sign in sign up
<<
Home , Ileostomy, Rectal discharge, Stoma (medicine)

Ostomy of the Bowel

National Digestive Diseases Information Clearinghouse

What is ostomy surgery of the bowel? Ostomy surgery of the bowel, also known as bowel diversion, refers to surgical procedures that reroute the normal movement of intestinal contents out of the body when Mouth part of the bowel is diseased or removed. Creating an ostomy means bringing part of the intestine through the abdominal wall so that waste exits through the abdominal wall instead of passing through the anus. Ostomy surgery of the bowel may be temporary or permanent, depending on the reason for the surgery. A surgeon specially Colon trained in intestinal surgery performs the Small procedure in a hospital. During the surgery, intestine the person receives general anesthesia. Jejunum Ostomy of the bowel include • Cecum Anus • Appendix • ileoanal reservoir The normal GI tract • continent ileostomy intestine, and anus. The What is the bowel? measures about 20 feet long in adults and The bowel is another word for the small and includes large intestines. The bowel forms the largest • the duodenum––the first part of the part of the gastrointestinal (GI) tract—a small intestine nearest the stomach series of hollow organs joined in a long, twisting tube from the mouth to the anus. • the jejunum––the middle section of the The anus is a 1-inch-long opening through small intestine between the duodenum which stool leaves the body. Organs that and ileum make up the GI tract include the mouth, • the ileum––the lower end of the small esophagus, stomach, small intestine, ––a wavelike movement of muscles Why does a person need in the GI tract––moves food and liquid through the GI tract. Peristalsis, along with ostomy surgery of the bowel? the release of hormones and enzymes, helps A person may need ostomy surgery of the food digest. The small intestine absorbs bowel if he or she has nutrients from foods and liquids passed • cancer of the colon or rectum from the stomach. Most food and nutrient absorption take place in the small • an injury to the small or large intestine intestine. • inflammatory bowel disease––long- The large intestine consists of the cecum, lasting disorders, such as Crohn’s colon, and rectum. The cecum connects to disease and ulcerative , that cause the last part of the ileum and contains the irritation or sores in the GI tract appendix. The large intestine measures • obstruction––a blockage in the bowel about 5 feet in adults and absorbs water that prevents the flow of fluids or solids and any remaining nutrients from partially digested food passed from the small • diverticulitis––a condition that occurs intestine. The large intestine then changes when small pouches in the colon waste from liquid to semisolid or solid , called diverticula become inflamed, or or stool. Stool passes from the colon to the irritated and swollen, and infected rectum. The rectum measures 6 to 8 inches Read more in these publications at www. in adults and is located between the last part digestive.niddk.nih.gov: of the colon and the anus. The rectum stores • Crohn’s Disease stool prior to a bowel movement. During a bowel movement, stool moves from the • Diverticular Disease rectum, through the anus, and out of the • body. • What I need to know about Crohn’s Read more in The Digestive System and How Disease It Works at www.digestive.niddk.nih.gov. • What I need to know about Diverticular Disease

2 Ostomy Surgery of the Bowel What is a ? What is an ileostomy? During ostomy surgery of the bowel, a An ileostomy is a stoma created from a part surgeon creates a stoma by bringing the end of the ileum. For this surgery, the surgeon of the intestine through an opening in the brings the ileum through the abdominal and attaching it to the skin to create wall to make a stoma. An ileostomy may an opening outside the body. A stoma may be permanent or temporary. An ileostomy be three-fourths of an inch to a little less than is permanent when the surgeon removes 2 inches wide. The stoma is usually located in or bypasses the entire colon, rectum, and the lower part of the abdomen, just below the anus. A surgeon may perform a temporary beltline. However, sometimes the stoma is ileostomy for a damaged or an inflamed located in the upper abdomen. The surgeon colon or rectum that only needs time to rest and a wound, ostomy, and continence (WOC) or heal from injury or surgery. After the nurse or an enterostomal therapist will work colon or rectum heals, the surgeon repairs together to select the best location for the the opening in the abdominal wall and stoma. A removable external collection reconnects the ileum so stool will pass into pouch, called an ostomy pouch or ostomy the colon normally. An ileostomy is the appliance, is attached to the stoma and worn most common temporary bowel diversion. outside the body to collect intestinal contents A surgeon performs an ileostomy most often or stool. Intestinal contents or stool passes to treat inflammatory bowel disease or rectal through the stoma instead of passing through cancer. the anus. The stoma has no muscle, so it Read more about rectal cancer at www. cannot control the flow of stool, and the flow cancer.gov/cancertopics/types/colon-and-rectal. occurs whenever peristalsis occurs. Ileostomy and colostomy are the two main types of ostomy surgery of the bowel during which a surgeon creates a stoma.

