Glossary

Abdominoperineal Resection (A-P Resection) - resection of a part of the lower bowel in which all or part of the colon and the rectum and anus are removed. Two incisions are needed - one through the abdomen and one through the perineum (the area between the genitals and the anus).

Anastomosis - the surgical joining of two body parts.

Anti-Reflux Valve - Incorporated in urostomy appliances, this valve stops the urine from going back into the kidneys once it has drained into the bag.

Appliance - See Pouch.

Barium Enema - A barium enema is an x-ray of your large intestine (large bowel). The intestines cannot be seen well on regular x-ray pictures without barium. Barium is a white liquid that is put into the bowel as an enema. It looks white on x-ray pictures and fills the part of the bowel that the doctors need to see.

Barnett's Continent Internal Reservoir (BCIR) - See Continent Ileostomy.

Biopsy - Removing a piece of tissue and examining it under a microscope to diagnose disease.

Blockage - Any obstruction in the digestive or urinary tract. Symptoms include: pain, little or no output from the stoma for several hours, nausea, and sometimes fever. If the blockage doesn't shift within a few hours, medical advice is needed.

Bowel Prep - Usually needed before bowel surgery and certain diagnostic procedures. Consists of taking of a laxative such as Golitely or Fleet Soda - be prepared to live in the toilet for the next few hours after taking it!

Bricker Loop - See Ileal Conduit.

Brooke Ileostomy - See Ileostomy

Cecostomy - A cecostomy is a catheter that is inserted into the cecum, which is the first part of the large bowel and is usually located within the right lower quadrant of the abdomen. Since a cecostomy is inserted into this first part of large bowel, patients with fecal incontinence can use the cecostomy to administer a small-volume phosphate enema followed by a saline enema to quickly and completely evacuate and cleanse the large intestine, emptying through the anal opening.

Colectomy - Removal of the colon (large intestine) either in part (partial colectomy) or all of it (total colectomy).

Colonoscopy - lets the physician look inside your entire large intestine, from the lowest part, the rectum, all the way up through the colon to the lower end of the small intestine. The procedure is used to look for early signs of cancer in the colon and rectum. It is also used to diagnose the causes of unexplained changes in bowel habits. Colonoscopy enables the physician to see inflamed tissue, abnormal growths, ulcers, and bleeding.

Coloproctectomy (Proctocolectomy) - Removal of all or part of the colon plus the rectum.

Colorectal Cancer - Cancer of the colon or rectum. The most common reason for a permanent colostomy.

Colostomy - An operation where part of the large intestines is removed. The stoma is made from the large colon, hence "col" ostomy. Colostomies are named after where the stoma is located in the colon:

• Ascending Colostomy. The stoma is in the ascending colon. This is a rare, temporary ostomy.
• Transverse Colostomy. The stoma is in the transverse colon. The stoma is located on the upper abdomen usually at or above the waistline. This is usually a temporary procedure.
• Descending Colostomy. The stoma is in the descending colon. This type of ostomy may be temporary or permanent.  It can occasionally be managed with irrigation but usually a pouch must be worn at all times.
• Sigmoid Colostomy. The stoma is in the sigmoid colon. It is the most common type of permanent colostomy, but can be temporary is the rectum and anus are left. It can be managed via irrigation if preferable to wearing a bag.

Cone - Part of a colostomy irrigation set. The soft, plastic cone-shaped piece at the end of the tubing, fits snugly against the stoma to keep irrigation fluid in the colostomy.

Continent Ileostomy (Barnett's Continent Intestinal Reservoir (BCIR), Kock's Pouch) - A variation of the ileostomy where the pouch is internal made of the small intestine. It is drained via a catheter which is inserted into a tiny stoma on the abdomen a few times a day. There is no need to wear a bag instead a gauze pad or bandaid covers the stoma at all other times. Not suitable for those with Crohns Disease.

