary stoma is formed to restrict the passage of intestinal contents through the intestine, if necessary, to exclude the impact of feces on the anastomotic zone – a surgically formed connection between the two ends of the intestine; or in the event that it is not possible to achieve good preparation of the intestine for surgery (in case of violation of intestinal patency due to a tumor or adhesions).Also, the formation of a temporary stoma may be required in the staged surgical treatment of patients with Crohn’s disease, familial adenomatous polyposis, when at the first stage the entire colon or the entire colon is removed together with the rectum with the formation of a J-shaped reservoir; with severe incontinence (anal incontinence).

Surgical treatment of complicated forms of acute diverticulitis (Hartmann’s operation or Hartmann-type operations) ends with the formation of an end sigmoidostomy.Subsequently, in the absence of contraindications, it is possible to carry out reconstructive surgery, in which the stoma is removed, and the intestinal permeability is restored.

With low rectal resection, the creation of a protective (preventive) stoma is also temporary. At a certain time, after proctography – a research method that confirms the consistency of the anastomosis, the stoma is eliminated.

Permanent stoma

A permanent stoma is most often formed in patients with colorectal cancer when it is impossible to perform radical surgery – to eliminate or prevent intestinal obstruction.

In radical surgical treatment of rectal cancer and cancer of the anal canal with the spread of the tumor process to the sphincter apparatus of the rectum (anal sphincters), the sphincter apparatus is removed together with the tumor. In this situation, the surgeon forms an end permanent stoma on the anterior abdominal wall, which is the new unnatural anus (anuspraeternaturalis – lat.).

Whether the stoma is temporary or permanent depends largely on the underlying disease, as well as on many other factors: the person’s age, concomitant diseases, complications after surgery, anatomical features of the patient.

You can get a clear answer about the possibility of eliminating the stoma from your doctor.

How a stoma is formed

The specific location of the colostomy is determined by the surgeon, taking into account the clinical situation, the anatomical features of the patient. In addition, the condition of the outer covers and the abdominal wall is necessarily taken into account – scars and scars significantly complicate the installation of a colostomy bag.

The ileostomy is most often located in the right ileal region, a section of the ileum is displayed on the anterior abdominal wall.

Colostomy:

• Ascendostomy , the cecostomy is located in the right iliac region or right mesogastrium, formed from the ascending, cecum. Intestinal discharge is similar in composition to the intestinal contents.
• Transversostomy can be located in the right or left hypochondrium, as well as in the midline of the abdomen above the navel, at the level of the navel to the left or right of it. This type of stoma is formed from the transverse colon.In most patients, there is a release of mushy contents, easily irritating the skin around the stoma.
• Sigmostoma is located in the left iliac region, the sigmoid colon is removed. According to the sigmostome, the feces are excreted, as a rule, once or twice a day, according to the consistency it is semi-formed.

How does a stoma work? Stoma Physiology

The consistency, color of stool and the frequency of changing or emptying the bag will differ depending on which section of the intestine was used to form the intestinal stoma.

Small intestine stoma

The contents of the small intestine are liquid and alkaline, therefore the same chemical composition and consistency is excreted in the small intestine stoma and is excreted. The alkaline reaction of the discharge of this type of stoma is the reason why severe skin irritation occurs – when the contents of the stoma get on it. Prolonged contact of chyme with the skin leads to the formation of non-healing erosions and ulcers on the skin.

When comparing the volume of discharge per day, the daily volume of liquid chyme from small intestinal stomas significantly exceeds the volume of discharge from a colostomy.Due to electrolyte losses in the stomas formed on the loop of the small intestine, a significant amount of fluid with a high content of potassium and sodium (the so-called blood electrolytes) – most people with a small intestinal stoma are susceptible to dehydration (dehydration) and electrolyte imbalance in the blood. It is also possible to form kidney stones and gallbladder: when dehydrated, the kidneys reabsorb water from the primary urine, thereby producing more concentrated urine. From such concentrated urine, a mineral sediment can “fall out” and form stones – in the kidneys and other parts of the urinary tract.

Colon stoma (colostomy)

For the process of digestion (fermentation) of food, the large intestine is of relatively little importance, since, with the exception of some substances, food is almost completely digested and absorbed already in the small intestine. From the small intestine to the cecum – the initial section of the large intestine – an average of 500-800 ml of liquid content is delivered per day. In the large intestine, the formation of feces occurs due to the absorption of water, and already fully formed feces enter the sigmoid colon.Thus, the segment of intestine from which the colostomy will be formed will act as an artificial anus. Colostomy discharge has an odor that depends on the quality of the food consumed. The volume and consistency of feces can be regulated by the selection of an appropriate diet, the amount of liquid (juice, water) drunk per day.

What is the preferred diet for the ostomy patient

It is very important that the diet of ostomy patients is balanced and varied, including a wide variety of foods.Typically, no special diet is required. After the operation, you must return to your usual regular diet. It is best to gradually expand your diet by adding one type of food per day, while noticing changes in stool pattern and frequency and drawing appropriate conclusions. You should try to eat slowly, often and little by little, chewing food well.

It should be borne in mind that some foodstuffs fix the stool, while others, on the contrary, cause it to weaken. By changing their diet, the patient can adjust the frequency of bowel movements up to one or two times a day.

White bread, pasta, slimy soups, rice porridge on water, butter, boiled meat and fish, hard-boiled eggs, broths, mashed potatoes, black tea, cocoa, some fruits (pear, quince) have a firming effect.

Relax: black rye bread, oatmeal, fried meat, fish and lard, raw milk, kefir, yogurt, sour cream, most vegetables and fruits (cabbage, beets, cucumbers, grapes, apples, plums, figs).

Legumes, cabbage, sugar, carbonated drinks contribute to increased gas formation.An unpleasant odor from a colostomy may appear if the patient consumes too many eggs, onions, or garlic.

Will I be able to control the process of defecation in the presence of a stoma

The intestinal stoma should be viewed as the anus (unnatural anus), but located elsewhere, on the abdomen. A feature of the new unnatural anus is the absence of a sphincter apparatus, and hence the function of holding.

Often you will not feel the urge to defecate, feces and gases will pass spontaneously, you will not be able to control this process.However, having received the necessary advice on care and modern colostomy bags, you can cope with this new feature of self-hygiene and everyday life.

Modern colostomy bags compensate for the functions lost after the operation, the contents of the intestine (feces and gases) are reliably isolated in a sealed ostomy bag made of gas-tight materials. Colostomy bags are designed not only to collect feces, but also to protect the skin around the stoma, and are fixed on the skin of the abdomen immediately after the formation of the stoma at the end of the operation.Modern colostomy bags offered by manufacturers are compact, invisible under clothes.

