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Artificial anus: reasons, system and diet

by Josephine Andrews
Published: Last Updated on 301 views

An artificial anus, also known as an enterostomy or anus praeter, describes a surgically created connection between the intestine and the abdominal wall. The intestinal contents can be drained via this connection if this is no longer possible naturally due to illness or surgery. Read all about the colostomy and how defecation with a colostomy works.

Artificial anus: what types are there?

The name of the artificial entrance to the intestine is divided according to which section of the intestine is connected to the abdominal wall. The connection between the ileum and the abdominal wall is called an ileostomy. Other artificial bowel outlets are:

  • Colostomy: Large intestine stoma
  • Transverse ostomy: from the transverse part of the large intestine
  • Descendostoma: from the descending part of the large intestine

Artificial anus: when is it necessary?

An artificial anus is always recommended when the patient can no longer empty his bowels independently. Surgical removal of the natural anus is usually the reason. This measure may be necessary, for example, in the case of the following diseases:

Sometimes a colostomy is temporary, but sometimes it is a permanent solution. A temporary artificial anus can be used if a certain section of the intestine is to be relieved, for example until the sutures in the small intestine have healed. This is called a protective ileostomy.

With an ileostomy, the patient cannot voluntarily control the excretion of stool. If, on the other hand, the doctor has created a colostomy, the patient can voluntarily empty his intestines at fixed times using irrigation.

Artificial anus: the terminal stoma

A terminal stoma creates a single opening in the abdominal wall. A bag is glued to this, which catches the stool that continuously seeps out of the stoma. The patient cannot voluntarily control this. However, the airtight bag prevents unpleasant odors.

A terminal stoma is usually created in patients where the following section of bowel has had to be removed. Therefore, in these cases, the artificial anus is also a permanent solution, which means that the patient has to pass the contents of his intestine through the stoma for the rest of his life.

Artificial anus: the double-barreled stoma

In the case of a double-barreled stoma (eg double-barreled ileostomy), the doctor creates two connections between the intestine and the abdominal wall of the patient. One leads to the stoma, the other away from the colostomy. The feeding part serves to excrete the food so that it cannot pass through the following sections of the intestine. The leading leg represents the connection between the temporarily unused section of bowel and the anus. This part can resume its function after the artificial anus has been relocated and the patient can pass the stool naturally.

If the patient plans to have a long-term or permanent stoma, the surgeon will reinforce the exit site with a mesh sewn behind the abdominal muscles.

Artificial anus: risks

The following problems can occur, especially if the enterostomy is worn for a long time:

  • Mechanical skin irritation
  • Allergic reaction to ostomy material
  • Bacterial or fungal infections
  • abdominal wall hernia
  • Prolapse of the bowel through the stoma opening (prolapse)
  • Narrowing of the skin around the stoma (stenosis)
  • Pulling back of the bowel (retraction) with scarring of the stoma opening

Ostomy: nutrition

The diet of ostomy patients must first be changed after the operation. The German Cancer Society recommends a low-fiber diet with easily digestible carbohydrates. The fiber can mechanically irritate the already sensitive intestine. You should therefore avoid certain grains, legumes, dried fruit, nuts and oilseeds. Instead of the usual three main meals a day, you should also eat many small meals to promote a continuous supply of energy. Once your gut has recovered, you can slowly begin to bring your diet back to normal.

Be aware that some food ingredients can irritate the stoma! These include fruit acids, which are mainly found in citrus fruits, and vegetable acids, for example in tomatoes.

irrigation

Stoma patients with an artificial bowel outlet through the large intestine (colostomy) can specifically regulate their stool excretion with a so-called irrigation. This involves rinsing the intestines with tap water at body temperature. The water stimulates the intestinal movements, which leads to the complete emptying of the intestine. This also allows you to eliminate bloating and bowel sounds for several hours.

Artificial anus: reversal

A double-barreled artificial anus can be relocated as soon as the spared section of the intestine has healed. This is the case, for example, when intestinal sutures have healed or an inflammation has subsided. With a protective stoma, this usually takes six to eight weeks. As a rule, the patient can voluntarily empty his bowels as usual via the natural anus after the transfer. 

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