Stoma Colon

Ileum

An ostomy pouch Anus Rectum

Ileostomy 3 Ostomy Surgery of the Bowel What is a colostomy? What is an ileoanal reservoir? A colostomy is a stoma created from a part An ileoanal reservoir is an internal pouch of the colon. For this surgery, the surgeon made from the ileum. This surgery is a brings the colon through the abdominal common alternative to an ileostomy and does wall and makes a stoma. A colostomy not have a permanent stoma. Also known as a may be temporary or permanent. The J-pouch or pelvic pouch, the ileoanal reservoir colostomy is permanent when the surgeon connects to the anus after a surgeon removes removes or bypasses the lower end of the the colon and rectum. Stool collects in the colon or rectum. A surgeon may perform a ileoanal reservoir and then exits the body temporary colostomy for a damaged or an through the anus during a bowel movement. inflamed lower part of the colon or rectum An ileoanal reservoir is an option after that only needs time to rest or heal from removal of the entire large intestine when the injury or surgery. Once the colon or rectum anus remains intact and disease-free. The heals, the surgeon repairs the opening in the surgeon often makes a temporary ileostomy abdominal wall and reconnects the colon so before or at the time of making an ileoanal stool will pass normally. A surgeon performs reservoir. Once the ileoanal reservoir heals a colostomy most often to treat rectal cancer, from surgery, the surgeon reconnects the diverticulitis, or ––the ileum to the ileoanal pouch and closes the accidental loss of stool. temporary ileostomy. A person does not need a permanent external ostomy pouch for an Read more in Fecal Incontinence at www. ileoanal reservoir. digestive.niddk.nih.gov. A surgeon creates an ileoanal reservoir most often to treat ulcerative colitis or familial adenomatous polyposis. Familial Small intestine adenomatous polyposis is an inherited disease characterized by the presence of 100 or more Colon polyps in the colon. The polyps may lead to if not treated. People with

Stoma

Colon section Colon (removed) (removed)

Anus Rectum (may be removed)

Ileum Colostomy

Ileoanal reservoir Anus

Ileoanal reservoir

4 Ostomy Surgery of the Bowel Crohn’s disease usually are not candidates for continent ileostomy is now uncommon, and this procedure. most hospitals do not have a specialist who knows how to perform this type of surgery. As Read more in What I need to know about with ileoanal reservoir surgery, the surgeon Colon Polyps at www.digestive.niddk.nih.gov. usually removes the colon and rectum to treat the original bowel disease, such as ulcerative What is a continent colitis or familial adenomatous polyposis. ileostomy? People with Crohn’s disease are not usually candidates for this procedure. A continent ileostomy is an internal pouch, sometimes called a Kock pouch, fashioned from the end of the ileum just before it exits What are the complications the abdominal wall as an ileostomy. The of ostomy surgery of the surgeon makes a valve inside the pouch so that intestinal contents do not flow out. The bowel? person drains the pouch each day by inserting Complications of ostomy surgery of the a thin, flexible tube, called a , through bowel may include the stoma. The person covers the stoma • skin irritation with a simple patch or dressing. A continent ileostomy is an option for people who are • stoma problems not good candidates for an ileoanal reservoir • blockage because of damage to the rectum or anus and who do not want to wear an ostomy pouch. • • bleeding Creating the Kock pouch is a delicate surgical procedure that requires a healthy bowel • electrolyte imbalance for proper healing. Therefore, a surgeon • usually does not perform Kock pouch surgery during an acute attack of bowel disease. A • irritation of the internal pouch, or pouchitis • vitamin B12 deficiency • phantom rectum • short bowel syndrome Colon (removed) • rectal discharge Skin Irritation Ileum Skin irritation is the most common complication for people with an ostomy. If the external ostomy pouch does not fit Stoma properly, stool or stool contents can leak out around the stoma and under the pouch. Kock Rectum When irritated, a person’s skin will become pouch (removed) itchy, red, and uncomfortable. When changing the pouch, a person can use an Continent ileostomy ostomy powder on the skin around the stoma