What complications can there be in the presence of an intestinal stoma

Peristomal dermatitis (skin irritation in the stoma area)

Dermatitis is observed quite often, is the result of mechanical irritation (frequent change of colostomy bags, careless treatment of the skin), or chemical effects of intestinal discharge (leakage under the plate, poorly fitted, leaking colostomy bag).

Manifestations of dermatitis: redness, blisters, cracks, weeping sores on the skin around the stoma. Skin irritation causes itching, burning, and sometimes severe pain. An allergic skin reaction to stoma devices and products may develop. If the allergy is pronounced, then you should abandon the use of adhesive bags for a while. In such cases, the doctor should decide on the choice of the type of colostomy bag. Often the cause of skin complications is simply insufficient skin care in the stoma fixation zone.In case of irritation of the skin around the stoma, consultation with a coloproctologist or specialist in rehabilitation of ostomy patients is necessary.

Hypergranulation in the stoma area

With frequent dermatitis around the stoma, polypoid outgrowths are formed on the border between the skin and the mucous membrane, which bleed easily. Usually these formations are small, several millimeters in diameter. Seek medical attention if such skin changes occur.

Eventration of the small intestine

Small bowel event – prolapse of small bowel loops into a parastomy wound – occurs when an incision is too wide to form a stoma.This complication often occurs in restless children who cry a lot in the days following the operation, which is the reason for the increase in intra-abdominal pressure and, as a result, the formation of eventration. In adult patients, a prolonged increase in intra-abdominal pressure (persistent cough, repeated vomiting) and a violation of the therapeutic and protective regime (lifting weights) also leads to eventration. The prolapse of the loops of the small intestine requires emergency surgery.

Evagination

Evagination – inversion of the intestine outward.It occurs more often in children. A definite role in the occurrence of this complication can be played by constantly increased intra-abdominal pressure, increased peristaltic activity of the adducting intestine, an excessively free defect of the aponeurosis. Evagination can be minor and can be corrected with light pressure, but sometimes it is massive, for example, a cecostomy is often complicated by evagination of the ileocecal angle. In most cases, surgery is not required, but the patient has to constantly reposition the prolapsed colon.

Stoma stricture

Stoma stricture – Narrowing of the stoma outlet. It develops most often with the tendency of tissues (skin) to form keloid scars. Less commonly, stenosis can be caused by suturing the anterior abdominal wall around the stoma. With this complication, emptying is delayed, and in rare cases, intestinal obstruction may develop. With the gradual formation of a narrowing (stricture) of the outlet of the stoma, the patient’s struggle with this complication is reduced to a change in diet and the formation of soft feces, which greatly facilitates their passage through the narrowed opening.In the future, it is possible to expand the narrowing by the bougienage method, by introducing medical supplies (rubber probe, catheter) into the narrowed opening. It is not always possible to eliminate the stricture in a conservative way (bougienage), then they resort to an operational aid. During the operation, according to indications, the stoma is eliminated or its reconstruction is performed.

Bloody discharge from the stoma

In most cases, the appearance of blood is caused by damage to the intestinal mucosa due to inaccurate ostomy care or the use of rough materials.The edge of the narrow hole in the plate, the rigid flange of the colostomy bag can also injure the intestine and cause bleeding. Bleeding usually stops spontaneously. But if the bleeding is profuse, you need to see a doctor.

Retraction (stoma retraction)

This is a gradual dislocation of the ostomy opening below the level of the skin, retraction can be around the entire circumference of the ostomy opening or partial. The presence of a funnel-shaped depression significantly complicates the care of the stoma and requires the use of special colostomy bags with a convex (concave) plate and additional care products (special pastes for leveling the skin surface and protecting it).In case of ineffectiveness of these measures, surgical treatment (reconstruction of the stoma) is undertaken.

Parastomal hernias (hernias in the area of ​​stoma formation)

This is a protrusion of the abdominal organs around the stoma due to the weakness of the muscular layer of the anterior abdominal wall at the site of the stoma formation, more often against the background of increased intra-abdominal pressure. The risk of a hernia increases if the patient is obese. Contribute to the formation of hernias – prolonged cough and repeated vomiting in the early postoperative period.To prevent this complication, elastic bandages are used immediately after surgery. In the future, the bandage is worn for 2-3 months.

Patients with even small sizes of parastomal hernias may experience pain, constipation, and difficulty using colostomy bags. In case of infringement of parastomal hernias, only surgical treatment is possible.

Surgical rehabilitation of patients with intestinal stoma

Surgical rehabilitation is an important part of the medical rehabilitation of ostomy patients.

The timing of reconstructive and reconstructive-restorative operations is determined individually and depends on the initial diagnosis, the type of proposed intervention, the general condition of the patient.

Reconstructive and plastic surgery are among the most difficult in coloproctology and should be performed exclusively by qualified surgeons with special training and sufficient experience.

Currently, the restoration of intestinal continuity during the elimination of stomas is one of the urgent tasks of abdominal surgery.

Performing reconstructive surgery on the colon is becoming highly relevant for social and labor rehabilitation and improving the quality of life of ostomy patients (patients with ileo- or colostomy). This intervention, in terms of technical complexity, sometimes surpasses the primary operation, but at the same time, the methods of surgical correction during the elimination of stomas over the past 10 years have practically not undergone fundamental changes.

Until now, the exact timing of the restoration of intestinal continuity with stomas has not been determined and, depending on various factors, range from 2-3 weeks to 1.5 years.

With a double-barreled type of colostomy, the intestinal loop is isolated from the surrounding tissues, and then an anastomosis is formed from the intestinal walls.

In patients with a single-barreled terminal colostomy after a Hartmann-type operation, a complex reconstructive operation is required to restore the continuity of the colon. The sections of the intestine are connected by the “end-to-end” or “side-to-side” methods. Immediately after the formation of the anastomosis, before suturing the wound of the anterior abdominal wall, it is imperative to check the tightness of the connection by contrast or air sample

The presence of aggravating factors in the form of colostomy and paracolostomy complications complicates the surgeon’s task at the stage of reoperation.Paracolostomy and ventral hernias, colostomy strictures, ligature fistulas, evagination of the stoma lead to additional infection of the forthcoming surgical access.

The KKMH Clinic carries out all types of reconstructive surgery on the colon, as well as reconstructive surgery in the presence of an ileostomy – with or without parastomal complications.

Intestinal stomas – Tambov State Clinical Hospital named after Arch. Luka

Stoma (στομα – Greek.) Is an artificially created anastomosis (communication) between the lumen of any hollow organ (trachea, stomach, ureter, etc.) and the surface of the human skin.

Intestinal stoma (εντερικό στόμιο – Greek) is an artificially created anastomosis (communication) between one or another part of the human intestine and the surface of the skin.

There are several types of intestinal stomas. If the stoma is formed from a loop of the small intestine, then its name will correspond to the section of the small intestine on which it is formed: a stoma formed from a loop of the jejunum is called a jejunostomy, from a loop of the ileum – an ileostomy.

