Category: stoma caring

What is Hirschprung’s disease? How it can be treated?

Posted on by Janice

There is a complete cycle that is very crucial for our existence. We eat food, it is digested in our digestive system and then we excrete it out as waste material. Excretion is sometimes taken as humor and sometimes it seems awkward but this process starts as soon as you are born and until your death. The very first stool that a baby passes out is known as meconium.

But in some cases, it may be hard for a baby to have a proper bowel movement this condition is known as Hirschprung’s disease. In this situation, nerve cells are absent in the large bowel.

Hirschprung’s disease is considered a congenital disease. It starts at the time of pregnancy and can be observed as soon as the baby is born. This can be due to a faulty diet consumed by the mother or other issues with the health of the mother during pregnancy. Some cases are reported due to faulty genes in the offspring.

The cause of Hirschprung’s disease is still unknown. Even though some researchers do believe that it is due to the disordering of DNA instructions. The disease Can be fatal, but modern surgery can cure the patients and allows the babies to live a normal life like other babies.

What are the causes of Hirschsprung’s disease?

It takes place in the babies during the very early stage or trimester of the pregnancy.

Typically, during the growth of a baby, the nerve cells are formed throughout the whole digestive tract. It starts from esophagus l, from mouth to abdomen, and finally to the rectum. A normal baby has up to five hundred million of these nerve cells. Besides these functions, these nerve cells allow the movement of the food throughout the digestive system.

The babies with Hirschprung’s disease have a prohibited growth of these nerve cells at the last part of the digestive system, just near the rectum and the anus. In some cases, these nerve cells are also absent in some other parts of the body rather than the digestive system.

This indicates that the body of the baby can’t feel any sensation or urge to pass out stool. That’s why the bowel contents remain in the body and cause blockage.

Almost five thousand newborn babies are reported to be affected by Hirschprung’s disease. Babies having congenital diseases like Down syndrome and cardiac issues have higher chances to develop this disease. If any of the parents especially the mother carrier code of this disease it can be passed to the children. Boys are at more risk than girls to develop Hirschsprung’s disease.

A Danish doctor named it Harald Hirschprung’s disease in the 19 century in 1888.

What are some common symptoms?

The symptoms of Hirschprung’s disease usually appear in the first six weeks of birth. The signs appear within forty-eight hours.

There might be swelling in the abdomen of the baby. Some other symptoms are:

  • Difficulty in bowel movement: You should be worried and consult with the doctor if the baby does not pass stool in the starting days. The children (older) with this disease may have continuous chronic constipation.
  • Diarrhea with blood: Enterocolitis, fatal infection of the colon may attack the babies with Hirschprung’s disease.
  • Vomiting: The vomit may appear brown or green.
  • In some children, the signs such as retarded growth, tiredness, and worse constipation may be seen.

What is the diagnosis and what are prescribed tests for Hirschprung’s disease?

If you observe any of the above-mentioned symptoms then you should consult your doctor without any delay. Hirschprung’s disease can be confirmed through the following tests:

  • Contrast enema: It is also termed as barium enema. In this procedure, a doctor inserts a tube filled with a dye into the anus of the baby and moves it until it reaches the rectum. Then the doctor can have visibility of the rectum on the X=ray screen. The anesthesia is not necessary for this process.
  • Contrast enema is done along with the Lower GI series, this is a group of tests performed on the GIT.
  • Abdominal x-ray: This is the simple or standard x-ray technique. It enables the doctor to locate any possible blockage.
  • Biopsy: A sample is taken from the tissues of the rectum. These tissues undergo testing in the laboratory for locating Hirschprung’s disease. Anesthesia might be given to determine the age and growth of the child.
  • Anorectal manometry: In this method, a balloon-shaped thing is inserted into the rectum to test the response of the muscles. This method applies to older children only.

What are the possible treatments for Hirschsprung’s disease?

It is a very concerning situation. But if it is diagnosed earlier and proper treatment is provided it can be cured.

The surgeries are of two types:

Your child may face the following issues after the surgery:

  • Constipation
  • Diarrhea
  • Lack to control urination or feces

Enterocolitis, signs are rectal bleeding, temperature, nausea, and inflated belly.

If proper care is provided and a balanced diet is followed this issue can be resolved within one year. Some children may experience this issue now and then throughout their life.

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What is sigmoidoscopy?

Posted on by Janice

A test that is used for the diagnosis of the sigmoid colon is known as sigmoidoscopy. The sigmoid colon is the lowest portion of the large bowel or intestine. This portion is near the rectum and the anus.