5 Ostomy Surgery of the Bowel to treat skin irritation. If the skin irritation • Narrowing of the stoma. Narrowing of does not improve, the person should talk the stoma makes it difficult for stool to with a WOC nurse or an enterostomal pass through the stoma. A narrowed therapist—who are specially trained in stoma may need surgical repair. ostomy care and rehabilitation—or another health care provider about the symptoms. Blockage Skin irritation may occur around the Occasionally, an ileostomy or a colostomy stoma for people who have an ileostomy does not function for a short time. If the or a colostomy. People who have ileoanal stoma has not passed intestinal content reservoir surgery may have skin irritation or stool for 4 to 6 hours and the person is around the anus. Sometimes, using a barrier experiencing cramping or , the ileum ointment to protect the skin around the anus or colon may be blocked. Blockage may can help treat and prevent irritation. occur when foods that are hard to digest get stuck in the ileum or colon. Stoma Problems Abdominal adhesions in the ileum or colon Stoma problems include the following: may cause blockage as well. Abdominal • . A stoma hernia, seen as a adhesions are bands of fibrous tissue that bulge in the skin around the stoma, form between abdominal tissues and organs, is a weakening of the abdominal wall causing them to kink or narrow. Most around the stoma site. As with all blockages get better without additional , a stoma hernia continues to surgery by not eating food and drinking only increase in size and may eventually clear liquids to rest the bowel for a short need surgical repair when it becomes time. too large. Rarely, the intestine gets Read more in Abdominal Adhesions at www. trapped or kinked within the hernia and digestive.niddk.nih.gov. becomes blocked. A blocked intestine that loses its blood supply requires Diarrhea emergency surgery. Diarrhea is loose, watery stools. A person • Prolapse. A stoma prolapse occurs has diarrhea if he or she passes loose stools when the bowel pushes itself through three or more times a day. Diarrhea occurs the stoma. A person may be able to when intestinal contents pass through push the bowel back through the stoma the small intestine too quickly for fluid and keep it in place with a stoma shield. and mineral absorption. When fluids and If not, the stoma prolapse may require minerals such as sodium and potassium are special care and a larger ostomy pouch. not absorbed, they leave the body. Diarrhea A stoma prolapse that becomes blocked can lead to dehydration, malnutrition, and or loses its blood supply requires weight loss. Diarrhea is common, even surgical repair.

6 Ostomy Surgery of the Bowel normal, with an ileostomy or ileoanal chance of developing electrolyte imbalance. reservoir. In most cases of diarrhea, the only Symptoms of electrolyte imbalance may treatment necessary is replacing lost fluids include and electrolytes to prevent dehydration. • fatigue, or feeling tired Electrolytes are minerals in body fluids that are part of salts, including sodium, • weakness potassium, magnesium, and chloride. People • nausea should maintain good daily hydration by drinking plenty of water and liquids, such • muscle problems such as spasms, as fruit juices, sports drinks, caffeine-free weakness, uncontrolled twitching, and soft drinks, and broths. In some cases cramps of diarrhea, a health care provider may • dizziness and confusion recommend changes in diet and may prescribe medications to treat diarrhea. People with these symptoms require medical care and should contact a health care Read more in these publications at www. provider. digestive.niddk.nih.gov: People who have had their large intestine • Diarrhea removed should talk with a health care • What I need to know about Diarrhea provider or dietitian about diets that help maintain electrolyte balance. Bleeding As with any major surgery, ostomy surgery Infection may cause internal bleeding. If too much The GI tract is filled with bacteria that can blood is lost, the person may require a leak out during ostomy surgery and infect blood transfusion. Bleeding may also occur areas inside the abdomen. Bacteria entering through the stoma or through the anus after the body through the stoma or anus can surgery. also cause an infection. The person’s skin around the stoma may also become infected Electrolyte Imbalance with bacteria or skin fungus. Health care The main function of the large intestine is to providers treat with antibiotics. absorb water, nutrients, and electrolytes from Symptoms of infection may include partially digested food that enters from the • fever ileum. When a surgeon removes the large intestine, absorption of electrolytes does not • back pain occur to the same extent, making electrolyte • poor appetite imbalance more likely. Diarrhea, excessive sweating, and can increase the • nausea and vomiting

