Why Does Ostomy Often Lead to More Intestinal Blockages?

Why is it that once you lack a colon, intestinal blockages increase? Food enters the small intestine first and then the colon. So why does the removal of the colon make the small intestine more prone to blockage than before?

Gemd,

  So this is my opinion and in no way based on fact, just experience.  I've had an ileostomy for 23 years now.  If you understand how a stoma is formed, it might make more sense.  The contents of the small intestine are more liquid like and still have some stomach acid.  The large intestine would soak up the water/acid in the waste, making more solid poo's.

  Think of it this way.  An ileostomy stoma is formed by pulling your small intestine through the abdomen wall, cuffed or folded like a shirt sleeve and then sewn to the abdomen.  Before the surgery, my small intestine was used to just free flowing waste going into the large intestine.  But when the stoma is formed, the ability for the waste to flow freely is basically cut into half if not more because of a smaller opening for the waste to get out.  Not to mention, your body naturally tries to close the hole or wound through your abdomen that the stoma is sticking out of.  This is another reason why second surgery's are sometimes required to relocate the stoma site.

  Because the hole in a stoma is smaller, it has a harder time passing larger chunks of food that weren't thoroughly chewed up like corn, peanuts or naturally fiberous foods.  And when your body is trying to process naturally fiberous foods, they can start backing up insided the small intestine because the stoma can't get the food out fast enough, causing obstructions and/or blockages and of course the pain that comes with it.

  So to avoid the risk of getting an obstruction/blockage, ostomates have to learn all over again on how to properly chew their food.  No more woofing down food.  The more the food is broken down before it reaches your stomach the better.  You'll absorb more nutrients from it as food is fuel, you will actually get that "full" feeling faster and you will substantially reduce the risk of forming obstructions/blockages.

  Again, this is just my opinion/experience.  Hope it helps.

Bain

Gemd,

If I may add to Bain's note, I believe it also has to do with the fact that in the absence of the colon, the small intestine has been re-routed so to speak in order to pass it through the abdominal wall. This results in certain curvatures and correponding restrictions that were not there when attached to the colon. This raises the possibility that certain foods when improperly chewed and or taken in large quantities can get "trapped" in these new modifications leading to a blockage. This is only my opiion on the matter.

Xerxes

Hello Gemd. I do like Bain's and Xerxes' explanations as they make sense to me. There are other things to consider as well such as: 1) Timing: Soon after the operation, the body is still adjusting to what has gone on inside and sometimes doesn't work as well as it did previously.   2) Comparisons: In my case, I had not really thought about these things until the problems arose after the stoma. However, in discussions with the stoma nurse, I was prompted to recall that I often had constipation prior to the operation. This led us to the conclusion that my gut was probably working in the same way as it had before, except now there was less of it to cope. 3) Coupled with other symptoms, it was felt that I had a slow movement of waste due to the peristalisis not working very well. this was identified not by the waste in the colon  but by the failure of the oesophagus to push the food past my throat. In the short-term, medication helped in this regard but they would not precribe it long-term so I've had to adjust and manage in other ways. One of the things I  tried sucessfully at first was to liquidise everything I ate. This may seem like  a lazy way of mastication but it did help in those early days. Nowadays, I just chew everything much more. I still have problems at times but as I irrigate, these problems are nearly all in the area of the oesophagus rather tan further down the system.  Also, I found that taking Metamucil after meals helped to ease the stuff through the system more smoothly and the consistency at the other end was still softish and was therefore less likely to cause blockages.

Best wishes

Bill 

Yup, what everyone has said sure makes sense. I'll just add that another consideration is that any time bowel is disturbed (during surgery) your body reacts by forming adhesions all around the bowel. These adhesions tend to limit how much the bowels can move, which they do all the time to make bowel contents move thru (ie, peristalsis), and as gas is passed thru. So the chew, chew, chew advice.......is good advice!

Regards,

Bob

Staying Hydrated with an Ostomy with LeeAnne Hayden | Hollister