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Grand Rapids Ostomy Association
Helping People with Ostomies and Alternate Surgeries in Southwest Michigan
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Abdominoperineal Resection.
A surgical procedure in which the sigmoid colon and the entire rectum and anus
are removed. The end of the remaining colon is then brought out as a permanent
colostomy, the rectal wound is allowed to heal.
Sometimes called Miles procedure. Wide resection of the rectum, surrounding
tissues, and lymph nodes is accomplished by an abdomial and perineal approach.
Results in a permanent sigmoid or descending colostomy
Adhesive substance used to attach an ostomy pouch to the body.
Adhesions. Internal growth of scar tissues following surgical cutting. Adhesions may cause abdominal joining of parts and obstruction in organs such as the intestines. By themselves, adhesions do not cause trouble unless they produce obstruction of organs.
Adventitia; the outer covering of an organ, as of an artery: it is made up chiefly of connective tissue
Aldosterone a steroid hormone, produced synthetically and by the adrenal cortex glands.
Adhesive Remover liquid or wipe used to dissolve adhesive so pouches can be removed from the body.
Anal Fissure i a tiny tear in the mucous membrane and skin at the anus. It is an extremely painful disorder, so there often is a conscious effort to avoid having a bowel movement. If the fissure has been present only a short time, the treatment generally includes pain medicine, warm sitz baths, and medicines to soften the stool. If the fissure has been present for some time, it may be necessary to repair it surgically.
Anaerobic bacteria
Bacteria that can live and grow where there is no air or free oxygen.
Anastomosis the surgical formation of a passageway between two normally distant spaces or organs. A "hooking-up" of bowel, ureter, artery, vein, etc., after a section is removed.
Anthracene-containing antidiuretic hormone crystalline cyclic hydrocarbon, a product of coal-tar distillation used in making alizarin dyes and as a detector of radiation
antireflux valves in urinary pouches reduce backflow of urine onto the peristomal skin and thus provide peristomal skin protection.
Anus the lower opening of the rectum.
Appendix; the vermiform appendix extending from the cecum of the large intestine. A long narrow worm shaped tube of an average length of three inches. It is stated that the vermiform appendix tends to undergo obliteration as an involution change of as functionless organ.
Appendicitis refers to an inflammation of the appendix, that unexplained blind loop of tissue suspended from the cecum. The inflammation may be caused by obstruction of the appendix, although there are other causes. Appendicitis is rare before the age of 5 and seldom occurs after age 50. Typical symptoms are pain, nausea or vomiting, tenderness in the lower right portion of the abdomen, and fever. Often, the pain is felt first in the center of the abdomen, then shifts to the lower right portion after several hours. An important clue is sudden onset of symptoms in a person who previously was healthy. Prompt surgical intervention is necessary. It is important not to give the person food or laxatives, or to apply heat. Surgical removal of the inflamed appendix is a relatively simple procedure.
Appliance;
collecting device for waste eliminated from your ileostomy. Consists of a face
plate and a pouch. Other terms for face plate are disc, body holder, mounting
ring.
Colostomy and ileostomy pouches can be either open-ended, requiring a
closing device usually called a clamp or tail clip; or closed and sealed at
the bottom. Open-ended pouches are called drainable and are reused after
they are emptied. Most commonly closed end pouches are used by
colostomates who can irrigate , or by patients who have regular
elimination patterns.
These are the major types of appliances. There are also a number of styles. For instance there are flat faceplates and convex shaped ones. There are fairly rigid and very flexible ones. There are faceplates with and without adhesive backing and with and without a perimeter of tape. The decision as to what particular type of system to choose is a personal one geared to each individuals needs. ETs will tell people that there is no right or wrong choice, but each person must find the system that perforns best for him or her.
A wide selection of equipment options exist. Generally the larger mail-order catalogues will illustrate the types and styles from all or most of the suppliers (see Chapter III). If you have any trouble with your current pouching system, discuss the problem with an ET or other caregiver (see Chapter II) and find a system that works better for you. It is not uncommon to try several types until the best solution is found. Free samples are readily available for you to try. There is no reason to stay with a poorly perfonning or uncomfortable appliance.
These are the major types of appliances. There are also a number of styles. For instance there are flat and convex shaped faceplates. There are fairly rigid and very flexible ones. There are faceplates with and without adhesive backing and with and without a perimeter of tape. The decision as to what particular type of system to choose is a personal one geared to each individuals needs. ETs will tell people that there is no right or wrong choice, but each person must fmd the system that perfonns best for him or her.