7 Ostomy Surgery of the Bowel Irritation of the Internal Pouch, Phantom Rectum or Pouchitis Phantom rectum is the feeling of needing Pouchitis is an irritation or to have a bowel movement even though the of the lining of an ileoanal reservoir or a rectum is not present. Phantom rectum continent ileostomy pouch. A health care is relatively common. Symptoms are provider treats pouchitis with antibiotics. usually mild and often go away without For severe or chronic pouchitis, a health care treatment. However, for some people, provider may prescribe immunosuppressive phantom rectum may occur for years after medications, such as corticosteroids. a surgeon removes the rectum. Some Symptoms of pouchitis include people with phantom rectum may feel pain. Health care providers treat • frequent bowel movements with with medications such as pain relievers and diarrhea sometimes antidepressants. To help control • an urgent need to have a bowel phantom rectum, a health care provider movement may recommend complementary therapies such as guided imagery and other relaxation • a feeling of pressure in the pouch techniques. • Short Bowel Syndrome • cramping or bleeding Short bowel syndrome is a group of problems • dehydration related to inadequate absorption of nutrients • low-grade fever after removal of part of the small intestine. People with short bowel syndrome cannot • a general unwell feeling absorb enough water, vitamins, and other nutrients from food to sustain life. Diarrhea Vitamin B12 Deficiency is the main symptom of short bowel Ostomy surgery of the bowel may affect syndrome. Other symptoms may include vitamin B12 absorption from food and result in a gradual drop in vitamin B12 levels in • cramping the body. Low levels of vitamin B12 can • affect the body’s ability to use nutrients and may cause anemia. Anemia is a condition • in which red blood cells are fewer or smaller • weakness and fatigue than normal, which prevents the body’s cells • vomiting from getting enough oxygen. Health care providers treat vitamin B12 deficiency with • excessive gas vitamin B12 supplements. • foul-smelling stool

8 Ostomy Surgery of the Bowel Short bowel syndrome is uncommon and can occur with Crohn’s disease, trauma, or other conditions that lead to removal of a large Seek Immediate Care amount of the small intestine. People should seek immediate medical care if they have any of the following A health care provider will recommend a symptoms, as complications of treatment for short bowel syndrome based ostomy surgery can become a medical on a person’s nutritional needs. Treatment emergency: may include nutritional support, medications, and surgery. • continuous nausea and vomiting Read more in Short Bowel Syndrome at www. • dramatic change in stoma size, digestive.niddk.nih.gov. shape, or color • continuous bleeding at the junction Rectal Discharge between the stoma and the skin People with an ileostomy or a colostomy that does not stop by applying whose lower colon, rectum, and anus are pressure still present may experience a discharge of • obstruction, prolapse, or narrowing from their rectum. Mucus is a clear of the stoma fluid made by the GI tract that coats and protects the lining of the bowel. Mucus • a deep cut in the stoma within the bypassed part of the colon may • no output of intestinal content leak out of the rectum from time to time or or stool from the stoma for 4 to gradually build up, forming a small, stoollike 6 hours, with cramping and nausea ball that passes out of the rectum. A person cannot control mucus production and rectal • severe diarrhea with risk of discharge. However, people who have rectal dehydration discharge can learn how to manage and cope • excessive bleeding from the stoma with this problem. opening