When a stoma is formed from any part of the large intestine, it is called a colostomy – this is the general name for all artificial anastomies of the large intestine.

In addition, the name of the stoma may indicate the section of the colon that was used to form it. So, from the cecum (caecum – lat.) A cecostoma can be formed, from the ascending colon (colon ascendens – lat.) – an ascendostomy, from the transverse colon (colon transversum – lat.) form a transverse colon, from the descending colon (colon descendens – lat.) form a descendostomy, and from the sigmoid colon (colon sygmoideum – lat.) form a sigmoid colon. The most common stomas are formed on the most mobile part of the colon – on the loop of the transverse colon.

The range of diseases and conditions in which it is necessary to form an intestinal stoma is quite wide. Among the diseases, one can distinguish colorectal cancer complicated by intestinal obstruction, severe and complicated forms of ulcerative colitis, Crohn’s disease, complicated forms of acute diverticulitis, in the surgical treatment of multiple knife and gunshot wounds of the intestine.

A stoma can be temporary or permanent.

Whether the stoma is temporary or permanent depends largely on the underlying disease, as well as on many other factors: the person’s age, concomitant diseases, complications after surgery, anatomical features of the patient.

You can get a clear answer about the possibility of eliminating the stoma from your doctor.

The specific localization of the colostomy is determined by the surgeon, taking into account the clinical situation, the anatomical features of the patient.In addition, the condition of the outer covers and the abdominal wall is necessarily taken into account – scars and scars significantly complicate the installation of a colostomy bag.

The ileostomy is most often located in the right ileal region, a section of the ileum is displayed on the anterior abdominal wall.

Colostomy can be located in different parts of the anterior abdominal wall, depending on the part of the colon that was stomy.

The consistency, color of stool and the frequency of changing or emptying the colostomy bag will differ depending on which section of the intestine was used to form the intestinal stoma.

It is very important that the diet of ostomy patients is balanced and varied, including a wide variety of foods. Typically, no special diet is required. After the operation, you must return to your usual regular diet. It is best to gradually expand your diet by adding one type of food per day, while noticing changes in stool pattern and frequency and drawing appropriate conclusions. You should try to eat slowly, often and little by little, chewing food well.

It should be borne in mind that some foodstuffs fix the stool, while others, on the contrary, cause it to weaken. By changing their diet, the patient can adjust the frequency of bowel movements up to one or two times a day.
White bread, pasta, slimy soups, rice porridge on water, butter, boiled meat and fish, hard-boiled eggs, broths, mashed potatoes, black tea, cocoa, some fruits (pear, quince) have a firming effect.

Loosen: black rye bread, oatmeal, fried meat, fish and lard, raw milk, kefir, yogurt, sour cream, most vegetables and fruits (cabbage, beets, cucumbers, grapes, apples, plums, figs).

Legumes, cabbage, sugar, carbonated drinks contribute to increased gas formation. An unpleasant odor from a colostomy may appear if the patient consumes too many eggs, onions, or garlic.

The intestinal stoma should be viewed as the anus (unnatural anus), but located elsewhere, on the abdomen. A feature of the new unnatural anus is the absence of the sphincter apparatus, and hence the function of retention.

Often you will not feel the urge to defecate, feces and gases will pass spontaneously, you will not be able to control this process.However, having received the necessary advice on care and modern colostomy bags, you can cope with this new feature of self-hygiene and everyday life.

Modern colostomy bags compensate for the functions lost after the operation, the contents of the intestine (feces and gases) are reliably isolated in a sealed ostomy bag made of gas-tight materials. Colostomy bags are designed not only to collect feces, but also to protect the skin around the stoma and are fixed on the abdominal skin immediately after the formation of the stoma at the end of the operation.Modern colostomy bags offered by manufacturers are compact, invisible under clothes.

Surgical rehabilitation is an important part of the medical rehabilitation of ostomy patients.

The timing of reconstructive and reconstructive-restorative operations is determined individually and depends on the initial diagnosis, the type of proposed intervention, the general condition of the patient.

Performing reconstructive surgery on the colon is becoming highly relevant for social and labor rehabilitation and improving the quality of life of ostomy patients (patients with ileo- or colostomy).This intervention, in terms of technical complexity, sometimes surpasses the primary operation.

The terms of restoration of intestinal continuity, depending on various factors, range from 2-3 weeks to 1.5 years.

The presence of aggravating factors in the form of colostomy and paracolostomy complications complicates the surgeon’s task at the stage of re-intervention.

In the Department of Purulent Surgery, TGBUZ “GKB im. Arch. Luke g Tambov “treatment of patients with localization of stomas in various parts of the intestine is carried out.Most often, stomas are superimposed on the large intestine – so-called colostomas are formed. The main disease leading to the imposition of a colostomy is tumors of various parts of the colon. Depending on the disease and its neglect, as mentioned above, the stoma can be temporary and permanent.

Reconstructive operations are also performed in the department: closing of some types of intestinal stomas.

Everything about the intestinal stoma

What is an intestinal stoma?

In the course of a particular operation on the intestine, the surgeon sometimes needs to form an intestinal stoma – the withdrawal of the intestine to the surface of the anterior abdominal wall.

The colon is most often excreted and a colostomy is formed, much less often the end of the small intestine is excreted, then we are talking about an ileostomy.

Why can’t you do without a stoma? Is it permanent or is it possible to remove this conclusion?

These questions are usually answered by your surgeon. In any case, we can say that the stoma is imposed only for health reasons, when without this it is simply impossible to save the patient’s life. There are several diseases that lead to the need to perform such an operation.Whether the stoma is temporary or permanent, depends largely on this underlying disease, as well as on many other factors: the person’s age, concomitant diseases, complications after surgery.

Taking into account the number of ends of the gut that have been removed, a distinction is made between single and double-barreled holes. Depending on whether it is possible to carry out an operation to restore the intestines, it happens:

Temporary stoma – recovery is possible and takes time. Permanent stoma – Reconstruction surgery is not possible.

Holes are also distinguished by their shape. They can be convex or, on the contrary, flat, or even retracted, as well as oval or round. Since the stoma does not have a locking device, patients cannot feel the urge to defecate and control the process itself. In order to eliminate the discomfort associated with spontaneous emptying and passing of gases, there are colostomy bags. They contain a sealed, odor-free bag into which gases and intestinal contents are released.In addition, the colostomy bag protects the skin around the stoma. It is compact and invisible under clothing.

How will the stoma function? What kind of chair will I have?

In any case, the intestinal stoma should be considered as a normal anus, but located in a different place, on the abdomen, and devoid of sphincters, and hence the function of holding. Also, you will not feel the urge to defecate, feces and gases will pass spontaneously, you will not be able to control this.However, having received the necessary advice on care and modern colostomy bags, you will cope with this new feature of self-hygiene and everyday life.

