colostomy. It is important to empty or change the
colostomy bag frequently and regularly and to
cleanse the skin around the stoma with each
changing to minimize irritation from the adhesive
and from fecal matter. Frequent bag changes also
reduce odor, as do deodorizing tablets that go into
the ostomy bag. Over time, most people find that
certain foods (such as meats and many processed
foods) are more likely than others to cause odor or
irritation and can avoid eating them to further
reduce odor.
Concerns about how having a colostomy will
change appearance and daily living activities are
natural and common. A colostomy significantly
alters the body’s structure and excretory function,
which many people find challenging. An ostomy-
care specialist can provide information and sug-
gestions to smooth the adjustment. Most people
find they are able to return to their regular activi-
ties when the stoma fully heals. The colostomy
should not interfere with clothing, exercise, lifting
and carrying, and most other daily activities.
The effect of colostomy on SEXUALITYis a major
concern for most people. A risk of surgery on the
colon is damage to the nerves that supply the per-
ineal area, which can result in altered sensations
in men and women and ERECTILE DYSFUNCTIONin
men. Some people feel self-conscious or embar-
rassed about having a colostomy. However, many
people who have colostomies can return to regu-
lar sexual activity as soon as they feel the desire to
do so. A special cap can cover the stoma during
sex. Having SEXUAL INTERCOURSEor ORGASMdoes not
cause any harm to the colostomy or adversely
affect the underlying condition in most circum-
stances. It is important for partners to discuss
their concerns and feelings openly and honestly so
they can maintain intimacy within their relation-
ships.
See also ILEOANAL RESERVOIR; ILEOSTOMY.
constipation Difficult or delayed bowel move-
ments. Constipation may occur as a delay in the
frequency of bowel movements, an attempt to
pass stools that are hard and compact, or a combi-
nation. Constipation tends to be chronic (long-
term), though can occur as acute (sudden)
episodes. Abdominal cramping and bloating may
accompany constipation.
Any rectal bleeding that accompanies
constipation or bowel movements
requires medical evaluation.Though constipation can signal serious health
conditions such as intestinal obstruction or
HYPOTHYROIDISM, most often constipation relates to
lifestyle factors such as diet, physical exercise,
and HYDRATION(fluid intake). Numerous medica-
tions, notably ANTIHISTAMINE MEDICATIONS, narcotic
ANALGESIC MEDICATIONS(pain relievers) and ANTIDE-
PRESSANT MEDICATIONS, can cause constipation. Con-
stipation becomes more common with increasing
age, partly due to lifestyle factors and partly due to
age-related changes in intestinal motility.
Stools become hardened when the COLON
extracts too much water from the fecal matter that
passes through it. This can occur because the body
needs more fluid (inadequate fluid intake) or
because the fecal matter spends too much time in
the colon (a consequence of inactivity or
decreased intestinal motility). Hardened stools are
difficult to pass and may cause irritation and even
ABRASIONSto the anal canal and ANUS. Straining
with the effort of a difficult BOWEL MOVEMENT
aggravates common conditions such as HEMOR-
RHOIDSand can have cardiovascular consequences
such as ARRHYTHMIA (irregular heartbeat). Long-
term use of LAXATIVEScauses the colon to become
reliant on them to stimulate bowel movements;
overuse of laxatives is a frequent cause of chronic
constipation.
For occasional constipation, many doctors rec-
ommend home treatment for two to three weeks,
consisting of:- increased water consumption
- increased fiber in the diet (eating more vegeta-
bles, fruits, whole grains, and whole grain
products) - 45 minutes to an hour of daily physical exercise
such as walking, which encourages PERISTALSIS
(the rhythmic, wavelike contractions of the
intestinal wall) and improves BLOODflow - no laxatives
- sitz baths and hemorrhoidal preparations to
soothe irritated hemorrhoids
32 The Gastrointestinal System