A colostomy is a surgical procedure that brings one end of the large intestine out through the abdominal wall. During this procedure, one end of the colon is diverted through an incision in the abdominal wall to create a stoma. A stoma is the opening in the skin where a pouch for collecting feces is attached. People with colostomies, whether temporary or long-term, have pouches attached to their sides where feces collects and can be easily disposed of.
Colostomies aren’t always permanent, especially in children with birth defects. However, people with chronic conditions may find near immediate relief from the surgery.
A colostomy can result from one of several procedures to correct problems with the lower digestive tract. Other “ostomies” include ileostomy (diversion of the bottom of the small intestine) or urostomy (diversion of the tubes that carry urine out of the bladder).
Colostomy may also be referred to as bowel diversion therapy.
Colostomies are performed because of problems with the lower bowel. Some problems can be corrected simply by “giving part of the bowel a rest,” according to the American Cancer Society. This is when temporary colostomies are used to keep stool out of the colon.
If the colon becomes diseased, as in the case of colon cancer, permanent colostomies are performed and the colon may be removed completely.
Conditions that may warrant a permanent colostomy include:
- Crohn’s disease: an autoimmune form of inflammatory bowel disease
- colorectal cancer
- colonic polyps: extra tissue growing inside the colon, which may be cancer or may turn into cancer
- diverticulitis: small pouches in your digestive system, called diverticula, become infected or inflamed
- imperforate anus, or other birth defects
- irritable bowel syndrome: a condition affecting the colon that causes diarrhea, bloating, constipation, and pain in the abdominal area
- ulcerative colitis: another form of inflammatory bowel disease which causes the digestive tract to become inflamed on a long-term basis
Colostomy is major surgery. As with any surgery, there are risks of allergic reactions to anesthesia and excessive bleeding.
Colostomy also carries these other risks:
- blockage of the colostomy
- damage to other organs
- hernia: an internal organ pushes through a weak area of muscle
- internal bleeding
- problems from scar tissue
- prolapse of the colostomy
- wound breaking open
Your doctor can best explain your personal risks. The risks of the surgery and potential for complications are weighed against the advantages of the surgery for you.
Before surgery, your doctor will complete a full examination, which will include taking blood samples, a physical examination, and a complete medical history. During these visits, tell your doctor about any prior surgeries you’ve had and any medications you are taking, including over-the-counter medicines and supplements.
Your doctor will typically have you fast for at least 12 hours before surgery. You may also be given a laxative or enema for the night before to help cleanse your bowels.
You can expect to stay in the hospital between three to seven days, so plan accordingly. This includes packing the right necessities, arranging care for your children, pets, or home, and taking the appropriate amount of time off of work.
Prior to surgery, you’ll change into a hospital gown. Reclining in a rolling bed, a nurse will place an IV in your arm. This allows the hospital staff to administer fluids and medications easily. This is also how you will be given your general anesthesia. This will put you into a deep, painless sleep during the operation.
While you’re asleep, you’ll be wheeled into the operating room for your colostomy. When you’ve been cleaned and prepared, your surgeon will begin with an incision into your abdomen. This incision may be large, or a series of smaller incisions. Smaller incisions are used for for laparoscopy, a technique using small tools and a camera inserted into an incision to guide them.
During the procedure, your doctor will locate the ideal part of the large intestine for the stoma. Your doctor will cut the intestine in the appropriate area and bring it through your abdominal wall.
A ring will be surgically implanted onto your abdominal wall. This ring will hold the end of the intestine in place. This ring may be permanent or temporary to help your skin heal around your exposed intestine.
After everything is in place, your wound will be closed with stitches and you’ll be brought into a recovery room for observation. During that time, while staff waits for you to wake up, they will be watching your vital signs to ensure everything goes smoothly.
Recovery in the hospital involves being slowly reintroduced to liquids and foods to ensure there are no digestive problems. On the first day, you’ll most likely be given only ice chips to ease your thirst. Afterward, you’ll be given clear liquids, and later on you will receive soft foods.
You’ll also be taught how to correctly use colostomy bags, where your feces will collect while you have your colostomy. Hospital staff will also instruct you about your diet, activity level, and more. It’s important to follow these instructions.
You will have follow-up appointments to check on the status of the colostomy, as well as the condition for which it was needed.