Modern colostomy bags will compensate for the functions lost after the operation, the contents of the intestine – feces and gases – will be reliably isolated in an airtight bag, which you will empty or throw away yourself. These colostomy bags are compact, invisible under clothes.

The consistency and frequency of the patient’s stool depends on which part of the intestine is removed.Usually in people with sigmostoma, the stool is almost normal – decorated, once a day. According to the ileostomy, the stool is liquid, acrid and frequent. Also, the nature of the stool depends on the nutrition and psycho-emotional state of the person. Stress or certain foods can cause you digestive upset, just like before your surgery.

How can I cope with leaving?

The period of recovery and adaptation is quite long, several weeks. During this time, each person experiences a range of different feelings: pain, anxiety, despondency, depression are gradually giving way to hope and joy.This is the law of life. All these feelings require recognition and attention, both from the person himself and from his loved ones. With the help of doctors, medical personnel, your loved ones, you will be able to learn how to take care of yourself on your own, because it is not so difficult. Do not dare to give yourself up, say that life is over. It is not true! You will be able to return to your usual way of life, to work, outdoor activities, sports, etc.

Will I be disabled?

The concept of a disabled person is very subjective.A stoma may not change anything in your usual lifestyle that you led before the operation. It is necessary to master new skills in hygienic self-care. You need to be aware of reality, but not dramatize it. If you lose heart, stop noticing good things, do not respond to the help offered to you, you will undoubtedly become disabled. Believe me, a lot is only in your hands and in your power.

Some ostomy people do not apply for disability, because they do not consider themselves disabled, they work, and they lead a very active lifestyle.Many, especially the elderly, people usually receive a 2nd group of disability. Everyone decides this question for himself. In any case, the most important thing for you is not to consider yourself a cripple.

What does the gastrointestinal tract look like, how does digestion take place?

The gastrointestinal tract consists of the oral cavity, pharynx, esophagus, stomach, small intestine and large intestine.

Digestion is a complex physiological process by which food enters the digestive tract, undergoes physical and chemical changes, and the nutrients it contains are absorbed into the blood and lymph.For the digestion of food, the large intestine is of relatively little importance, since, with the exception of some substances, food is almost completely digested and absorbed already in the small intestine. From the small intestine to the cecum, an average of 500-800 ml of liquid content per day comes. In the large intestine, the formation of feces occurs due to the absorption of water. Already fully formed feces enter the sigmoid colon.

Is it better to hide your stoma from everyone, or vice versa?

You will not give a single piece of advice.If you live with a large family in the same apartment, you can hardly hide that you are a stoma. It is necessary to explain to all family members that now you need to conduct hygienic self-care in a different way, and if necessary, then ask for help. Most importantly, try not to be ashamed of this, because everyone in the family is interested in hygiene.

If you live in a separate apartment, do not need help with caring, then you do not need to tell all the details to your relatives and friends, except perhaps to your closest ones.

We know of cases when a woman who was ostomy successfully hid from her husband and children that she had a stoma, and she masked her neat colostomy bag with a special belt, explaining that after the operation it was “so necessary.”

Keep in mind that the vast majority of people have no idea what exactly a stoma is, and it is not always necessary to reveal to them all the secrets of your operation.

How do I care for my ostomy?

You will regularly perform a hygienic toilet for your stoma, and you need to understand that this is not a dressing, that a stoma is not a wound, and you do not need any special, let alone sterile, conditions for caring for the stoma and the skin around it.You will do everything yourself without gloves. Don’t be afraid to touch your stoma.

Rinse the stoma and the skin around it with running warm water, you can use baby soap. It is convenient to take a shower by removing the colostomy bag from the body.

After rinsing, gently blot dry the skin with a soft towel. Avoid rubbing, especially with a terry towel. During the toilet, if you touch it carelessly, your stoma can bleed. This is normal, because a stoma is a gut turned outward by a mucous membrane, and any mucous membrane is very delicate (like on the gums).To stop the bleeding, gently but firmly press a gauze pad onto the stoma.

If there is hair around the stoma, it must be removed. The best thing to do is trim the hairs regularly with scissors. Shaving your hair is not recommended.

Basic rule: do not use any special solutions or liquids to wipe the skin around the stoma: no alcohol, no ether, no liquid soap, no antiseptic solutions. All this can cause irritation, dry skin, allergic reactions, and worsen the adhesion of the colostomy bag.

If you plan not to use the colostomy bag for some time after using the ostomy toilet, to give your skin a little rest, you can lubricate it with a cream (for example, “Children’s”). But, before you put on the colostomy bag again, be sure to rinse the skin. The stoma itself does not need to be lubricated.

Where to replace the colostomy bag? In what position?

If living conditions permit, you can change the colostomy bag in the bathroom, and you can also use the ostomy toilet there. It is preferable to be in a standing position in front of a mirror so that you can clearly see the stoma.If it is difficult for you to stand, you can change the colostomy bag while sitting or lying down. A small mirror can be used.

What should be prepared for the ostomy toilet and colostomy bag replacement?

• Wipes (gauze, for example) moistened with water
• Dry wipes
• Plastic garbage bags, for used colostomy bag
• Scissors, preferably with curved ends, manicure type
• Pencil or pen
• New colostomy bag
• Healing sealing paste (similar in consistency to glue, close tightly, store at room temperature)

It will be convenient if you put all these things in one place, then you will not have to look for one thing or the other every time.By the way, for those cases when you leave, and you may need to change the colostomy bag outside the house, prepare the same items in a separate package and take with you.

Will I be able to change the colostomy bag without assistance?

During your stay in the hospital after surgery, try to remember how the nurse changes your colostomy bag. Maybe you can even participate in this: peel off the old bag yourself, touch your stoma, the skin around it. Experienced nurses will help you master all nursing skills.If you want to be independent in your life, then everything will work out, despite your problems – someone has age, poor eyesight, someone has “poor hands”. It is important that each patient will be helped to choose the most suitable colostomy bag, which they will be able to cope with.

So the answer to this question is, “Of course, yes!”

How often should the colostomy bag be changed?

The rhythm of replacing the colostomy bag depends on the type of your stoma, and therefore on what kind of product you are using.

The disposable one-piece filter bag must be replaced when it is full of feces, usually once or twice a day. If such a need arises more often – 3-4 times a day, then you need to abandon these colostomy bags, since your skin will suffer from their frequent peeling off.

A one-piece colostomy bag with an outlet from the bottom is usually used by those people who have frequent and loose stools. Such a bag must be replaced after 2-3 days, and emptied as needed.

