stoma colonoscopy

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strategygirl
Posts: 4
Joined: Fri Sep 07, 2018 2:06 pm

stoma colonoscopy

Postby strategygirl » Thu Oct 11, 2018 2:37 pm

Hi, all - I am ten months post surgery with a permanent stoma left of my navel. My surgical oncologist wants me to have a colonoscopy within the next month to take a look around and make sure everything is okay. My question - is it difficult to prepare and have a colonoscopy with a permanent stoma? I remember the "fun" the original colonoscopy prep was and can't imagine how this will work with a bag on my belly. Suggestions? Thanks in advance.

NHMike
Posts: 1805
Joined: Fri Jul 21, 2017 3:43 am

Re: stoma colonoscopy

Postby NHMike » Thu Oct 11, 2018 8:22 pm

I would think that you wouldn't need to do a prep with a Stoma as the prep would wind up in the bag.

I had a Barium Enema before my reversal and the surgeon indicated no prep for the same reason.
6/17: ER rectal bleeding; Colonoscopy
7/17: 3B rectal. T3N1bM0. 5.2 4.5 4.3 cm. Lymphs: 6 x 4 mm, 8 x 6, 5 x 5
7/17-9/17: Xeloda radiation
7/5: CEA 2.7; 8/16: 1.9; 9/8: 1.8; 11/30: 0.6; 12/20 1.4; 1/10 1.8; 1/31 2.2; 2/28 2.6; 4/10 2.8; 5/1 2.8; 5/29 3.2; 7/13 4.5; 8/9 2.8
MSS, KRAS G12D
10/17: 2.7 2.2 1.6 cm (-90%). Lymphs: 3 x 3 mm (-62.5%), 4 x 3 (-75%), 5 x 3 (-40%). 5.1 CM from AV
10/17: LAR, Temp Ileostomy, Path Complete Response
CapeOx (8) 12/17-6/18
7/18: Reversal, Port Removal

MissMolly
Posts: 564
Joined: Wed Jun 03, 2015 4:33 pm
Location: Portland, Ore

Re: stoma colonoscopy

Postby MissMolly » Thu Oct 11, 2018 8:58 pm

Strategygirl:
If you have a permanent end colostomy, your colonoscopy will be similar to a regular colonoscopy. Instead of the scope entering the anus to look at the length of large intestine, the scope will enter and be advanced through your stoma through the length of remaining large intestine.

You will be prescribed a colon cleanse, likely the same as you had with your prior colonoscopy studies pre-stoma. Yes, as MikeNH mentioned, the cleanse will empty your remaining colon and the fecal cleansing will empty into what ever ostomy pouch you use.

For consideration:
A. Purchase through your ostomy supplier (Byram, EdgePark, whom ever you use as your medical supply provider) high volume capacity drainable ileostomy pouches to use during your prep. Make sure that the high capacity pouches fit the wafer that you are using if you are currently using a two-piece system.

B. Purchase through your ostomy supplier what are called “irrigation bags.” Many individuals with a colostomy practice a daily irrigation/enema through their stoma to clear the lower digestive tract of fecal matter. This enables people with a colostomy to go without wearing an ostomy pouch for 24 hours. Irrigation bags collect the fecal matter vis-a-vis colostomy irrigation, which is then emptied into the toilet. Irrigation bags are essentially high capacity/high volume ostomy pouches. They are handy during the prep for a colonoscopy with a colostomy.

Be sure to take 1-2 new wafers and pouches with you to your colonoscopy procedure. You will need to place a new wafer/pouch on after the procedure.

Remember: The colonoscopy through the stoma will be a scope and viewing of the active and on-line large intestine proximal and connected to the stoma.

The segment of large intestine distal/away from the stoma (residual colon or rectal stump that is off-line) is not studied by the colonoscopy that enters through the stoma. To visual the resting residual colon/rectal stump, the GI physician will use a protocscope (anal scope) or flexible sigmoidoscopy scope as a seperate procedure if this is indicated for you. Your GI physician should discuss with you whether a back-end/rectal stump scope will also be performed. If this information is not shared with you upfront, ask for clarification. It is your body. You deserve to understand what areas of intestine will be scoped/visualized.

Feel free to hop on over to the UOAA (Ostomy Association) forum and talk to fellow colostomates who have had a colonoscopy through a stoma. Including managing prep with a stoma and using high capacity drainable bags. http://www.uoaa.org

Best wishes,
Karen
Dear friend to Bella Piazza, former Colon Club member (NWGirl).
I have a permanent ileostomy and offer advice on living with an ostomy - in loving remembrance of Bella
I am on Palliative Care for broad endocrine failure + Addison's disease + osteonecrosis of both hips/jaw + immunosuppression. I live a simple life due to frail health.