Continent Urostomy (Urinary Kock Pouch or Indiana Pouch) - A kind of urinary diversion. An internal pouch is constructed as in the continent ileostomy, but with ureters attached. An additional valve at the junction of the ureters an reservoir to prevent urine from backing up into the kidneys. Urine is drained a few times a day via a small stoma using a catheter. A gauze pad or bandaid is worn the rest of the time. A Kock pouch is made from the last section of the ileum; an Indiana pouch uses a small piece of ileum and the segment at the beginning of the large intestine.

Convexity - Used for stomas which are flush to the skin. It is a small part that can be incorporated into the wafer or added later the presses the skin around the stoma in, making the stoma protrude a little more.

Crohns Colitis - Crohns disease involving the colon only. If the disease has been contained in the large intestine only for at least 5 years, then chances are that ostomy surgery will be a "cure" and the disease won't manifest itself elsewhere.

Cystectomy - Removal of the bladder, either part (partial cystectomy) or all of it (total cystectomy).

Cystoscopy - A cystoscopy is a test to evaluate the bladder. A small telescope-like instrument is inserted through the urethra into the bladder.

Double-Barrel Ostomy - Type of ostomy (usually temporary) in which the intestine is severed, and both severed ends are brought through the abdominal wall to form separate stomas. Stomas may be close to each other or not. One stoma, still connected to the food-digesting part of the intestinal tract, discharges faeces; the ohter, the mucous fistula, no longer connected to the functioning digestive tract, may discharge a small amount of mucous or may discharge nothing.

Electrolyte - Chemical compounds (such as salt) which dissolve in body fluids to form particles with an electric charge. They are needed in small amounts and in the right balance to maintain normal body functioning. If electrolytes are out of balance, a person may become weak and ill, and may need electrolyte supplementation by mouth or through a vein.

Encrustation - Deposits of gritty urine crystals on urostomy stoma or skin around the stoma. Prevented by drinking lots of fluids, keeping urine acidic and protecting all skin around the stoma with correctly-fitted pouch. Treatment is half-strength vinegar soaks (one part water to one part vinegar), either with compresses applied directly to the area or solution inserted into the ostomy pouch.

Endoscopy - Examination of hollow organ in the body by means of a lighted tube. Aesophagus, stomach and part of the small intestine can be visualised with an endoscope inserted through the mouth.

End Ostomy - An ostomy with a stoma with a single opening. The digestive tract or urinary tract is severed and the functional end is brought through the abdominal wall as a stoma (as opposed to a loop ostomy).

Enterostomal Therapy Nurse (ET Nurse) - See Stomal Therapy Nurse (STN),

Enterostomy - Any ostomy in the digestive tract.

Excoriation - For people with ostomies, it refers to red, raw, sore skin around the stoma, often from enzymes in loose faeces.

Excretory Urography - see Intravenous Pyelogram.

Familial Polyposis (Familial polyposis coli, familial adenomatous polyposis, hereditary multiple polyps) - any of several inherited diseases (as Gardner's syndrome or Peutz-Jegher's syndrome) that are characterized esp. by the formation of polyps in the gastrointestinal tract - they become cancerous over time. To prevent cancer, the colon is removed; the rectum (all or the surface layer) is usually removed. An ileostomy (either conventional or continent), ileorectal anastomosis (ileum to rectum) or an ileonal reserviour are options.

Fistula - An abnormal tract (passage) between a body organ and the skin or between two body organs. These are frequent complications of Crohns Disease (see also Mucous Fistula, a surgically-created planned fistula).

Flush Stoma - A stoma that is flat with skin level. It may be difficult to manage but a convex flange may help.

Folliculitis - Inflammation of the hair follicles. Can be caused around the stoma by ripping body hair off when pouches are removed or by shaving closely with a safety razor.

Gardner's Syndrome - A disease passed down in families; marked by multiple polyps in the large intestine and other abnormalities. Polyps have high potential for becoming cancerous. Colon and rectum are often removed to prevent colorectal cancer. Part of adenomatous polyposis syndrome.