Two-piece colostomy bags – plates with removable bags on rings – are very convenient. But not everyone can use them, since for gluing the plate, it is necessary that around the stoma there is, as it were, a flat area measuring 6 cm by 6 cm at least, without pits, scars, and bumps. This is not always the case. The plate needs to be replaced on average 2 times a week. Sometimes less often, sometimes more often. Keep in mind that when filling the bag on the plate, there is a risk of depressurization of the colostomy bag. Try to keep the bag as full as possible.Empty the release bag as often as needed! The release bag is usually replaced every 2 days. The closed bags on the plate are changed once to several times a day.

People with an ileostomy usually need to change their colostomy bag more often. the contents of the small intestine quickly corrode the healing base of the plate or self-adhesive bag and irritate the skin.

In any case, we recommend that the patient or relatives who help with care keep a kind of self-control diary. First of all, it is necessary each time to note the date and time of the colostomy bag replacement, the frequency of replacing the bag on the plate or emptying it during the day.

What time of day to change the colostomy bag?

Do not change your colostomy bag immediately after eating. It is good time in the morning before breakfast or in the evening before bed. Gradually, you yourself will develop your own rhythm of replacement, although, of course, you will not do without “accidents” when you have to replace the colostomy bag unscheduled.

What to do with the used colostomy bag?

Observe precautions when peeling off a colostomy bag, especially one filled with contents. Peel it off gently starting from the top.Discard the contents of the bag or drain into the toilet. Then, put the kp in a plastic bag and tie it up. And only after that, throw the kp into the trash can or into the garbage chute.

You may be away from home when replacing the colostomy bag, so be sure to always carry a pair of dark plastic bags for used colostomy bags with you.

Which hole should be cut in the colostomy bag?

If the opening is too large in relation to the size and shape of the stoma, the skin around the stoma will be exposed, and the feces and mucus will irritate it, especially if the stool is loose.

If the opening is too small, it is even worse, because the edges of the colostomy bag can injure or compress the stoma, cause it to swell or bleed.

Thus, the opening of the colostomy bag needs to match the shape and size of your stoma. It is also very important to consider the location of the stoma on the anterior abdominal wall: it is one thing if your stoma is on level ground, protrudes above the level of the skin, and quite another, if the stoma is “drowned in a hole”, located in a fold.To make the correct hole, you need to make a stencil from thick sample paper. A nurse at the Stoma Center will help you with this.

Why is there skin irritation around the stoma?

There may be several reasons. Let’s figure it out in order.

• You wiped your skin with an irritating liquid (alcohol, ether, lotion).

• Use only running water, baby soap can be used.

• With the help of the Stoma Center nurse, you need to find the most suitable colostomy bag for you, perhaps you need a bag with a drain.

• The opening in the colostomy bag is not suitable or the surface of the abdomen around the stoma is uneven, therefore, the adhesive surface of the colostomy bag does not adhere tightly to the skin, feces and mucus flow under the colostomy bag and accumulate there.

Anyway, contact the nurse at the Stoma Center who will help you solve all these problems.

What other complications are there with ostomy?

Stoma bleeding

In most cases, it is caused by damage to the intestinal mucosa due to inaccurate ostomy maintenance or the use of rough materials.The edge of the narrow hole in the plate, the rigid flange of the colostomy bag can also injure the intestine and cause bleeding. Bleeding usually stops spontaneously. But if it is prolonged and profuse, you need to see a doctor.

Narrowing (stenosis)

The stoma must be passable, the index finger must be passed freely. The narrowing is usually caused by inflammation in the stoma in the early postoperative period. If the narrowing reaches a degree that interferes with bowel emptying, surgery must be performed to widen the opening.If the stoma is narrowed, do not take laxatives without consulting a surgeon!

Ostomy obstruction (retraction)

This is retraction of the intestinal wall below the skin level, circular or partial. The presence of a funnel-shaped depression significantly complicates the care of the stoma and requires the use of special two-component colostomy bags with a convex (concave) plate and additional care products (special pastes for leveling the skin surface and protecting it). In case of ineffectiveness of these measures, surgical treatment is undertaken.

Stoma prolapse (prolapse)

Small (3-4 cm) prolapse of the mucous membrane occurs quite often, but, as a rule, is not accompanied by a violation of the patient’s condition and the function of the stoma. Complete prolapse of all layers of the intestinal wall disrupts the function of emptying, makes it difficult to care for the stoma, and can lead to intestinal entrapment. The prolapse increases in a standing position, with a cough, with physical exertion. In the supine position, it is sometimes adjusted; the prolapsed intestine in most cases can be set back by hand.In case of repeated or permanent loss, you must consult a doctor, and in case of infringement – immediately!

Stoma hypergranulation

Sometimes on the border between the skin and the mucous membrane, polypoid outgrowths are formed that bleed easily. They are usually small, several millimeters in diameter. The appearance of whitish, bleeding vesicles on the mucous membrane is possible. In all such cases, you must consult a doctor. The problems, complications and their prevention in patients with urinary tract stomas (urostomas) are similar to those faced by patients with intestinal stomas.

Hernia in the ostomy area

Hernia in the area of ​​the stoma (parastomal hernia) – protrusion of the internal organs around the stoma due to the weakness of the muscle layer of the abdominal wall at the site of the stoma removal. This is a common complication of colostomy; with ileostomy, it is less common. The risk of a hernia increases with obesity, as well as with prolonged cough. Patients with even small hernia may experience pain, constipation, and difficulty using colostomy bags.

Parastomal hernia

can be infringed, in such cases, only surgical treatment. As a prophylaxis of this complication, in the first time after surgery (2-3 months), patients wear a specially selected elastic bandage. The bandage is used for parastomal hernia and intestinal prolapse in case of impossibility of surgical treatment due to concomitant diseases.

Will the stoma change? How?

Changing your stoma is part of the natural healing process.These changes occur in two successive stages:

• In the early postoperative period, the so-called “maturation of the stoma” occurs. Immediately after the operation, the stoma is swollen, intensely red in color, bleeds easily. Gradually, a circular scar forms around the stoma, it becomes smaller, usually pink-red in color, and other postoperative wounds heal. This period lasts an average of 3 to 6 weeks.
• Stage of “mature” stoma. It becomes its constant size.But you should know that the stoma is constantly “before our eyes” that slightly increases, then decreases slightly. This is due to the muscle contraction of the stoma gut wall, and this is normal.

There may be changes in your stoma in the future, some may not be harmless. That is why it is advisable to regularly, at least 1 time in six months, come to the reception at the Stoma Center, as well as if you are alarmed by changes in the stoma.

Can a stoma hurt?

No, the stoma cannot hurt, since there are no painful nerve endings in the intestinal wall.Painful sensations in the stoma area may be, but it is not the stoma that hurts. Pain and burning sensation are usually caused by irritation of the skin around the stoma. Also, increased peristalsis (work) of the intestine may be accompanied by pain. In any case, you can contact your surgeon or the Ostomy Patient Rehabilitation Office if you are concerned about pain in the stoma area.

What is a postoperative bandage? Does everyone need to wear it?