A sigmoidoscopy helps in determining the following signs:

  • Pain in abdomen
  • Diarrhea
  • Constipation
  • Polyps
  • Blood loss

A sigmoidoscopy can be performed to obtain tissues for laboratory samples or biopsies. Also, it helps eradicate polyps or hemorrhoids. A hemorrhoid is a condition when the veins of the anus and the rectum are swollen due to any reason. It can be preferred as a diagnosis for colon and rectal cancer.

A thin and flexible tube that has a camera at one end is used for the sigmoidoscopy. It is known as a sigmoidoscope.  It is inserted through the anus and gradually it reaches up to the rectum and finally into the colon. There is an air blowing feature in the tube, which further expands the colon and it can be seen clearly.

Why does someone need a sigmoidoscopy?

A sigmoidoscopy can be considered an option for the examining and diagnosis of the  different parts of your colon, such as:

  • Polyps or tumors
  • Ulcers
  • Pain in the lower abdomen
  • Discomfort near the anus
  • Iron deficiency
  • Irregular bowel movements
  • Low blood level

Sigmoidoscopy is a single test both for the colon and rectal cancer diagnosis. The doctors and the experts advise that once you are 50 or above you should start colon and rectal cancer screening. It is recommended for both men and women. You can talk with your doctor about the best screening method for you. There are several choices for the diagnosis of colon cancer.

There can be other reasons too if your surgeon asks you for a sigmoidoscopy. If a poly comes in the sigmoidoscopy reports then a colonoscopy is performed for a more detailed diagnosis of the colon.

What are some possible complications after the sigmoidoscopy?

The sigmoidoscopy involves the following risks:

  • Blood loss following a biopsy
  • Peritonitis (inflammation in the abdominal lining)
  • A hole or perforation in the wall of the intestine is a very uncommon risk.
  • The problems which can affect sigmoidoscopy are:
  • Usage of an enema or any laxative before the test, leading to discomfort in the colon’s lining
  • If you recently had another colon screening test then this time it may cause barium in the colon
  • Improper bowel homework before the process
  • The problem that can block the movement of the tube such as surgical scars or chronic diseases
  • Bleeding in the rectum can blur the screening

There might be other risks. You can discuss them before with your doctor.

How to prepare yourself for the sigmoidoscopy?

  • Your doctor will completely explain the procedure and answer all your concerns and questions. Before the procedure, you need to sign a consent form. You must read the form keenly. You must discuss the following things before the process of sigmoidoscopy:
  • If you an expecting or there are chances for you to get pregnant
  • Any specific drug you are allergic to, counting in the prescribed medicines, supplements, and herbs.
  • Any bleeding background or history
  • If you have been taking any drug which helps in thinning the blood such as aspirin. And also, the medicines which influence blood clotting. You must need to stop taking these types of medicines.

Your doctor or nurse will give you some tips regarding the preparation of the bowel before the procedure. You may drink water with laxatives or enemas. This will cleanse your bowel thoroughly. You may ask to stop eating several hours before the test.

What will happen through the sigmoidoscopy?

You may be admitted to the hospital or you might reach the hospital on the morning of the test. The method of the test depends on your medical condition expertness of your doctor. Typically, anesthesia or a sedative is not needed before this test.

Position

You need to put off any jewelry or any other accessories which can disturb the procedure. You may need to wear a hospital gown and change your clothes.

Your doctor will ask you to lie down on the table with your kneed fold to your chest, on your left side. Also, your doctor may set you in a knee-chest position with your head bent down, contact with the table.

Sigmoidoscopy procedure

Typically, it is done as:

  • Your doctor will look for any possible bleeding, mucus, or feces in the rectum. Then he or she will expand or dilate the anus.
  • Then the doctor will gently put a tube (lubricated) in the anus and moves it slowly to the rectum until it finally reaches into the lower colon. After the examination of the lower part, it will be taken out of the anus.
  • A sigmoidoscopy may be performed along with the anoscopy or proctoscopy. Anoscopy is a test for checking the anus and proctoscopy is for checking the anus and rectum both. In this case, a specially designed tube is used.
  • A sigmoidoscopy may be a little uneasy. You might need to pass out bowel movements once the tube enters the anus. There may be cramps or pain in the lower abdomen. You can lessen this pain by breathing deeply.

Biopsy

During this screening, a sample for checking cancer can be obtained from the lining of your intestine’s wall. For this purpose a specially designed forceps, swab, or brush is needed. Any observed polyp can be removed.

What happens following the sigmoidoscopy?

  • You must lie back on your back for few minutes before getting up. Make very slow movements. In this way, you will feel less dizzy.
  • You can resume your diet and activities if your doctor allows you.
  • In case of poly removal or biopsy, you might observe some blood in the feces. Don’t worry it will stop after some days.

The patient may feel a lot of gas in the abdomen. This can be resolved by walking.