Hartmann's Pouch - A surgical option for a temporary ileostomy or colostomy. The intestine is servered, and the functional end is brought through the abdominal wall as a stoma which discharges stool. The remaining end (which leads to the anus) can be stitched or stapled shut and left in the abdomen as a blind-end Hartmann's pouch. The surgical procedure is called a Hartmann's Procedure.

Hernia (Parastomal hernia, peristomal hernia) - Protrusion of intestine through abdominal muscles around stoma. Seen as a bulge under the skin around stoma. May be supported with a wide belt or binder; sometimes needs surgical correction.

Hyperplasia (Epidermal Hyperplasia) - "Warty" looking gray thickening of skin that can occur around urostomy stoma. Caused by alkaline urine, incorrectly-fitted skin barrier/pouch, and/or lack of night drainage system.

IBD or Inflammatory Bowel Disease - Commonly used to collectively describe Crohns Disease and Ulcerative Colitis.

IBS or Irritable Bowel Syndrome - This is NOT another acronym for IBD and should not be confused as such. IBS is a functional bowel disorder of the gastrointestinal (GI) tract characterized by recurrent abdominal pain and discomfort accompanied by alterations in bowel function, diarrhea, constipation or a combination of both, typically over months or years.

Ileal Conduit (Bricker Loop, Ileal Loop) - An ileal conduit, or ileal loop as it is sometimes called, is a way of diverting urine outside of the body when the urinary bladder has been removed. A piece of small intestine is used to form a conduit. A short section of the small intestine is separated and the intestine is sewn back together with no change in bowel movements. One end of the separated section is closed and the ureters, which normally carry urine from the kidneys to the bladder are sewn into the piece of small intestine. The open end of the intestine section is brought out to the right side of the abdomen where it opens to the outside as a stoma. Urine will now pass through this conduit and out the opening in the abdomen.

Ileitis - Also known as Crohns Disease.

Ieoanal Pull-Through Procedure - Surgical procedure in which the colon and the surface layer of the rectum are removed and the ileum is pulled through the rectal "sleeve" and attached to the anus. The last part of the ileum is usually made into a reserviour; without a reservious, the frequency and looseness of stool cause major management problems for most people. Stool passes through the anus and no permanent stoma is necessary; patient usually has temporary ileostomy while reserviour heals.

Ileonal Reserviour - With an ileonal pull-through, the construction of an internal pouch, made of ileum, to provide some storage area for stool. Depending on how the ileum is looped before it is cut, folded and stitched to make the pouch, the reserviour is called a J Pouch (intestine with one loop, like the letter "J", the most common). An S Poouch or a W pouch.

Ileorectal Anastamosis - A surgical procedure in which the colon is removed, and the ileum is attached directly to the rectum.

Ileostomy - A surgical opening into the ileum.

• Conventional Ileostomy (Brooke Ileostomy) - Intestine is severed and the end of the ileum is brough through the abdominal wall to form a stoma, usually on the lower right side of the abdomen. The entire colon and rectum is removed or bypassed. A Pouch is worn over the stoma at all times.
• Continent Ileostomy - see Continent Ileostomy.
• Loop Ileostomy - see Loop Ileostomy.

Indiana Pouch - See Continent Urostomy.

Inflammatory Bowel Disease (IBD) - Collective term for Crohns Disease and Ulcerative Colitis. NOT to be confused with Inflammatory Bowel Sydrome (IBS) which is something completely different.

Intermittent Cathererisation - A technique used by people with urinary incontinence to empty the bladder at regular intervals by inserting a catheter through the urethra into the bladder.

Intravenous Pyelogram (IVP, Excetory Urography) - Special x-rays of the urinary tract. Medicine is injected into the vein so the urinary tract will show up clearly in the x-rays (not done if the patient is allergic to iodine).