9 Ostomy Surgery of the Bowel Living with an Ostomy ileoanal reservoir takes several months to stretch and adjust to its new function. After At first, living with an ostomy can be the adjustment period, bowel movements overwhelming and scary for some people. decrease to as few as four to six a day. However, most people adjust and lead People with an ileoanal reservoir may have active and productive lives. A WOC nurse mild fecal incontinence and may have to get or an enterostomal therapist will provide up during periods of sleep to pass stool. education, support, and medical advice on topics that include the following: Continent ileostomy. Similar to people with an ileostomy or a colostomy, people with a • what to expect after ostomy surgery continent ileostomy may have excessive gas • caring for an ostomy during the early weeks and months after • resuming normal activities after ostomy surgery. surgery Caring for an Ostomy • maintaining personal relationships after During the recovery in the hospital and at ostomy surgery home, a person will learn to care for the • coping with practical, social, and ostomy. The type of care required depends emotional issues on the type of ostomy surgery. A WOC nurse or an enterostomal therapist will teach What to Expect after Ostomy a person about special care after ostomy Surgery surgery. Once the person is home from the hospital, Ileostomy and colostomy. People with an the first week or two are considered an ileostomy or a colostomy will to learn how to extension of the hospital stay. Most people attach, drain, and change their ostomy pouch will tire quite easily when they first come and care for the stoma and the surrounding home. Getting enough rest is important. skin. Ostomy pouches, or pouching systems, Gradually, stamina and strength will may be one piece or two pieces. They improve. Most people can return to work include a barrier, also called a wafer or about 6 to 8 weeks after surgery. People flange, and a disposable plastic pouch. In a may have certain GI issues––such as gas, two-piece system, the pouch can be detached diarrhea, and ––as the bowel or replaced without removing the barrier. heals, depending on the type of bowel For both systems, the barrier attaches to the diversion. skin around the stoma and protects it from Ileostomy and colostomy. During the early stool. The length of time the barrier stays weeks and months after surgery, people sealed to the skin depends on many things, with an ileostomy or a colostomy may have such as excessive gas. This extra gas will decrease • how well the barrier fits once the bowel has had time to heal and the person resumes a regular diet. • the condition of the skin around the stoma Ileoanal reservoir. People with an ileoanal • the person’s level of physical activity reservoir initially have about six to 10 bowel movements a day. The newly formed • the shape of the body around the stoma

10 Ostomy Surgery of the Bowel Most people can leave the barrier on for 3 to color. People should look for blood and 7 days. However, a person should change signs of skin irritation around the stoma. the barrier as soon as stool starts to go Sensitivities or allergies to ostomy products underneath it and onto the skin. such as adhesives, skin barriers, pastes, tape, or pouch materials can cause skin irritation. Most ostomy pouches empty through an People with pouching systems can test opening in the bottom. Emptying the pouch different products to see if their skin reacts several times a day reduces the chance of to them. People should use only ostomy leakage and bulges underneath the person’s products recommended by their health care clothing. A person should empty the pouch provider. when it is about one-third full. He or she should rinse the pouch in a two-piece system Ileoanal reservoir. People with an ileoanal before reattaching it to the skin barrier. reservoir will learn how to care for irritated skin around the anus resulting from How often a person needs to change his or frequent stools or fecal incontinence. A her pouching system depends on the type WOC nurse or an enterostomal therapist of system. Many pouching systems may be may recommend pelvic floor exercises to worn for 3 to 7 days. Some pouching systems help strengthen the muscles around the are made to be changed every day. When anus. changing a pouch system, the person should Read more about pelvic floor exercises in • wipe away any mucus on the stoma Kegel Exercise Tips at www.urologic.niddk. • clean the skin around the stoma with nih.gov. warm water and a washcloth Continent ileostomy. People with a • rinse the skin thoroughly continent ileostomy will learn how to insert • dry the skin completely a catheter through the stoma to drain the internal pouch. They can drain the pouch People may use mild soap to clean the skin. by standing in front of the toilet or by sitting However, the soap should not have oils, on the toilet and then emptying the catheter. perfumes, or deodorants, which may cause During the first few weeks after a continent skin problems or keep the skin barrier from ileostomy, the person needs to drain the sticking. A WOC nurse or an enterostomal internal pouch about every 2 hours. After therapist can give advice if a person has a few weeks, the person is able to go 4 to problems attaching the skin barrier or 6 hours between pouch drainings. The keeping it attached. person should wash his or her hands with When changing the pouching system, soap and water after using a catheter. The people should inspect the stoma and person should clean the skin around the contact a health care provider about any stoma with warm water and a washcloth and dramatic changes in stoma size, shape, or let the skin dry completely.