Soccermom2boys
Posts: 195
Joined: Tue Nov 10, 2015 10:29 pm

Re: stoma colonoscopy

Postby Soccermom2boys » Fri Oct 12, 2018 9:26 pm

Hi Strategygirl—

From what I can tell of your description of your permanent stoma, it appears you have a colostomy, correct? I have a permanent one myself—had rectum and sigmoid removed, but rest of colon intact. I have had a colonoscopy with my stoma and the prep is identical in nature to what is done for people who have “normal plumbing”. I do the miralax prep and honestly have zero issues with drinking what is asked of me. As for dealing with the output that comes with a colonoscopy prep, I found it slightly easier having a pouch to hold it in until I could get to the bathroom plus, no burning butt syndrome! :mrgreen: My colostomy pouch is also a “midi” size which isn’t quite as large as I guess the typical pouch and I had no problems always emptying in time for the next round to flush through. Just as with anyone else’s colonoscopy prep, be within close range of the bathroom as you will need to empty every 10-15 minutes during the more voluminous portion of the prep. :wink: I assure you, this is not something that will be any more effort than before you had a stoma. I have another colonoscopy coming up in a few weeks and aside from the 24 hours of no solids, I honestly don’t mind the prep, a minor inconvenience but that is it. Good luck and let me know how you faired with the new plumbing! :lol:
8/3/15 Went in with a hemorrhoid, came out with a tumor
8/12/15 Biopsy from colonoscopy confirms RC (45 yrs old--zero family history!)
9/21 - 10/29/15 chemorad 28 tx (with Xeloda)
12/17/15 APR with perm colostomy
Pathology report stages me as IIIA (T2N1M0)--1/15 LN detects cancer
2/3/16 chemo port inserted
2/8-6/2/16 8 rounds of Folfox

Lee
Posts: 5724
Joined: Sun Apr 16, 2006 4:09 pm

Re: stoma colonoscopy

Postby Lee » Sat Oct 13, 2018 12:19 am

I am a 14 yrs survivor and have a permanent colostomy. I've had MANY scopes through the years, yes you have to use prep solution as if you had a rectum, butt in my case I don't always need to finish that 2nd dose of the that wonderful prep solution. When my output turns a yellowish color, I'm done. I keep the schedule, butt when I see yellowish output, I stop drinking the prep solution.

Good luck, hope this helps.

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!

strategygirl
Posts: 4
Joined: Fri Sep 07, 2018 2:06 pm

Re: stoma colonoscopy

Postby strategygirl » Mon Oct 15, 2018 9:37 am

Thank you all for the advice and support. Diagnosed with stage 3 rectal cancer in July 2017 with the tumor located right inside the anus, hence I lost everything down there permanently and had reconstruction including a perineal flap. Knowing output during my pre-surgical colostomy, I had visions of my bag blowing off with all the fluid that will be discharged. It is also good to read that it is manageable and I will order a few of the larger ostomy output bags for that procedure. Thanks again for the advise and support. I'm going into this procedure with much less concern. Will let you know the outcome.

User avatar
mobrouser
Posts: 101
Joined: Wed Apr 11, 2018 1:44 pm
Location: Ontario

Re: stoma colonoscopy

Postby mobrouser » Mon Oct 15, 2018 1:39 pm

strategygirl wrote:Thank you all for the advice and support. Diagnosed with stage 3 rectal cancer in July 2017 with the tumor located right inside the anus, hence I lost everything down there permanently and had reconstruction including a perineal flap. Knowing output during my pre-surgical colostomy, I had visions of my bag blowing off with all the fluid that will be discharged. It is also good to read that it is manageable and I will order a few of the larger ostomy output bags for that procedure. Thanks again for the advise and support. I'm going into this procedure with much less concern. Will let you know the outcome.


So happy to read that, I hope your scope is as stress free as possible.

8) mob
CC Dx Oct 2017 @ age 58
Laparoscopic right hemi-colectomy Dec 2017
Adenocarcinoma ascending colon – 6cm x 6cm x 2cm, Low Grade, penetrates to peritoneum
T4a N2a M0, Stage IIIC
lymph nodes 6 positive out of 18
FOLFOX started Jan 16 2018; finished Aug 2 2018 (felt like a year)
CEA - 01/15/18 - 2.8; 07/29/18 - 5.3
CT scan Aug 8 2018 - Clear
PET scan Sept 6 2018 (thought about bringing the cat :wink: ) - Clear

Lee
Posts: 5724
Joined: Sun Apr 16, 2006 4:09 pm

Re: stoma colonoscopy

Postby Lee » Mon Oct 15, 2018 3:56 pm

I normally use the non drainable bags (disposal bags, one time use), butt I always keep drainable bags on hand for situations like prepping for colonoscopy, or if I'm sick, ie diarrhea, non normal situations.

Good luck

Lee
rectal cancer - April 2004
46 yrs old at diagnoses
stage III C - 6/13 lymph positive
radiation - 6 weeks
surgery - August 2004/hernia repair 2014
permanent colostomy
chemo - FOLFOX
NED - 10 years and counting!


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