Cecostomy Button: Procedure, Daily Use, and Care

A cecostomy button is a small, skin-level medical device that provides direct access to the beginning of the large intestine, known as the cecum. Its primary function is to simplify emptying the bowels by allowing for the administration of an antegrade enema, which flushes stool out from above. This approach offers a manageable and predictable way to address bowel function challenges, improving the daily lives of those who require it.

Understanding the Need for a Cecostomy Button

A cecostomy button is primarily used to facilitate antegrade continence enemas (ACE), a procedure that helps to clean out the colon. This method is considered for individuals with severe, chronic constipation that has not responded to other treatments. It is also a solution for fecal incontinence, the inability to control bowel movements, which can result from various underlying medical conditions.

Conditions that may lead a healthcare provider to recommend a cecostomy include neurological disorders like spina bifida or spinal cord injuries that interfere with nerve signals. Anorectal malformations, where the anus and rectum do not develop properly, or conditions like Hirschsprung disease, can also necessitate such an intervention. For individuals facing these challenges, the button provides a reliable and structured bowel management routine.

The procedure allows a person to avoid the discomfort of traditional rectal enemas and gain control over what can be an unpredictable and often embarrassing condition. By flushing the colon from the start, it results in more complete emptying and fewer accidents. This predictability allows for greater freedom and participation in daily activities.

The Cecostomy Button Placement Procedure

The placement of a cecostomy button begins with a cecostomy tube, often referred to as a C-tube. This initial tube is typically placed through a minimally invasive procedure, such as a laparoscopy, where a surgeon makes small incisions in the abdomen to guide the tube into the cecum. In some cases, it may be done as an open surgery or through a percutaneous endoscopic cecostomy (PEC).

During the procedure, the cecum is stitched to the inside of the abdominal wall to hold it in place. The C-tube is then inserted through the abdominal wall into the cecum, with one end remaining outside the body. After a healing period allows a mature tract to form, this initial tube is replaced with a more discreet, low-profile cecostomy button that sits flush against the skin. A hospital stay of one to two days is common for the initial placement.

Using and Caring for a Cecostomy Button

Daily life with a cecostomy button involves a regular routine for use and care. The primary function is administering an antegrade enema, which involves connecting an extension tube to the button’s valve. A prescribed liquid solution is slowly instilled directly into the cecum, which stimulates a bowel movement that occurs through the rectum. The volume and frequency of these flushes are tailored to the individual’s needs.

Proper hygiene is a fundamental aspect of caring for the cecostomy site to prevent complications. The skin around the stoma—the opening where the button is placed—must be cleaned daily with mild soap and water and kept dry. Users and caregivers are taught to look for any signs of infection, such as redness or swelling, as well as skin irritation, and to check that the button is secure.

Life with a Cecostomy Button

Living with a cecostomy button becomes a manageable part of a daily routine, enabling individuals to participate more freely in life’s activities. While the button is generally discreet and secure, users may encounter issues such as minor leakage of stool or fluid around the site, skin irritation, or the formation of granulation tissue. Granulation tissue is a type of healing tissue that can build up around the stoma; these issues are typically manageable with guidance from a healthcare provider.

Accidental dislodgement of the button can occur, and it is important to have a plan for prompt replacement to prevent the stoma from closing. The buttons themselves require periodic replacement, typically every six months to a year, due to normal wear and tear or changes in the patient’s body size. This is a simple, non-surgical procedure that can often be done in a clinic setting, allowing individuals to engage in most activities, including sports and swimming, with minimal adjustments.