Irrigation - For colostomates only. An enema is directed through the stoma of sigmoid or descending colostomy, done at regular intervals (usually every one to two days) to regulate the passage of stool. Water stretches the bowel, stimulates the bowel to constrict and pass stool. One way of managing sigmoid or descending colostomies, so the person only needs a gauze pad or security pouch over the stoma between irrigations.

J Pouch - see Ileoanal reserviour.

Karaya - Water-soluble, gummy substance from the bark of a tree, used for healing or preventing damage to skin. Comes in gelatinous sheets, powder, paste; used as skin barrier around stoma.

Loop Ostomy - One kind of stoma, usually for a temporary ostomy. Loop of intestine is brough through abdominal wall to form stoma; for several days, a plastic rod or "bridge" of tissue from the body under the loop keeps it from falling back into the abdomen. The loop is opened to create a single stoma with two openings. One opening, still connected to the food-digesting intestinal tract, continues to discharge stool; the other opening may discharge a small amount of mucous. Similar urinary tract ostomy can be made with ureters.

Magnetic Resonance Imaging (MRI) - An imaging techique which uses radiowaves to give a cross-sectional picture of the internal body structures. It can be used to picture the urinary tract and the non-moving structures in the abdoment. For the patient, it involves lying still inside a large tube.

Mucous Fistula - The non-working stoma in a loop ileostomy. The mucous fistula can be the second of two stomas in a temporary ostomy, or the second opening in a single loop ostomy stoma. It may discharge some mucous.

Nephrostomy - A temporary urinary diversion in which a plastic catheter (nephrostomy tube) is inserted through the skin into the kidney, stitched into place, and left to drain urine. The rest of the urinary tract is bypassed.

Night Drainage System - A large container with tubing which can be connected to a valve bottom of a urostomy pouch at night of while the person is on bedrest. It provides additional storage capacity for urine, they keep pouches from becoming too full and pulling loose from the skin, and they keep urine draining away from the stoma.

Nitrazine Paper - Strips of paper which change colour to show how acidic or alkaline urine is.

Obstruction - see Blockage.

Ostomy - A Surgical opening. Shortened name for colostomy, ileostomy, or urostomy.

Ostomy Visitor - A person with an ostomy, who has completed a training program and visits people before or shortly after ostomy surgery, The visitor gives support and practical advice rather than medical information.

Patch Testing - A way of discovering whether part of the ostomy pouching system causes allergic reaction. A small bit of the product is taped on the skin away from the stoma area. The site is checked in 48 hours for redness, itching, swelling and again, 48 hours later for any delayed reaction. If symptoms occur earlier, the product should not be used.

Perineal Wound (Posterior Wound) - Large gap where the anus used to be. It occurs when the rectum and anus are removed in a colostomy or ileostomy. It heals slowly as new tissue fills the area. It can be closed, loosely stitched, or left open by the surgeon.

Peristalsis - Normal progressive movement of the intestine by which food, digestive enzymes and waste are pushed towards an outlet (anus or stoma).

Peristomal Skin - Skin around the stoma.

Permanent Ostomy - An ostomy meant to last through the rest of a person's lifetime.

Pouch (Appliance, Bag) - A device worn over the stoma to collect faeces or urine. They may be one or two pieced depending on the ostomate's personal preferences.

Pouchitis - Inflammation of the internal reserviour (J Pouch or continent ileostomy) causing pain, bloating and watery diarrhoea. Often likened to the symptoms of UC prior to surgery. Treated with antibiotics.

Proctocolectomy - see Coloproctectomy.

Prolapse of Stoma - Extreme protrusion ('falling out') of stoma end of intestine, an uncommon complication after ostomy surgery. The prolapsed stoma may protrude several inches from the body.  Imagine a sock rolled back in on itself (this is how a stoma is constructed). If the inside of the sock slowly rolls out and the sock becomes longer, this is what a prolapse is like. This can be surgically corrected, if necessary.

