The descending colon is located on the lower left side of the abdomen, at the end of the colon. Generally, the discharge is firm and can be regulated.
A sigmoid colostomy is in the sigmoid colon, just a few inches lower in the intestinal tract. Because of this, it may produce more solid and more regular fecal discharges. The sigmoid colostomy is probably the most frequently performed surgery of all the colostomies.
Both the descending and the sigmoid colostomies can have a double-barrel or single-barrel opening. The single-barrel, or end colostomy is the more common type. (The stoma of the end colostomy is either sewn flush with the skin or it is turned back on itself (like the turned down top of a sock).
The stool of a descending or sigmoid colostomy is firmer than that of the transverse colostomy and without the caustic enzyme content. At this location, elimination may occur on a reflex basis at regular, predictable intervals. The bowel movement will take place after a considerable quantity of stool has collected in the bowel above the colostomy. Two or three days may elapse between such elimination's. Spilling may happen between movements because there is no anus to hold the stool back. Many people use a lightweight disposable pouch to prevent accidental soiling. A reflex will set up quite naturally in some people. In others, mild stimulation, such as juice or coffee, a meal, a mild laxative, or irrigation is necessary.
While many descending and sigmoid colostomies can be trained to move regularly, others cannot. Satisfactory training, with or without stimulation, is likely to happen only in those people who have had regular bowel movements before they became ill. If the bowel has been irregular and temperamental in earlier years, it may be quite difficult, or impossible, to have regular, predictable colostomy function. This is true, too, for spastic colon, irritable bowel, and some types of indigestion and conditions in which the patient has bouts of constipation or loose stool. A person who has had such conditions in the past, before becoming ill, may not achieve regularity any better with a colostomy than without one.
It is often said that a person must have a bowel movement every day. Actually, people vary greatly in this respect. Some have two or three movements a day, others have one every two or three days or even less often. You must judge constipation and loose bowels by what is usual for you and not what is usual for others.
Metro Maryland
via Vancouver Ostomy Highlife
via Regina Ostomy News Mar-Apr 2001 |
