Around 160,000 people in Germany live with an artificial anus. Those affected can lead a largely normal life. The artificial anus also goes unnoticed by outsiders in most everyday situations. Nevertheless, it initially causes many sufferers great concern and feelings of shame.
But life with an artificial anus can be managed well.
The connection between a hollow organ and the surface of the body is known in medicine as a stoma. The artificial bowel outlet is specifically known here as an enterostomy.
With an artificial bowel outlet, the digestive products are passed through the abdominal wall into a stoma bag. The skin around the outlet on the abdominal surface is protected by a plate. There is an opening in the middle of the plate through which the part of the bowel bulges.
The collection bag is attached to the plate by a click mechanism.
Illustration of an artificial bowel outlet (left) and the attached collection bag (right) © Artemida-psy | AdobeStock
There are different types of artificial bowel outlet, depending on which section of the bowel is involved. The two most common types of bowel outlet are
With an ileostomy, the small intestine is passed to the outside. With the colostomy, there is a connection between the large intestine and the abdominal wall. At 70 percent, the colon outlet is the most common variant.
Cancer is the most common reason for a permanent artificial bowel outlet. In the case of colon cancer, part of the bowel or the anal sphincter muscle often has to be removed. In this case in particular, an artificial anus is mandatory.
However, other circumstances can also make a temporary or permanent artificial anus necessary.
These include
Before the operation, the doctor informs the patient in detail about the procedure and possible risks. The future position of the anus is marked on the skin. The operation is performed under general anesthesia.
There are two different options for creating an artificial bowel outlet:
The doctor usually opts for a permanent anus if the anus is to be permanent .
During the operation, the diseased section of the bowel is removed and the healthy part is guided by the surgeon to the artificial opening in the abdominal wall. The upper bowel loop is attached to the abdominal wall with sutures.
A double anus is often used for temporary therapies. The reason may be to protect certain sections of the bowel after an operation.
For a double anus, the surgeon passes the bowel loop through the abdominal wall to the surface of the body and cuts the loop open. This creates two openings, which are attached side by side to the abdominal wall with sutures.
Defecation can only pass through the upper bowel loop. The double anus can be repositioned after a few weeks or months. To do this, the doctors reconnect the two openings of the bowel loop.
The risk of complications is very low if the artificial bowel outlet is properly cared for.
One complication that typically occurs is the so-called parastomal hernia. This is a hernia around the anus through which the abdominal wall bulges outwards. If the hernia is very pronounced, an operation is required to close the hernia.
Other possible complications of an artificial anus are
An artificial anus is safe and can be worn very discreetly © Martina | AdobeStock
Many patients are initially ashamed of their artificial anus and fear major restrictions in everyday life. Over time, however, patients usually find that very little changes in their lives despite the artificial anus. All activities, such as sports or sexual activities, can still be carried out.
It can be very helpful to talk to other affected people in a self-help group. So-called stoma therapists
Patients with an enterostomy do not have to follow a specific diet. Should
should be tested to see which food is best tolerated. Chewing food thoroughly and eating smaller and more regular meals will reduce digestive problems.
Odours do not escape through the stoma bag, as the bags contain a carbon filter that neutralizes odours. Only cooing noises may be audible in the event of flatulence.
There are numerous aids and even special clothing for people with an artificial bowel outlet in specialist medical stores. For example, special swimming belts are available that cover the anus so that those affected can go swimming without feeling ashamed.
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