Regional Enteritis - Also known as Crohns Disease

Remission - The disappearance of all or most of the signs and symptoms of a cancer or other chronic disease. This can be for a period of time or permanent.

Resection - Cutting out section of intestine or other internal organ.

Retracted Stoma - Stoma below skin level.

Revision - Construction of a new stoma/ostomy when the original one does not function well.

Sigmoid Colostomy See Colostomy.

Sigmoidoscopy - A visual examination of the anus, rectum, sigmoid colon and part of the descending colon with 10 inches (25cm) or longer lighted tube, either rigid or flexible. Biopsy specimens can be removed through the sigmoidoscope.

Skin Barrier - Any one of several substances (pliable sheets, powders, pastes) used to cover the skin around a stoma to protect it from faeces or urine.

Skin Sealant (Skin Protection) - Liquids wiped, painted, or sprayed on the peristomal skin to protect the surface layer of skin cells (Not a substitute for Skin Barrier).

Short Bowel Syndrome (SBS) - A condition in which not enough of the small intestine remains to absorb nutrients necessary to sustain life. It can occur with Crohns Disease after surgical removal of large segments of small intestine.

Sphincter - Ring-like muscle which opens and closes a body passageway. Two sphincters in the anus provide bowel control, bladder sphincter controls urine.

Stenosis (Stricture) - Narrowing, often at opening of a stoma, so passage of stool or urine is partially or completely blocked. May need surgical correction.

Stent - A thin plastic tube used to keep narrow body passageways open while they heal after surgery, eg the connection between ureters and the segment of ileum in an ileal conduit. they are removed after healing is established.

Stoma - The visible portion of ostomy located on abdoment. A piece of ileum, colon, or ureter protruding above the skin.

Stomal Therapy Nurse (STN) - depending on what country you're from, you may call them STN's or ET's. They're health care professionals with special training in ostomy care and related fields. They're invaluable in helping you care for your ostomy and should be consulted in times of need.

Temporary Ostomy - A digestive tract ostomy in which the rectum and anus have not been removed or a urinary tract ostomy in which the bladder has not been removed.

Total Parenteral Nutrition (TPN, Hyperalimentation) - Administration of a nutritionally-adequate solution into a large vein, usually in the chest (central intravenous line). Solution usually contains high-concentration carbohydrate, protein, vitamins and minerals; fats can also be given. A less concentrated solution can be given through a smaller vein, usually in the arm (peripheral parenteral nutrition, PPN).

Transverse Colostomy - See Colostomy.

Ulcerative Colitis - One of the Inflammatory Bowel Diseases, in which ulcers form in the surface lining of the colon and rectum. Severe, often bloody, diarrhoea is the primary symptom of this disease, which comes and goes unpredictably, and is experienced most often by children, young adults and people over 60. Removal of the colon and at least the surface layer of the rectum is curative in severe cases. The cause of the disease is unknown.

Undiversion - Reconnection of the urinary tract after a urinary diversion in which the bladder remains, to elimate the stoma and permit passage of urine through the normal opening.

Ureterostomy - Ostomy procedure in which one or both ureters are brough through the abodominal wall to form stoma(s), often a loop ostomy. A temporary procedure (unless the bladder is removed), frequently preformed on chidren. A pouch must be worn at all times.

Urinary Diversion - Any one of several surgical procedures to reroute urine flow away from diseased or defective ureters, bladder or urethra, either temporarily or permanently. Some diversions result in a stoma.

Urinary Kock Pouch - See Continent Urostomy.

Urine Crystals - Sharp, gritty crystals which can encrust on a urostomy stoma or unprotected peristomal skin. See Encrustation.

Urostomy - Any kind of urinary diversion which results in a stoma. New passageway for urine is formed through the abdominal wall to outside the body. See Urinary Diversion.

Vesicostomy - A temporary urinary diversion (rarely done now) in which the bladder opens directly to a stoma, located low in the abdomen. Some are drained with a catheter.

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