After major bowel surgeries, patients usually have a large postoperative scar on the abdomen.To prevent the occurrence of a postoperative hernia in the area of ​​this scar and in the area of ​​the stoma, doctors recommend wearing a bandage for the first year after surgery and not lifting more than 5 kg. For many older people, it is advisable to wear the bandage for longer.

As a rule, it is necessary to order a bandage immediately with a special hole for a colostomy bag. Be sure to consult on this issue at the Stoma Center.

Can a stoma “go under the skin” or “fall out”?

Yes, it is possible.Both retraction and prolapse (prolapse) of the stoma are complications, in some cases even requiring surgical correction. If you suddenly find that your stoma “leaves” or turns outward, be sure to contact the surgeon or the Stoma Center.

Does a stoma always have one hole or does it have two?

There are also two holes in the stoma. And from one excreted feces, and from the other only mucus.

You can always ask your surgeon to draw a diagram of your operation.This will help you to correctly imagine what kind of stoma you have.

Should ostomy patients follow a diet?

NO, but each person should define for themselves some individual rules of nutrition and follow them in one way or another.

Generally recommended:

• Eat at least 3 times a day
• Eat at the same time every day, i.e. regularly
• Always chew food thoroughly
• Drink enough liquid, at least 1.5 liters per day

So, ostomy people do not need to follow a special diet, if there is no special medical indication for this.They, like all people, should eat normal, varied and healthy foods. Healthy foods include low-fat, high-fiber foods. However, approach this definition carefully. Too much fiber in food can lead to strong gas and loose stools. Do not seek to change the functioning of the stoma by frequently changing food, as this can lead to a continuous release of feces and gas.

Different foods affect stool for each person individually, and it is difficult to define a single rule for everyone.

The peels of nuts, fruits and vegetables contain coarse fibrous tissue that cannot be digested, and this is easily identified by the contents of the stool, especially in the case of an ileostomy. The accumulation of coarse fibers in the intestine leads to discomfort. Chewing thoroughly while eating, eating cooked vegetables will help eliminate these problems.

CONSTRUCTION in most cases is caused by a general imbalance in the diet, lack of fiber, than by some individual food.It is necessary to increase the amount of fiber in food: vegetables, fruits, bran bread, prunes. You also need to drink at least 2-3 liters of fluid per day.

GASES are largely formed as a result of the fermentation of undigested residues of fibrous food tissue containing nitrogen, under the influence of bacteria that make up the intestinal microbial flora. Everyone is well aware of the result of eating peas or lentils. Some ostomy patients report a decrease in gas production due to a reduction in the diet of onions, cabbage, radishes and, in some cases, cucumbers.

DIARRHEA can cause some fruits, vegetables, too spicy food, beer. Spicy food should be eaten carefully and in limited quantities with plain rice, pasta.

On all issues of the functioning of the stoma, in case of problems, you should consult with doctors who will help solve these problems, taking into account your individual characteristics.

ILEOSTOMA . In any case, liquid, enzyme-rich contents are constantly supplied through the ileostomy throughout the day.It is necessary to consume a sufficient amount of liquid, at least 2.5-3 liters per day. It is best to avoid fruits and vegetables rich in indigestible fiber containing nitrogen (peas, cabbage, legumes), which can cause bloating. You can recommend fractional multiple meals in small portions throughout the day.

BOLT. It is necessary to take into account the individual existing tendency to constipation or diarrhea and adjust the stool, giving preference to certain products.Stool-strengthening foods: rice, white bread, pasta, jelly, butter, etc. Laxative foods: fruits, vegetables rich in fiber, prunes, figs, juices, dairy products, beer, etc.

While still in the clinic, start a Nutrition Diary according to this sample:

Add each new dish or product to your diet in isolation, record the result.As a result, you will be able to make a list of foods that are not good for you and will avoid them. This way, you can balance your diet almost on your own.

Will I be able to control the bowel movement in the presence of a stoma?

The intestinal stoma should be viewed as the anus (unnatural anus), but located elsewhere, on the abdomen. A feature of the new unnatural anus is the absence of a sphincter apparatus, and hence the function of holding.

Often you will not feel the urge to defecate, feces and gases will pass spontaneously, you will not be able to control this process. However, having received the necessary advice on care and modern colostomy bags, you can cope with this new feature of self-hygiene and everyday life.

Modern colostomy bags compensate for the functions lost after the operation, the contents of the intestine (feces and gases) are reliably isolated in a sealed ostomy bag made of gas-tight materials.Colostomy bags are designed not only to collect feces, but also to protect the skin around the stoma, and are fixed on the skin of the abdomen immediately after the formation of the stoma at the end of the operation. Modern colostomy bags offered by manufacturers are compact, invisible under clothes.

Do I need to wear special clothing to hide the colostomy bag?

Modern colostomy bags are compact enough and you can wear your usual clothes as before the operation. You just need to refrain from tight-fitting clothing and make sure that the belt of your trousers does not press directly on the stoma.

Choose different modifications of the colostomy bag depending on the season and your activity. For recreation and sports, one-piece soft articles and ostomy covers are preferred. All bags are covered with a net or soft cloth to prevent rustling. This means that you can move as you want without fear. Being stomaed does not mean being crippled in front of everyone and limiting yourself in everything.

Can you wear a swimsuit?

Of course! Choose the right fit.For men, the best swimwear is Bermuda briefs, and for women, closed or semi-closed swimwear. For swimming, use special mini-colostomy bags – stoma-covers, they will be invisible even under a tight bathing suit. And be sure to make sure that your colostomy bag is securely fixed before bathing.

Are there any restrictions on playing sports?

There are some restrictions. It is not recommended to practice any kind of wrestling: sambo, judo, etc. Also undesirable are activities in which physical activity is very intense, for example, playing rugby, lifting weights in the gym.

There are no prohibitions for aerobics, cycling, tennis, swimming.

Is it possible for a stomaed person to travel?

Of course. Yes. You can go to relatives in another city, and to a holiday home, and on a business trip or travel to another country; by train or plane as you like. Just remember to take some precautions:

• The required minimum kit for replacing the colostomy bag (see description above) should always be with you in your carry-on luggage.
• Be careful with food that is new to you, do not use raw water. Be sure to take medicines with you to normalize the functions of the gastrointestinal tract (enzyme preparations, etc.), – consult your doctor about this.

Is it possible to continue a normal sex life after such an operation?

Sexual life is a very intimate question for any person, including the ostomy one. It is necessary to approach its discussion delicately.Sexual problems are not a matter of life or death, but are often just as serious for a good feeling and quality of life.

After the operation, your body changes, and your sexuality may also change. It is possible to avoid or prevent negative phenomena associated with these changes. Ask your surgeon or the Stoma Center for advice, they will help you find the balance you need. A person’s sexual life is very multifaceted, and if after the operation problems arise in one, then one must try to compensate for them in another.

