In elective cases, the colon is cleaned before the surgery with enemas and oral agents.
Small bowel resection is performed while the patient is under general anesthesia (unconscious and pain-free). An incision is made in the abdomen. The diseased part of the large intestine is removed and the two healthy ends are sewn back together (resected). The abdominal incision is closed.
If it is necessary to spare the colon from its normal digestive work while it heals, a temporary opening of the colon through the abdominal wall (colostomy) may be created. The proximal proximal (nearer to the small intestine) end of the healthy bowel tissue is then passed through the abdominal wall, and the edges are stitched to the skin of the abdominal wall. An adhesive drainage bag (stoma appliance) is placed around the opening.
In most cases, depending on the disease process being treated, the colostomy is temporary and can be closed with another operation at a later date. If a large portion of the bowel is removed, the colostomy may be permanent.
The large intestine absorbs a significant amount of water from digested food. When the colon is bypassed by a colostomy, the patient should expect loose or liquid stool (feces) from the colostomy. Careful skin care and a well-fitting colostomy bag are necessary to reduce skin irritation around the colostomy.
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