Stoma (medicine)

A stoma (plural: stomata) is a surgically created opening connecting an internal organ to the surface of the body. It can be created in various parts of the digestive, respiratory, or urinary systems to divert the flow of waste products, fluids, or air when normal pathways are blocked or impaired. The procedure to create a stoma is typically referred to as an ostomy.

Types of Stomata:

Several types of stomata are created depending on the underlying medical condition and the organ involved. Common types include:

• Colostomy: A surgical procedure that brings a portion of the colon through the abdominal wall. It is usually performed when a portion of the colon is diseased, damaged, or needs to rest after surgery. Fecal matter passes through the colostomy into a collection bag.

• Ileostomy: A surgical procedure that brings the end of the small intestine (ileum) through the abdominal wall. It is often performed when the colon is diseased or needs to be bypassed, such as in cases of Crohn's disease or ulcerative colitis. Stool from an ileostomy is typically more liquid than from a colostomy.

• Urostomy: A surgical procedure that diverts urine away from the bladder. It's usually created when the bladder is diseased, damaged, or has been removed. An example is an ileal conduit, where a segment of the ileum is used to create a conduit for urine to flow from the ureters to the stoma on the abdomen.

• Tracheostomy: A surgical opening created in the trachea (windpipe) to provide an airway. It's often necessary when a person cannot breathe on their own due to airway obstruction, injury, or disease. A tracheostomy tube is inserted into the stoma to keep the airway open.

• Gastrostomy: A surgical opening created in the stomach, through which a feeding tube is inserted. This allows for the administration of nutrition directly into the stomach when a person is unable to eat or swallow adequately.

• Jejunostomy: Similar to a gastrostomy, a jejunostomy is a surgical opening into the jejunum (part of the small intestine) for feeding purposes.

Indications:

Stomata are created for a wide range of medical conditions, including:

• Cancer of the colon, rectum, bladder, or larynx
• Inflammatory bowel disease (Crohn's disease, ulcerative colitis)
• Diverticulitis
• Bowel obstruction
• Trauma to the abdomen or neck
• Congenital anomalies
• Paralysis or coma affecting swallowing or breathing.

Stoma Care:

Proper stoma care is crucial to prevent complications such as skin irritation, infection, and stoma retraction or prolapse. This involves regular cleaning of the skin around the stoma, proper application of the ostomy appliance (if applicable), and monitoring for any signs of problems. Patients with stomata receive specialized training from healthcare professionals on how to manage their stoma and maintain their quality of life.

Complications:

Potential complications associated with stomata include:

• Skin irritation or breakdown around the stoma
• Stoma retraction or prolapse
• Stoma stenosis (narrowing)
• Parastomal hernia
• Infection
• Bleeding
• Bowel obstruction
• Dehydration (especially with ileostomies)

Psychological Impact:

Living with a stoma can have a significant psychological impact on patients. Adjusting to the changes in body image, self-esteem, and social interactions can be challenging. Support groups and counseling are often helpful in assisting patients in coping with these challenges and improving their overall well-being.