Not everyone with colorectal cancers and bowel diseases needs a colostomy. You may be able to avoid ostomy surgery, depending on the reason for it.

A colostomy is a surgical procedure that creates an opening from your colon to your abdomen. This procedure is usually done to treat bowel diseases and injuries.

Some colostomies may be avoided, but not all. This article will explore some things you can do to try and avoid needing a colostomy, and in which situations an ostomy may be unavoidable.

You can’t always avoid having a colostomy.

Although some colostomies are done as planned surgical treatment for chronic conditions, such as inflammatory bowel disease or colorectal cancers, abdominal trauma or injury is also a leading cause for ostomy surgery.

According to one study, 22% of stomas in adults were created to treat abdominal traumas.

In comparison, about 25% were created to treat bowel cancers, and 12% were done to treat intestinal perforations or tears.

Some of the top reasons you might need a colostomy aren’t what you think. Inflammatory bowel diseases and chronic conditions such as Crohn’s disease are actually some of the less common reasons for the creation of a stoma.

The most common indications for colostomy surgery include things such as:

Risk factors for needing a colostomy vary based on the underlying issue being treated. Below are some conditions that could lead to colostomy placement and their risk factors.


Risk factors for developing a volvulus may include:

Bowel obstruction/perforation

Contributors to a bowel perforation or obstruction can include things such as:

Colorectal cancers

You may be at a higher risk of developing colorectal cancer with:

How long you’ll need a colostomy depends on the initial reason for your colostomy, what risks you experience, and how much of your digestive tract is removed.

Up to a third of people who have what they think are temporary colostomies end up keeping their stomas permanently. This can be the result of unexpected risks or even personal choice.

For people who are able to have their colostomy reversed, this usually happens between 3–6 months after the initial surgery, once your tissues have healed or the acute problem is treated. But some people even have colostomies reversed years after their initial procedure was done.

If you have colorectal cancer, how your cancer will be treated is a decision best made by you and your healthcare team, based on the stage and spread of your cancer.

If your cancer’s spread is limited, you may be able to have just a tumor or small area removed surgically. Your healthcare team may also offer you treatments such as chemotherapy, radiation, or surgical ablation.

In 2013, between 18–35% of colorectal cancer survivors were treated with either a temporary or permanent colostomy.

If you need surgery to divert the flow of waste through your large intestine or colon due to colorectal cancer or other conditions, your healthcare team may offer you a few choices when it comes to waste collection.

Some possible alternatives to a colostomy bag or other external waste collection include things such as internal pouching systems.

This option, sometimes called an ileal pouch anal-anastomosis or j-pouch, uses a portion of the intestine that’s left behind after diseased areas are removed to create an internal pouch. Stool is collected internally in this pouch and can be emptied through your anus.

There are benefits and risks to a j-pouch, and a doctor or other healthcare professional is the best person to ask if this option is viable for your specific situation and needs.

You can’t always avoid needing a colostomy. Traumatic injuries or acute issues such as a volvulus are difficult to both predict or prevent. Eating a healthy, balanced diet with enough fiber, getting enough exercise, and making other gut-healthy choices throughout your life can help, but they’re not guarantees.

In some cases, you may have some options for alternatives to an external colostomy bag to treat your underlying condition, but this is an issue best discussed with your healthcare team based on your unique needs.