A wide selection of equipment options exist. Generally the larger mail-order cataloges will illustrate the types and styles from all or most of the suppliers . If you have any trouble with your current pouching system, discuss the problem with an ET or other caregiver and find a system that works better for you. It is not uncommon to try several types until the best solution is found. Free samples are readily available for you to try. There is no reason to stay with a poorly perfonning or uncomfortable appliance.
Atresia of the rectum an abnormality of the structure of the rectum caused by a failure to develop properly
Artificial urinary sphincterArtificial urinary sphincter The artificial sphinster is mechanmical device that is surgically implanted. It consists of a urethal cuff that is wrapped around the urethra, a reservoir ballon that is implanted in the abdominal cavity, and a control pump located in the scrotum or labia. Deflation of thecuff permits voiding.
Ascending Colon The ascending colon is smaller than the caecum, with which it is continuous. It passes upward, from its commencement at the caecum, opposite the ileo-caecal valve, here it bends abruptly inward to the left, forming the hepatic flexuere. See Large Intestine
Ascending cholangitis Ascending cholangitis is a common complication of corrective surgery. A bacterial infection of the biliary tree often occuring behind an obstruction in the duct.
Auerbach's plexus Meissner's plexus, located in the submucosal layer of the intestinal wall and Auerbach's plexus, located in the muscularis, are jointly known as the intramural plexus. It is composed of nerve cell bodies and nerve fibers, or processes; the nerve fibers originate in receptor cells located in the bowel wall. These receptors are sensitive to local stimuli, such as stretch. The intramural plexus is the primary mediator of intestinal secretion and motility. Autonomic nerve fibers synapse on nerve cells in the intramural plexus and serve to modify its response, but autonomic stimulation is not critical to intestinal secretion or motility.
Autologous bone marrow transplantation uses the patients own bone marrow.
Autonomic nerve fibers synapse on nerve cells in the intramural plexus and serve to modify its response, but autonomic stimulation is not critical to intestinal secretion or motility.
Benign not cancerous, not malignant, having a favorable prognosis.
Bilateral . Pertaining to, or affecting, both sides.
Bilateral Ureterostomy . A surgical procedure which involves detaching the ureters from the bladder and bringing them through the abdominal wall, one on the left side and one one the right, to empty outside the body. In some cases both ureters are brought out at the same place, with stomas adjacent to each other. Collection devices must be worn at all times.
Bilary tree
The biliary system consists of the gallbladder and the biliary ductal system,
which provide a passageway for bile from the liver to the intestine This liver
bile, when produced, is golden or orange-yellow. When concentrated in the
gallbladder, this fluid becomes tenacious and a dark golden brown.
The duct system consists of two hepatic ducts that drain the liver and the
cystic duct that drains the gallbladder. These converge to form the common bile
duct. The common bile duct empties into the duodenum at Vater's ampulla. The
sphincter of Oddi surrounds Vater's ampulla to control the flow of bile into
the duodenum.
The gallbladder is a pear-shaped organ that lies on the underside of the liver.
Bile is the the bitter, alkaline, yellow-brown or greenish fluid secreted by the liver and stored in the gallbladder: it is discharged into the duodenum and helps in digestion, esp. of fats
Biologic response modifiers are used as a cancer treatment to decrease local recurrence. Biotheraphy is the treatment with agents derived from biologic sources that affect biologic responses. Known as Biologic response modifiers (BRMs) , these agents are a cancer treatment. As their name suggests, BRMs boost the body's response to tumor cells and other foreign substances, so BRMs fight the cancer indirectly. Immunotherapy is a subcategory of BRM therapies.
Bladder exstrophy In cases of bladder exstrophy the infant is born with an everted bladder and fusion of the mucosa to the skin.
Brooke ileostomy , End Ileostomy. An end ileostomy, frequently referred to as a Brooke ileostorny, was named after Bryan Brooke of London, who in 1952 described the technique used today. Until that time the end of the small bowel was simply brought out through the abdominal wall, with 4 to 6 cm protruding, and allowed to mature on its own. Partial obstruction of the stoma as a result of serositis and edema usually developed in patients having this procedure, and resulted in cramping abdominal pain, watery diarrhea, and fluid-electrolyte imbalance. Brooke's technique was to evert the distal end of the ileum, exposing the mucosa, and to suture the stoma to the dermal layer of the skin.' This technique, known as maturing the stoma, has eliminated ileostomy dysfunction.
Bypass Procedure. A "detour" procedure in which the bowel is made to take a short-cut, but the bypassed area is left in. Sometimes used in iletitis and as relief from discomfort in obstruction due to other causes.
