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 temporary or long-term colostomies have pouches attached to their sides where feces collect and can be easily disposed of.
Colostomies aren’t always permanent, especially in children with birth defects.
A colostomy can be the result of one of several procedures to correct problems with the lower digestive tract. Other “ostomies” include ileostomy and urostomy. An ileostomy is a diversion of the bottom of the small intestine. A urostomy is a diversion of the tubes that carry urine out of the bladder.
A 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 by temporarily diverting stool away from the bowel. 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 in which you may need a permanent colostomy include:
- a blockage
- an injury
- Crohn’s disease, which is an autoimmune form of inflammatory bowel disease
- colorectal cancer
- colonic polyps, which is extra tissue growing inside the colon that may be cancer or may turn into cancer
- diverticulitis, which occurs when small pouches in your digestive system, called diverticula, become infected or inflamed
- imperforate anus or other birth defects
- irritable bowel syndrome, which is a condition affecting the colon that causes diarrhea, bloating, constipation, and pain in the abdominal area
- ulcerative colitis, which is an inflammatory bowel disease that causes the long-term inflammation of the digestive tract
A colostomy is a major surgery. As with any surgery, there are risks of allergic reactions to anesthesia and excessive bleeding.
Colostomy also carries these other risks:
- a blockage of the colostomy
- damage to other organs
- a hernia, which occurs when an internal organ pushes through a weak area of muscle
- an infection
- internal bleeding
- problems from scar tissue
- a prolapse of the colostomy
- a wound breaking open
Your doctor can best explain your personal risks, the risks of the surgery, the potential for complications, and the advantages of the surgery.
Before surgery, your doctor will take blood samples, perform a physical examination, and review your complete medical history. During these visits, tell your doctor about any prior surgeries you’ve had and any medications you’re taking, including over-the-counter medicines and supplements.
Your doctor will likely ask you to fast for at least 12 hours before surgery. You may also be given a laxative or an enema to take the night before the surgery to help cleanse your bowels.
You should prepare to stay in the hospital for three to seven days. This includes packing the right necessities, arranging care for your children, pets, or home, and taking the appropriate amount of time off of work.
You’ll change into a hospital gown before surgery. A nurse will place intravenous access, or an IV, in your arm. This allows the hospital staff to give you fluids and medications easily, and it’s also how you’ll be given your general anesthesia. This will put you into a deep, painless sleep during the operation.
While you’re asleep, the hospital staff will wheel you into the operating room for your colostomy. When you’ve been cleaned and prepared, your surgeon will make an incision in your abdomen. This incision may be large, or it may be a series of smaller incisions. Smaller incisions are used for a laparoscopy. This type of surgery involves using small tools and a camera that’s inserted into an incision. The camera will be used to guide your doctor during the surgery.
During the procedure, your doctor will locate the ideal part of the large intestine for the opening, or stoma. Your doctor will cut the intestine in the appropriate area and bring it through your abdominal wall.
Your doctor will surgically implant a ring onto your abdominal wall. This ring will hold the end of the intestine in place. This ring may be permanent, or it may be placed temporarily to help your skin heal around your exposed intestine.
After everything is in place, your doctor will close your wound with stitches and you’ll be brought into a recovery room. During that time, the staff will wait for you to wake up and they’ll watch 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 eventually soft foods.
You’ll also be taught how to use colostomy bags correctly. A colostomy bag is where your feces will collect while you have your colostomy. Hospital staff will also instruct you on your diet, activity level, and more. It’s important to follow these instructions.
You’ll have follow-up appointments with your doctor to check on your condition and the colostomy.