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 passes through 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 when a part of this bowel is cut out and reconnected and needs to heal, the body must have another way to eliminate the waste. By bringing the large intestine through a hole in the abdominal wall, gas and feces empty into a bag worn on the outside of the abdomen. This is called a colostomy, or stoma, and it provides a new path for waste material to leave the body. Colostomies can be permanent or temporary.

Why is a colostomy created?

There are many reasons why a colostomy becomes necessary. Some of the conditions that may require a colostomy include:

  • Colon, rectal, or anal cancer
  • Traumatic injury
  • Intestinal blockage
  • Diverticulitis (an inflammation or infection of small sacs or outpouchings, called diverticula, of the inner lining of the intestine)
  • Crohn's disease (a type of inflammatory bowel disease)
  • Incontinence or constipation

How is a colostomy created?

A colostomy requires a surgical procedure performed under general anesthesia. During the surgery, the surgeon creates a hole in the abdominal wall. A part of the healthy colon is brought through this opening in the abdomen and stitched to the skin. Unlike the anus, the opening of the colostomy has no sphincter muscle, so you cannot control the exit of waste. A pouch or stoma bag is worn on the abdomen and collects the waste. The pouch is emptied several times throughout the day, and the pouch is replaced a couple of times a week.

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. Only 10% of patients with rectal cancer and less than 1% with colon cancer will need a permanent colostomy.

How will a colostomy change my life?

If you do need to have a colostomy, there will be some changes in your lifestyle, but generally, you can do all the same activities as someone who doesn’t have a colostomy.

While in the hospital after your surgery, we will teach you how to take care of the colostomy. You will learn how to empty and change the pouch. 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. We will also help arrange for a nurse to come to your home to reinforce what you’ve learned in the hospital. 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 it covers colostomy supplies.

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.

With a colostomy, you may have to regulate your diet to avoid constipation or diarrhea.

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. 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 physical intimacy with another person – 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 a stoma nurse, can help choose an appropriate pouch and suggest ways to care for your skin.

References

© Copyright 1995-2017 The Cleveland Clinic Foundation. All rights reserved.

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: 12/7/2016…#10748