Cecum is the large blind pouch, or cul-de-sac, situated below the ileo-caecal valve, in which the large intestine commences . Its blind end is directed downward, and its open end upward, communicating directly with the colon, of which this blind pouch appears to be the beginning or head. Its size is variously estimated by different authors, but on an average it may be said to be two and a half inches in length and three in breadth.
Caput medusae refers to a bluish-purple discoloration of the slin caused by dilation of the cutaneous veins around a stoma. The discolored area blanches when pressed and displays irregular, small blood vesels. The name, caput medusa comes from the resemblence of the dilated vessels to the head of the snake-haired Medusa.
Carcinoma cancer, malignant growth. Colectomy / removal of all or part of the colon.
Catheter a slender, hollow tube, as of metal or rubber, inserted into a body passage, vessel, or cavity for passing fluids, making examinations, etc., esp. one for draining urine from the bladder
Cecostomy Opening in the cecum , located on the lower right side. Evacuation is involuntary and cannot be controlled by irrigation. Usually temporary to rest colon. When the cecum is allowed to remain in the abdominal cavity but has an external tube draining it, it is known as a tube cecostomy.
Chemotherapeutic agents are alkylating, antibiotics, and hormones.
Chyme Ingested foods and liquids are retained in the stomach until they have been thoroughly mixed with the gastric juices and converted to a semi liquid material known as chyme.
Colectomy . The partial or total removal of the colon.
Colitis inflammation of the large intestine. A particularly severe type is ulcerative colitis, which may require an ileostomy.
Colon part of the intestine which stores digestive material and absorbs water. Also referred to as the large intestine or the large bowel. Like the small intestine, the colon is subject to disease throughout its length, malformations, and structural abnormalities. The more common malformations of the colon include imperforate anus and congenital megacolon.
Colonoscopy (Surgical). Use of sterile sigmoidoscope during operation to examine visually the colon for presence of polyps. Done through two or three small openings in the colon. The term is also used to mean the visual examination of the entire colon through a new device. See Sigmoidoscopy.
Colorectal cancer common cancer in people over 45. Most common reason for permanent colostomy. Colostomy a surgical opening of the colon (largr Intestine) brought to the abdominal surface a relatively rare opening in the ascending portion of the colon. It is located on the right side of the abdomen.
Colostomy Ascending; a relatively rare opening in the ascending portion of the colon. It is located on the right side of the abdomen.
Colostomy Loop; usually created in the transverse colon. This is one stoma with two openings; one discharges stool, the second mucous. Colostomy (permanent) usually involves the loss of the colon and in most cases, the rectum. Here, the end portion of the remaining colon is brought through the abdominal wall to form a stoma. This is also known as an end colostomy.
Colostomy (sigmoid) surgically created opening in the upper end of the sigmoid colon, resulting in a stoma on the lower left side of the abdomen. Evacuation may be controlled by irrigation. May be temporary or permanent.
Colostomy (temporary) usually performed to allow the lower part of the colon and / or rectum to heal or rest. There are two openings; usually the one on the right discharges waste, the other only mucus.
Colostomy (transverse) surgically created opening in the transverse colon resulting in a stoma (or stomas) located on the upper abdomen, middle or right side. Occasionally the transverse colostomy is an end colostomy with one opening, with all or most of the colon beyond it removed.
Cone part of irrigation set for sigmoid colostomy. Plastic cone-shaped piece at the end of tubing, fits snugly against the stoma to keep solution in the colostomy.
Congenital present or existing at the time of birth, such as a deformity, disease, or tendency.
Congenital megacolon (Hirschsprung's disease) occurs because of faulty development of the nerves that control the rectum. Megacolon, usually becomes apparent shortly after birth, when the obstructed colon grows to giant proportions, swelling the abdomen. The condition can be corrected surgically.
Continence able to retain feces, urine voluntarily.
Continent Ileostomy surgical variation on ileostomy which avoids need for an external appliance. The surgeon loops part of ileum back on itself and constructs from this loop a reservoir inside the abdomen. A nipple valve is constructed of intussuscepted ileum. The ostomate inserts a catheter a few times each day to drain feces from reservoir. Often a conversion procedure for a conventional ileostomy.
Continent Urostomy; There are two main continent procedure alternatives to the ileal or cecal loop (others exist). In both the Indiana and Kock Pouch versions, a reservoir or pouch is created inside the abdomen with a portion of either the smaller or large bowel. A valve is constructed in the pouch and a stoma is brought through the abdominal wall. A catheter or tube is inserted several times daily to drain urine from the reservoir.