11 Ostomy Surgery of the Bowel Resuming Normal Activities Maintaining Personal after Ostomy Surgery Relationships after Ostomy After ostomy surgery, people should be Surgery able to resume their normal activities after People with an ostomy should be able to healing completes and their strength returns. maintain personal relationships just as However, they may need to restrict activities, before their surgery. Some people may including driving and heavy lifting, during the worry that friends and relatives will have first 2 to 3 weeks after surgery. Strenuous negative reactions to their ostomy and activities, such as heavy lifting, increase the stoma. Only a spouse, sexual partner, or chance of a stoma hernia. A person who primary caretaker needs to know the details has recovered from the ostomy surgery of the ostomy surgery. People can choose should be able to do most of the activities he how much they share with others about their or she enjoyed before the ostomy surgery, health condition, including the ostomy. even swimming and other water sports. The only exceptions may be contact sports such People can still maintain a satisfying sexual as football or karate. People whose jobs relationship after ostomy surgery and include strenuous physical activities should may resume sexual activity as soon as the talk with their health care provider and health care provider says it is safe to do so. employer about making adjustments to job People should talk with their health care responsibilities. provider about any concerns they have with maintaining sexual relations. For people People should avoid extreme physical with ostomies, the health care provider can exercise and sports activities for the first also give information about ways to protect 3 months. Walking, biking, and swimming the stoma during sexual activity. People with are fine and should be encouraged as long as ostomies may want to ask about specially they are not overly strenuous. designed apparel to enhance intimacy. People with an ostomy should talk with their Communicating with a sexual partner is health care provider about when they can essential. People should share their concerns resume normal activities. and wishes and listen carefully to their partner’s concerns.

12 Ostomy Surgery of the Bowel Coping with Practical, Social, Most people are eventually able to resume and Emotional Issues their regular diet and eat what they like. However, various foods may affect Although ostomy surgery can bring great the GI tract differently. Just as before relief, many people have problems coping ostomy surgery, certain foods are more with the practical, social, and emotional likely to cause gas, diarrhea, constipation, issues related to having this type of surgery. or incomplete digestion. Foods such as Every person reacts differently. A person’s cucumbers, cabbage, broccoli, onions, emotions may change frequently during fish, eggs, and beans may cause more recovery. People with an ostomy adjust gas and odor than others. People should faster and experience fewer problems when consume carbonated drinks and chew gum they have help from their family members, with moderation, as they may also cause partners, and health care providers. gas. Constipation is often the result of an Community and online resources for unbalanced diet or eating and drinking too support and education are available to help little. After ostomy surgery, people should people with an ostomy cope with practical, social, and emotional issues. A WOC nurse • avoid large amounts of liquids with and an enterostomal therapist can provide a meals list of resources and support groups. • drink plenty of liquids between meals Eating, Diet, and Nutrition • eat regularly • avoid high-fiber foods on an empty For the first 6 to 8 weeks after ostomy stomach surgery, the health care provider may recommend a low-fiber diet to give the • introduce new foods gradually bowel time to heal. The health care • chew foods thoroughly provider will tell a person when to add high-fiber foods to the diet. People should People should talk with their health care introduce fiber into the diet gradually, provider or dietitian about what diet is right as high-fiber foods may cause blockage. for them.

13 Ostomy Surgery of the Bowel Points to Remember –– obstruction––a blockage in the bowel that prevents the flow of • Ostomy surgery of the bowel, also fluids or solids known as bowel diversion, refers to surgical procedures that reroute –– diverticulitis––a condition that the normal movement of intestinal occurs when small pouches in the contents out of the body when part of colon called diverticula become the bowel is diseased or removed. inflamed, or irritated and swollen, and infected • Ostomy surgeries of the bowel include • Complications of ostomy surgery of the –– ileostomy––a stoma created from a bowel may include part of the ileum –– skin irritation –– colostomy––a stoma created from a part of the colon –– stoma problems –– ileoanal reservoir––an internal –– blockage pouch made from the ileum –– diarrhea –– continent ileostomy––an internal –– bleeding pouch, sometimes called a Kock –– electrolyte imbalance pouch, fashioned from the end of –– infection the ileum just before it exits the –– irritation of the internal pouch, or abdominal wall as an ileostomy pouchitis • A person may need ostomy surgery of –– vitamin B12 deficiency the bowel if he or she has –– phantom rectum –– cancer of the colon or rectum –– short bowel syndrome –– an injury to the small or large –– rectal discharge intestine • At first, living with an ostomy can be –– inflammatory bowel disease–– overwhelming and scary for some long‑lasting disorders, such as people. However, most people adjust Crohn’s disease and ulcerative and lead active and productive lives. colitis, that cause irritation or sores in the gastrointestinal (GI) tract