As for married life, as a rule, people are connected by many feelings, all of which make up love. Your spouse understands what happened to you and will support you with his attention and warmth. Don’t consider your stoma to be an insurmountable obstacle to a happy family life. In some families, discord ensues, although none of the spouses was operated on. There are many reasons for disharmony in the family. For your part, be honest and attentive to your loved one and believe that nothing will change in your relationship!

Can a woman with an ostomy get pregnant and have a baby?

Yes! If during the operation the woman’s uterus and ovaries are not affected, then there are no obstacles to getting pregnant.But it is still advisable to consult with your surgeon before making a decision. Pregnancy can proceed quite well, delivery will be on time, but, as a rule, by Caesarean section.

Where can I get a colostomy bag, who to contact for advice?

In case of urgent problems, you can also consult a doctor at the local polyclinic – a surgeon, coloproctologist, oncologist, and of course you can always buy colostomy bags from us.

90,000 Medical examination. Colorectal cancer. – GUZ “Regional Hospital No. 3”

Clinical examination in 2018 is aimed at detecting oncological diseases such as: breast cancer, cancer of the female genital organs, prostate cancer in men, colorectal cancer, etc.
By order of the Ministry of Health of the Russian Federation No. 869n dated October 26, 2017, age groups of the adult population were determined, which should in 2018 to undergo cancer screening to detect colorectal cancer.
These are age groups from 49 to 73 years old.Examinations are carried out once every 2 years.
Who will turn in 2018 -49, 51, 53.55, 57, 59, 61, 63, 65, 67, 69, 71.73 years should go to the clinic for cancer screening to detect colorectal cancer. To undergo cancer screening, the patient needs to donate feces for occult blood.

How to prepare for the analysis?

1. Diet before the analysis of feces for occult blood. For three days (72 hours), food of animal origin (meat, fish) should be excluded from the diet.You should also exclude some vegetables, especially green ones: cauliflower, cucumber, horseradish, green apples, spinach, lettuce, any greens and zucchini. Tomatoes are also excluded.
2. The use of iron-containing drugs, bismuth and barium sulfate is not recommended. Also, on the eve of the study, you should not take acetisalicylic acid (aspirin) and ascorbic acid (vitamin C).
3. Three days before the study, it is not recommended to carry out any diagnostic or therapeutic manipulations with the intestines (X-ray contrast study, sigmoidoscopy, colonoscopy).
4. Do not use laxatives or give enemas. Material for analysis is collected after three spontaneous bowel movements from different parts of the stool.
5. Women during menstruation are not recommended to carry out this analysis.

How to pass the test correctly?

For a reliable result, after proper preparation, you need to collect the feces in a specially designed container purchased at the pharmacy. The sampling of material should be carried out after natural emptying from several areas of feces.The amount of material is sufficient in the amount of 1 teaspoon.

What is colorectal cancer?

Colorectal cancer is a group of malignant neoplasms of epithelial origin located in the colon and anal canal. It is one of the most common forms of cancer. It accounts for almost 10% of the total number of diagnosed cases of malignant epithelial tumors worldwide
Experts often consider colorectal cancer as a “disease of civilization” associated with an increase in life expectancy, insufficient physical activity, the consumption of a large amount of meat products and insufficient amount of fiber.In recent decades, there has been an increase in the incidence of colorectal cancer in our country. Colorectal cancer ranks 3rd in men and 4th in women.

Causes of colorectal cancer.

The etiology has not been precisely established. Most researchers believe that colorectal cancer is one of the polyetiological diseases that arise under the influence of various external and internal factors, the main of which are genetic predisposition, the presence of chronic diseases of the large intestine, diet and lifestyle features.Modern specialists are increasingly focusing on the role of nutrition in the development of malignant colon tumors.
It has been found that colorectal cancer is more often diagnosed in people who eat a lot of meat and low fiber. In the process of digestion of meat products in the intestines, a large amount of fatty acids are formed, which are converted into carcinogenic substances. A small amount of fiber and insufficient physical activity lead to a slowdown in intestinal motility. As a result, a large number of carcinogenic agents come into contact with the intestinal wall for a long time, provoking the development of colorectal cancer.A factor aggravating this circumstance is improper processing of meat, which further increases the amount of carcinogens in food. Smoking and alcohol consumption play a role.
According to statistics, patients with chronic inflammatory diseases of the large intestine suffer from colorectal cancer more often than people who do not have such a pathology. The highest risk is observed in patients with ulcerative colitis and Crohn’s disease. The likelihood of colorectal cancer is directly correlated with the duration of the inflammatory process.With a disease duration of less than 5 years, the probability of malignancy is approximately 5%, with a duration of more than 20 years – about 50%.
Colon cancer often develops in the presence of colorectal cancer and other malignant neoplasms in close relatives. Other predisposing factors include age over 50, obesity, insufficient physical activity, diabetes mellitus, lack of calcium, hypovitaminosis, immunodeficiency states caused by various chronic diseases, weakening of the body and taking certain medications.

Colorectal cancer symptoms

Stages I-II colorectal cancer may be asymptomatic. Subsequently, manifestations depend on the localization and characteristics of the growth of the neoplasm. Weakness, malaise, fatigue, loss of appetite, bad taste in the mouth, belching, nausea, vomiting, flatulence, and a feeling of heaviness in the epigastrium are observed. One of the first signs of colorectal cancer is often abdominal pain, which is more pronounced with tumors of the left half of the intestine (especially the colon).
occult blood and pus in the feces are detected. There are signs of intoxication associated with the absorption of the decay products of the neoplasm during their passage through the intestines.
Unlike hemorrhoids, blood in colorectal cancer appears at the beginning, not at the end of bowel movements. A typical manifestation of a malignant rectal lesion is a feeling of incomplete emptying of the intestine. With neoplasms of the anal region, pain during bowel movements and a ribbon-like stool are observed.
Anemia may develop due to repeated bleeding.With the localization of colorectal cancer in the right half of the large intestine, signs of anemia often appear already at the initial stage of the disease

Complications of colorectal cancer

The most common complication of colorectal cancer is bleeding, which occurs in 65-90% of patients. The frequency of bleeding and the amount of blood loss is highly variable. In most cases, there is a small, repetitive loss of blood, gradually leading to the development of iron deficiency anemia.Less commonly, with colorectal cancer, profuse bleeding occurs, which poses a threat to the patient’s life. With the defeat of the left sections of the sigmoid colon, obstructive intestinal obstruction often develops. Another serious complication of colorectal cancer is perforation of the intestinal wall.
Neoplasms of the lower sections of the large intestine can invade adjacent organs (vagina, bladder). Local inflammation in the area of ​​a low-lying tumor can provoke purulent lesions of the surrounding tissue.Bowel perforation in colorectal cancer of the upper intestine leads to the development of peritonitis. In advanced cases, a combination of several complications can be observed, which significantly increases the risk of surgery.