Convex pouching system; The patient with a soft abdomen and a flush or retracted stoma may require a pouching system with support (rigidity) or convexity, or both, to obtain a secure seal. Convex inserts can be added to selected two-piece systems to provide convexity and additional support.
Credé and Valsalva maneuvers One option for the urologic management of patients with a spinal cord injury is Credé and Valsalva maneuvers,
Crohn's Disease(ileitis, regional enteritis or granulomatous disease of the bowel) / inflammatory bowel disease which penetrates the deep lining of any part of small or large bowel. In selected cases, ileostomy becomes necessary; Crohn’s can flare up after ileostomy surgery, however. Crohn ‘s disease, may affect any part of the large or small intestine, and less commonly, the esophagus and stomach. There are three common patterns of the disease. Disease confined to the small intestine (enteritis) almost always involves the last portion of the ileum. Additional areas of the small intestine may be involved, sometimes with disease-free areas between. In the enterocolic variety, both the small intestine and the colon are diseased. Colonic Crohn ‘s disease may involve the entire colon, a segment or multiple segments, but the small bowel is spared.
Crypt abscesses Abscesses of various recesses, glandular cavities, in the body
Cutaneous T- cell lymphoma See Mycosis fungoides
Cyclophosphamide a white, crystalline compound, used in treating certain malignancies, esp. lymphomas
Cystectomy
. Excision of a cyst of of a fluid containing structure. Excision of the
urinary bladder (complete or total cystectomy) or resection of the bladder
(partial cystectomy).
Defaction
to excrete waste matter from the bowels.
Dentate line (anoderm)
Midpoint in the anal canal is the dentate line aIso referred to as the
pectinate line) . This is an important reference point because of the
differences that exist in the tissues above and below this line. Proximal to
this line, the mucosa assumes a pleated appearance known as the columns of
Morgagni. These longitudinal folds are created by the narrowing of the rectum
into the anal canal. Above the dentate line, the anal canal is lined with
columnar epithelium, whereas squamous epithelium lines the anal canal distal to
the dentate line.
dermis;
the layer of skin just below the epidermis
Descending Colon
The descending colon passes downward through the left hypochondriac and lumbar
regions along the outer border of the left kidney. At the lower end of the
kidney it turns inward and descends to the crest of the ilium, where it
terminates in the sigmoid flexure. See
Large Intestine
Desmoid tumors
osteomas, and duodenal polyps may be extraintestinal
manifestations
of Familial adenomatous polyposis.
Detrusor
is a smooth, involuntary muscle.
Dilation
(Dilatation). The condition of being dilated stretched beyond the normal
dimensions. Usually done to keep stoma open, when needed. Success not known.
(NOTE:
Never practice dilation except on the advice of your doctor.)
Distal
. Farthest away from the trunk, midline or heart. For example, the hand is
distal to the elbow, the rectum is distal to the colon.
Diverticulitis
inflammation of the diverticula (little sacs on the colon); can cause abscess,
scarring with stricture or perforation of the colon with peritonitis in severe
cases. Some cases are difficult to tell from cancer on x-rays of the colon.
Diverticulosis
presence of diverticula (little sacs on the colon); very common, one or two or
more found in more than half of the people over 50.
Diverticulosis and diverticulitis.
Diverticulosis means the presence of one or more diverticula in the colon. A
diverticulum is an outpouching through a weakened area in the wall of the
bowel. Such outpouchings are extremely common in people over age 50. In
general, diverticula cause no symptoms, but occasionally, bleeding, infection,
or inflammation may occur.
A person with a bleeding diverticulum develops sudden, copious, red rectal
bleeding. The onset is so dramatic that he or she usually wastes no time in
seeking medical attention. Treatment is to replace lost blood. If the bleeding
does not stop spontaneously, surgery is necessary.
The infected diverticulum is referred to as diverticulitis. Diverticulitis
begins as a rather abrupt onset of lower abdominal pain, a change in bowel
habits (usually constipation), fever and sometimes chills, and sometimes rectal
bleeding. Acute diverticulitis is treated with antibiotics. Fluids are given
intravenously, and diet is restricted. After an acute episode, a high-fiber
diet often is recommended.
Double-barrel colostomy
is usually intended to be a temporasry diversion.
In the construction of a double barrel colostomy a loop of bowel is completely
divided, nad the two ends are brought out to the surface and are sutured to
the skin.
Double-Barrel Stoma
A double-barrel stoma is constructed when the bowel is divided and both the
proximal and distal ends are brought to the surface as two separate stomas. One
is a proximal, functioning stoma; the other is a distal, nonfunctioning stoma.