14 Ostomy Surgery of the Bowel Hope through Research Crohn’s & Colitis Foundation of America 386 Park Avenue South, 17th Floor The National Institute of Diabetes and New York, NY 10016 Digestive and Kidney Diseases (NIDDK) Phone: 1–800–932–2423 and other components of the National Email: [email protected] Institutes of Health (NIH) conduct and Internet: www.ccfa.org support basic and clinical research into digestive disorders, including conditions National Cancer Institute treated with ostomy surgery of the bowel, 6116 Executive Boulevard, Suite 300 such as inflammatory bowel disease, bowel Bethesda, MD 20892–8322 obstruction, and diverticulitis. Phone: 1–800–4–CANCER (1–800–422–6237) Clinical trials are research studies involving Fax: 301–496–0846 people. Clinical trials look at safe and Internet: www.cancer.gov effective new ways to prevent, detect, or treat disease. Researchers also use clinical United Ostomy Associations of America, Inc. trials to look at other aspects of care, such P.O. Box 512 as improving the quality of life for people Northfield, MN 55057–0512 with chronic illnesses. To learn more about Phone: 1–800–826–0826 clinical trials, why they matter, and how to Email: [email protected] participate, visit the NIH Clinical Research Internet: www.ostomy.org Trials and You website at www.nih.gov/health/ clinicaltrials. For information about current Wound, Ostomy and Continence studies, visit www.ClinicalTrials.gov. Nurses Society 15000 Commerce Parkway, Suite C Mt. Laurel, NJ 08054 For More Information Phone: 1–888–224–WOCN American Cancer Society (1–888–224–9626) 250 Williams Street Northwest Fax: 856–439–0525 Atlanta, GA 30303 Email: [email protected] Phone: 1–800–227–2345 Internet: www.wocn.org Internet: www.cancer.org American Society of Colon and Rectal Surgeons 85 West Algonquin Road, Suite 550 Arlington Heights, IL 60005 Phone: 847–290–9184 Fax: 847–290–9203 Email: [email protected] Internet: www.fascrs.org

15 Ostomy Surgery of the Bowel Acknowledgments National Digestive Diseases Publications produced by the Clearinghouse Information Clearinghouse are carefully reviewed by both NIDDK 2 Information Way scientists and outside experts. This Bethesda, MD 20892–3570 publication was originally reviewed by Victor Phone: 1–800–891–5389 W. Fazio, M.D., chairman, Department TTY: 1–866–569–1162 of Colorectal Surgery, Cleveland Clinic Fax: 703–738–4929 Foundation, and Linda K. Aukett, advocacy Email: [email protected] chair, United Ostomy Associations of Internet: www.digestive.niddk.nih.gov America, Inc. Samantha Hendren, M.D., M.P.H., University of Michigan Colorectal The National Digestive Diseases Information Surgery Division, and Paula Erwin-Toth, Clearinghouse (NDDIC) is a service of the R.N., M.S.N., C.W.O.C.N., C.N.S., F.A.A.N., National Institute of Diabetes and Digestive director emerita, WOC Nursing Education, and Kidney Diseases (NIDDK). The Cleveland Clinic, reviewed the updated NIDDK is part of the National Institutes of version of this publication. Health of the U.S. Department of Health and Human Services. Established in 1980, the Clearinghouse provides information

You may also find additional information about this about digestive diseases to people with topic by visiting MedlinePlus at www.medlineplus.gov. digestive disorders and to their families, This publication may contain information about health care professionals, and the public. medications and, when taken as prescribed, The NDDIC answers inquiries, develops and the conditions they treat. When prepared, this publication included the most current information distributes publications, and works closely available. For updates or for questions about with professional and patient organizations any medications, contact the U.S. Food and Drug and Government agencies to coordinate Administration toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit www.fda.gov. Consult your resources about digestive diseases. health care provider for more information.

This publication is not copyrighted. The Clearinghouse encourages users of this publication to duplicate and distribute as many copies as desired. This publication is available at www.digestive.niddk.nih.gov.

NIH Publication No. 14–4641 July 2014

The NIDDK prints on recycled paper with bio-based ink.