You should contact your doctor if:

  • You feel high temperature
  • Blood from rectum
  • Pain in abdomen
  • Difficulty in passing out gas
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How To Prevent Issues With Your Ostomy

Posted on by Janice

Life is full of problems from day one. Honestly, it is ridiculous that some of us have to deal with so many different types of problems from day to day. What is worse is when you have to deal with ostomy related problems. If you are not sure what an ostomy is, then I am going to spend some time explaining it for you. An ostomy is a procedure done that ensures the functionality of a person’s digestive system even in the wake of serious illness or mishaps. One thing’s for sure, is that ostomies are super gross.

Basically, a person’s internal organs are rerouted through what is called a stoma that protrudes from the outside of their abdomen. That person then has to wear a bag called an ostomy pouch that sits on the outside of their body. The ostomy pouch allows for the collection of that person’s waste that filters out through the stoma (waste that would normally be excreted through the person’s anus or urethra. All in all, ostomies are super disgusting and I am sorry that I had to write all that down just now. If you have to bleach your eyes or something like that in order to try to recover from reading what I wrote down, I truly do not blame you in the slightest.

Well, there are actually a lot of things that can go wrong when you have a stoma. Believe it or not, ostomies are quite complicated and are generally only used if there is basically no other option. The reason for this is that the surgery itself to get an ostomy requires a lot of really hard work and attention to detail.

Due to this simple fact, an ostomy can be a pretty dangerous operation that needs the best doctors and surgeons available to properly get the job done. Ostomies can also be susceptible to lots of various complications that can come from simply trying to live through life. Those people reading this with an ostomy truly know the struggle of trying to get through life with a stoma. Honestly, I would rather sell my left kidney and move to West Virginia than have to have an ostomy myself. I wanted to write this article about how you can best prevent your own ostomy from having any sort of complications. This is super important for anyone who wants to live for an extended amount of time, because taking care of your stoma can mean the difference between life and death. 

The first thing that you should know about preventing issues with your stoma is that it is so important to keep that thing clean down there. I know that we often get lazy, tired, or frustrated and do not feel like cleaning out our stoma here and there, but it is actually super important to keep everything nice and tidy. Without cleaning your stoma, you may develop certain problems like bacterial infections and other things like that. You definitely do not want to be dealing with something like a bacterial infection in your precious, fragile stoma! That is why I suggest cleaning it very regularly. A good rule of thumb is to clean your stoma every time that you change your ostomy pouch. That way you can ensure that everything is nice and clean.

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Treatment of Rectal Cancer

Posted on by Janice

What is proctectomy?

The surgery which is performed for the removal of all parts of the rectum is known as proctectomy. It is performed as a treatment of rectal cancer. The treatment for rectal cancer is decided after determining with stage and extension of cancer in your rectum. Most people with rectal cancer are treated with a proctectomy. It can also be considered an option for the treatment of inflammatory bowel disease.

Outline

Proctectomy can be performed by different methods. The type of proctectomy is dependent on the:

  • Location of the cancer
  • Extension of the cancer

The large bowel or intestine which comprises the rectum and colon is referred to as the last portion of the digestive system. The rectum and anus involve the last 6 inches portion of the digestive system. A proctectomy may remove all the parts of the rectum or it may also include the anal area in some rare situations.

Factors that lead to proctectomy

Typically, proctectomy is used for treating rectal cancer. Once you are diagnosed with rectal cancer the next step is to determine the stage of cancer and if it has outgrowth into other regions than the rectum. Different types of proctectomy are used for treating different stages of rectal cancer.

Some inflammatory bowel diseases can also be treated with the help of proctectomy, such as:

  • Ulcerative colitis: Infection or ulcers in the colon
  • Crohn’s disease: Discomfort and soreness in the colon

Complications

Almost all surgeries have some risks and complications. The complications associated with proctectomy are:

  • Blood loss
  • Infection at the incision
  • Internal abdominal infections
  • Any fatal blood clot in the leg or arm which moves to the lungs
  • Difficulty in urination
  • Difficulty in bowel movements
  • Delay in wound recovery
  • Intimacy issues
  • Anesthesia can damage the heart or brain

Other risks might be there depending on the health condition of the patient. You can discuss all the possible risks with your doctor before this surgery.

What happens before the procedure?

You will be examined thoroughly before the procedure. This helps mark the stage and plans the whole surgery. You may undergo blood tests, x-rays, and EKG. A colonoscopy might be done. It is a procedure that allows the surgeon to examine the colon and the rectum. A tiny camera, light scope, and a flexible tube is used for this purpose.

The things that you may need to know before the surgery are:

You should thoroughly cleanse your bowel. It must be empty. You may need to make some changes in your diet and you need to follow all the instructions.

Your doctor will recommend you prepare your bowel before the surgery. It means you need to take enemas or laxatives.