Usually a bridge of skin is closed between the two stomas. The distal stoma
generally is referred to as a mucous fistula. A double-barrel stoma usually is
temporary.
Dukes' stage B
A colorectal tumor that is contained within the bowel wall and does not
involve lymph
nodes is a Dukes' stage B.
Duodenal
in or of the duodenum
Duodenum
; Food material which has been passed on from the stomach into the duodenum is
allowed to remain there until it is well mixed with the digestive juices poured
in at that point. It is then gradually pushed along into lower portions of the
intestine by peristaltic contractions and by further discharges from the
stomach. The duodenum has received its name from being about equal in length to
the breadth of twelve fingers (ten inches). It is the shortest, the widest, and
the most fixed part of the small intestine. Its course presents a remarkable
curve, which in the adult, as regards the greater part of its extent, is
U-shaped; though some times, in consequence of the transverse portion being
very short or altogether wanting. it partakes more of the character of the
letter V.
In children, up to the age of about seven, the duodenum is annular; its two
extremities are on about the same level; and between them it describes a
regular curve embracing the head of the pancreas, the neck of which lies
between the two extremities of the ring.
-ectomy
excision (cutting out) of an organ or part. For example:
appendectomy, removal of the appendix; tonsillectomy, removal of the tonsils;
colectomy, removal of the colon.
Electrolytes
salts and minerals needed by the body for health.
Endoscopy
. The general term for visual
examination of any hollow organ. See
Colonoscopy, Proctoscopy and
Sigmoidoscopy.
End Ureterostomy
may be unilateral or bilateral, depending on whether one or both kidneys are
functional and on the reason for the procedure. For example, a unilateral
ureterostomy may be performed in the patient who has only one functioning
kidney or in the patient who has two functioning kidneys but whose disease is
localized to one ureter. Bilateral ureterostomies are indicated for the patient
who has two functioning kidneys and bilateral disease requiring diversion. A
transureteroureterostomy is an alternative to bilateral ureterostomies; in this
procedure, one ureter is anastomosed to the other ureter, which is then brought
to the skin surface for diversion -. This procedure provides bilateral
diversion with only one stoma.The decision regarding the ureter to be used for
stoma construction and the ureter to be anastomosed is made on an individual
basis and is determined by the length, mobility, and size of the two ureters.
The ureter that can be more easily brought to the surface and that provides the
greater diameter for construction of an
adequate opening is selected.
Enteritis
. Used to refer to inflammation in the intestine.
Enterostomal Therapy Nurse
also known as
ET
nurse. A person who takes care of and teaches ostomy patients. A special
training course for registered nurses is required for certification.W.O.C.N.
Web Site--
Enterostomal Therapy Nurse
Enzymatic
any of various proteins, formed in plant and animal cells or made
synthetically, that act as organic catalysts in initiating or speeding up
specific chemical reactions and that usually become inactive or unstable above
c. 50 deg. C (122 deg. F)
Enzymatic Digestion
The stomach begins enzymatic digestion of proteins. The parietal cells produce
HCL acid, which converts pepsinogen (secreted by the chief cells) into pepsin.
Pepsin is a proteolytic enzyme.
Enzyme
substance formed in animal and plant cells that starts or speeds up specific
chemical reactions.
Epidermis
the outermost layer of the skin in vertebrates, having no blood vessels and
consisting of several layers of cells, covering the dermis:
Esophagus
The esophagus is a muscular tube that transports food from the mouth to the
stomach. The upper esophageal sphincter opens to permit the passage of food,
then closes to prevent swallowing air. The lower esophageal sphincter opens to
allow food so enter the stomach and closes to prevent food from backing up into
the esophagus again. The esophagus joins the stomach by passing through the
hiatus in the diaphragm, the set of muscles that divides the chest and
abdominal cavities
Esophagogastric sphincter
prevents reflux from
the stomach into the esophagus.
Excoriation
. Any superficial loss of substance, such as that produced on the skin by
scratching. In ostomy it commonly refers, when it is present, to the red,
raw-appearing, sore skin area surrounding the stoma. It is usually caused by
enzymes in the fecal matter or by urine eroding the skin surface, or abuse of
the skin by scrubbing or scratching.
Extrahepatic biliary atresia
a rare disease with an incidence of 1/8000 live births with a predominance in
the female. Whether this disease exists befor or after birth is unclear.
Biliary atresiais is characterized by the occlusion or complete destruction of
part or all of the exterahepatic bile duct, therby obstructing bile flow from
the liver.
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