What is a colostomy?
The colon, rectum and anus are the last sections of the body’s digestive system.
Although they are an important part of the system, they have little to do with
digesting food or absorbing nutrients. In fact, the large intestine can be
thought of as the body’s trash compactor. As "leftover" liquid flows through the
colon, it becomes solid waste (feces). The waste material is passed through the
various sections of the colon, then moves onward to the rectum. From there, it
is eliminated from the body through the anus.
When the colon, rectum or anus is unable to function normally
because of disease or injury, or needs to rest from normal function, the body
must have another way to eliminate the waste. A colostomy is an opening in the
large intestine that is brought out onto the surface of the abdomen. This
provides a new path for waste material and gas to leave the body. The colostomy
opening is also called a stoma. It can be permanent or temporary.
Why is a colostomy performed?
There are many reasons why a colostomy becomes necessary. Some of the conditions
that may require a colostomy include:
- Colorectal cancer
- Traumatic injury
- Intestinal obstruction
- Diverticulitis (an inflammation or infection of small sacs or
outpouchings, called diverticula, of the inner lining of the intestine)
- Crohn's disease (a chronic inflammatory disease that involves all layers
of the intestinal wall and can disrupt normal bowel function)
- Incontinence or constipation
How is a colostomy performed?
A colostomy results from a surgical procedure performed under general
anesthesia. During the surgery, healthy colon is brought through an opening in
the abdominal wall and stitched to your skin. Unlike the anus, the opening
(stoma) has no sphincter muscle, so you cannot control the exit of waste. You
will need to wear a pouch (called an ostomy collecting device) to collect the
waste flow.
Is a colostomy permanent?
A colostomy can be permanent or temporary, depending on the condition being
treated and the surgery performed. A temporary colostomy may be done to allow
part of the intestine to rest and heal.
How will a colostomy change my life?
For most colorectal patients, a colostomy will not be needed. Today’s modern
surgical techniques and instruments have decreased the number of operations that
require a colostomy. Only 10% of patients with rectal cancer and less than 1%
with colon cancer will ever need a permanent colostomy. If you do need to have a
colostomy, there will be some changes in your lifestyle, but you will receive
education to help manage and adjust to these changes.
While in the hospital after your surgery, you will be educated
about the care of your colostomy and given some tips to help make the necessary
adjustments. Some patients find the advice and support of other colostomy
patients helpful. There are ostomy support groups available to provide
additional information and emotional support.
Once you have learned how to care for your colostomy, you will
have to regulate your diet to avoid constipation and diarrhea. Some patients
find that a process called colostomy irrigation, which uses an enema through the
stoma, clears the colon for the day so a pouch may not be necessary. Medical
supply stores and some drug stores carry supplies to help you care for your
colostomy. You will need to check with your insurance carrier to determine if
they cover colostomy supplies.
Here are some additional tips to help you adjust to your colostomy:
- Monitor your medications – Some medicines can cause constipation or diarrhea.
- Eat a well-balanced diet – Avoid foods that cause excessive gas, such as
cabbage, beans, eggs, or carbonated beverages. A dietitian can help you
choose a balanced diet that will not interfere with your colostomy.
- Live your life – Modern colostomy supplies are odor proof, designed to
lie flat, and are not noticeable under clothing. Most colostomy patients are
able to return to work and to many of the activities – including sex – they
enjoyed before surgery.
Be sure to talk with your doctor or nurse about resuming your
normal activities and about any concerns you have about living with your colostomy.
What are the complications of a colostomy?
In some cases, skin irritation can result from stool that leaks under the pouch.
A hernia can develop around a colostomy. The bowel may become narrow or it may
prolapse, which means it gets longer. Proper fitting of an ostomy pouch can help
prevent skin irritation. The wound, ostomy, continence nurse, also called an
enterostomal therapy nurse, can help choose an appropriate pouch and suggest
ways to care for your skin.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 5/28/2009…#10748