Diagnosis of colorectal cancer

The most accessible screening tests for colorectal cancer are fecal occult blood analysis, sigmoidoscopy (with a low tumor location) or colonoscopy (with a high tumor location).If endoscopic techniques are unavailable, patients with suspected colorectal cancer are referred for irrigoscopy. A general blood test is prescribed to determine the severity of anemia and a biochemical blood test to assess liver dysfunctions.

Treatment and prognosis in colorectal cancer

The main method of treatment for colorectal cancer is surgical. The prognosis for colorectal cancer depends on the stage of the disease and the severity of the complications. The five-year survival rate after radical surgery performed at stage I is about 80%, at stage II – 40-70%, at stage III – 30-50%.

Dear patients! Get screened for colorectal cancer!

Medical prophylaxis doctor V. Luchankina
State Healthcare Institution “Regional Hospital No. 3”

Constipation – Coloproctology – Day (surgical) hospital – Departments

Constipation

Constipation is a decrease in bowel movement (bowel movements), stool retention for more than 48 hours. The stool is hard and dry, after stool there is no feeling of complete emptying of the intestine. Constipation, therefore, should include not only stool retention, but also those situations when stools are daily, but in an extremely small volume.Constipation is a common condition, especially in developed countries. In most cases, without threatening a person’s life, they cause a lot of suffering.

Constipation is caused by a violation of the formation and movement of feces through the intestines. With constipation, the flow of fluid into the intestinal cavity decreases, its absorption from the intestinal cavity into the intestinal wall increases, intestinal movements intensify, which mix the feces in the large intestine and at the same time weaken those movements that move the feces to the exit into the rectum.In order for the excretion of feces (defecation) to occur, a certain amount of it must accumulate in the rectum. Feces affect the nerve endings located in the rectum and a reflex to defecate occurs. In some patients suffering from constipation, the excitability of these nerve endings weakens and a paradoxical situation arises – there is a lot of feces in the rectum, but it is not excreted.

Causes of constipation

Eating disorders. This refers to the reduction in the diet of foods containing dietary fiber.These are substances that are not exposed to the action of digestive juices, they were also called ballast substances, since they believed that they did not matter much. It turned out that dietary fiber attracts water to itself, swells and increases the mass of feces, which contributes to the normal functioning of the intestines. Most of these fibers are in cereal products, bran, therefore, baked goods from wholemeal flour should be eaten, where the bran does not go to waste. Quite a lot, but less than in cereals, dietary fiber in vegetables and fruits.

Psychological factors. The disappearance of the reflex to defecate is mainly important here. Late getting up, morning rush, work in different shifts, irregular food intake contribute to disturbances in the usual rhythm of bowel emptying.

Hypodynamics (small physical activity). This is the cause of constipation in the elderly and old people who move a little due to illness, in hospital patients who are forced to stay in bed for a long time.

Diseases of the intestine and, especially, rectum – irritated colon, diverticulosis of the colon , megacolon, dolichosigma, hemorrhoids , anal fissure . In these diseases, all the factors causing constipation are important.

Mechanical factors preventing the movement of feces. Here we are talking about colon tumors that close the lumen of the intestine, adhesions in the abdominal cavity.

Toxic effects. This happens when working with lead, mercury, thallium, with the abuse of certain laxatives.

Medicinal influences. Constipation is a side effect of many medications. This includes atropine, codeine, drugs for depression, some hypnotics, diuretics. This usually happens with long-term medication.

Endocrine diseases – myxedema, hyperparathyroidism, diabetes mellitus, pheochromocytoma, pituitary disorders.

People with constipation often have abdominal pain, which is better after stool or gas. They also complain of decreased appetite, belching, heartburn, and nausea.

Persistent bloating can be painful for people with constipation. Constipation is often accompanied by decreased performance, headaches, sleep disturbances, and mood disorders.

As can be seen from the list of causes of constipation, in most cases they are caused by improper diet, a small amount of vegetables and fruits in the diet, and psychological factors.But they can also be a sign of more serious diseases of the intestines and other organs of the digestive system, especially tumors. A particularly alarming sign is constipation, which arises and intensifies within a relatively short time – 1-2-3 months. Therefore, persons suffering from constipation should consult a doctor in a timely manner in order to undergo the necessary examinations. These include digital examination of the rectum, sigmoidoscopy, colonoscopy, careful questioning of the patient. Here, diseases that require surgical intervention are identified, primarily tumors; or active methods of treatment – hemorrhoids, rectal fissures, rectal prolapse.

Treatment of constipation

1. Treatment of diseases contributing to constipation , primarily rectal diseases, inflammatory bowel diseases, endocrine disorders, rational use of drugs.

2. Diet. It is necessary to begin the treatment of constipation itself with it, and it is desirable to limit ourselves to it only, although this is not always possible. The main requirement for the diet is regular nutrition and the use of an increased amount of foods that promote bowel movement and reduce foods that interfere with emptying.

• Foods that promote bowel movement: sour milk, fruit juices, brown bread made from wholemeal flour, sour fruits, honey, vegetables and vegetable dishes, buckwheat, barley, white grape wines.
• Products that delay bowel movement: blueberries, strong tea, coffee, cocoa, red grape wines, mashed dishes, very hot, semolina and rice porridge, slimy soups, jelly.
• Products that do not affect bowel emptying: minced meat and fish, unleavened cottage cheese, wheat bread.
• Mandatory in the diet is fluid intake up to 2 liters per day.

3. Use of laxatives. They should be prescribed if dietary measures do not give the desired effect.

• The most important in this group are the so-called bulking agents – increasing the volume of intestinal contents. These funds are essentially dietary, they are suitable for long-term use. They should be assigned first. Chief among them are wheat bran, lactulose, seaweed – substances containing indigestible fibers, absorbing water, increasing the volume of intestinal contents and contributing to the normalization of intestinal motor function.Wheat bran, now produced by the food industry under different names, is doused with boiling water before use. They can be used in the form of a chatterbox for oral administration, as well as added to compotes, jelly, soups, cereals. The first 2-3 days, bran is prescribed 1 teaspoon 2 times a day, then every 2-3 days the dose is increased by 1 teaspoon a day until normal stool appears; then the amount of bran is slowly reduced until a dose is reached that guarantees a normal rhythm of bowel emptying (once a day or every 2 days).Bran can be used for a long time. In the first days of treatment with bran, abdominal pain may appear or increase, they are stopped by taking antispasmodics, the pain subsides, and then stops. Psyllium provides a good effect from this group of drugs.
• The second group of laxatives – drugs that inhibit the absorption of water in the colon and increase the flow of fluid into it. There are medicinal herbs and preparations from them – senna, buckthorn, rhubarb; synthetic drugs – phenolphthalein, bisacodyl.