Your doctor will tell you to stop eating or drinking anything 12 hours before the surgery.

You should discuss your medication such as vitamins, supplements, or antibiotics you have been consuming. He or she might tell you to stop taking some specific medicines some days before the procedure. Especially the blood-thinning medicines are prohibited.

What happens during the surgery?

Following events can take place during the surgery:

You will be given anesthesia; you will be asleep during the entire procedure.

Your surgeon might perform invasive laparoscopy. In this method, small incisions are made in the abdomen. The surgeon inserts some tools and sees the process on a screen.

Your surgeon might perform local resection of the anus. This is done to prevent cancer that may enter through the anal orifice and has not spread too far. In this method, there is no need for an incision.

Cancer which is severe and deeper in the rectum then another method is required. N incision is made in the lower abdomen and a relatively large part of the rectum is removed. This is termed low anterior resection (LAR).

If the healthy tissues in the rectum remain in a large number then they can be connected back. This process is known as anastomosis. You can pass out bowel movements through the anus normally. The frequency of the bowel movement will be altered after the process. This also changes the consistency of the feces.

In case if your rectal cancer is very severe and it is around the anus, you may undergo abdominoperineal resection. In this procedure, the anal opening is closed and the rectum is removed out. The other terminal of the colon is brought to the abdominal wall resulting in an opening that results in a stoma. This is known as colostomy. Then the feces are collected outside the body in a collecting pouch.

In some rare cases, a surgery termed pelvic exenteration is required. In this procedure, the surrounding parts or organs are removed such as the bladder, prostate, uterus. Typically a colostomy is required following this procedure.

What happens after the procedure?

You need to be admitted to the hospital for few days following the surgery. Once you are discharged, ensure that you must follow all the instructions regarding your diet, physical activities, and daily care routine.

In case of a colostomy afterward the procedure, you need to talk with your Ostomy nurse. He or she will guide you on how to change your pouch and care for your stoma.

The following tips may help recover faster:

You should start mild walking as soon as you can.

You should turn back to your normal life activities after some weeks of the surgery. Your doctor will tell you exactly when you should get back to bathing, swimming, and driving. You should avoid lifting weights for more than six weeks.

You should observe your wound closely and if you feel any changes or something weird you can call your doctor.

When to see your doctor or healthcare center

  • If you are having a high fever
  • If you experience swelling, rashes, blood, or leakage
  • Worsening pain
  • Breath shortage

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Keeping Your Stoma Clean

Posted on by Janice

What a lot of people don’t know about ostomies is that they are actually very annoying to try to maintain. Like all things in life that are frustrating to deal with, sometimes taking care of my stoma is that absolute last thing that I want to do. Especially when I’m having a really busy day or having a hard time at work or something like that, my stoma hygiene is usually the first thing to fall off since I just really don’t feel like dealing with it. Well, the bad news is that stoma care is super important when it comes down to it.

Keeping your stoma clean is one of the single most important things that you can do as far as avoiding any sort of complications with your stoma and all that. People with ostomies will know that taking care of a stoma is frustrating work sometimes, but it is much better than the alternative of having to deal with a stoma that has been neglected and now needs some immediate attention at the hospital.

Personally, I have had a stoma for a long period of time, so I know all the ins and outs of how to best care for one and what to do in any given situation. One thing to keep in mind is that everyone’s stoma is a little bit different; however, cleaning the stoma should be relatively consistent across the board. If you have been having trouble keeping your stoma clean, then you have come to the right place my friend. 

The best advice that I can give as far as keeping your stoma clean is that you need to be consistent. Like I mentioned earlier, a neglected stoma will leave you in a world of hurt as you move forward in your life. That’s why I highly recommend making some sort of stoma cleaning schedule and sticking to a routine if you can. One thing that could be beneficial is planning to clean out your stoma everytime you change your ostomy pouch.

Since you are going to have access to your stoma anyways, it makes sense to use this time to clean your stoma out. In addition to all this, it is super critical that you are using the right type of materials when cleaning your stoma. You may be surprised to hear that you actually don’t need some fancy stoma products or bath and body works products to clean out your stoma effectively. Actually, most soaps and other cleaning products will actually hurt your stoma more than they help it. My advice to you is to stick with some basic, clean water straight from your sink (if you have clean water at your place). Otherwise, using bottled distilled water is a good option and it is really cheap at most grocery stores or any other place where you can buy water.

Once you have cleaned out your stoma thoroughly with water, the next important step is to dry it off. In order to dry your stoma, the best advice I can give is to use a very soft rag or towel that is also clean. When you are drying your stoma, be very careful of the tissue and avoid rubbing the towel against the skin barrier and the stoma. Rather, it is best to lightly pat the towel onto the stoma to dry it off.

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