Cecostomy

What is a cecostomy?

A cecostomy is a surgical procedure to treat severe fecal incontinence or constipation. Surgeons perform this procedure in children or adults. Fecal incontinence is a term describing stool (poop) leaking out your anus accidentally. Accidental bowel leakage can make daily activities challenging, significantly affecting your quality of life.

Who is this procedure for?

A cecostomy is an option when you have a medical condition that causes severe fecal (bowel) incontinence or constipation. These conditions include:

• Congenital malformations, such as imperforate anus.
• Hirschsprung disease.
• Klippel Feil syndrome, a rare disorder in which spine bones (vertebrae) fuse where they shouldn’t join together.
• Spina bifida.

How can cecostomy tube surgery help?

To construct a cecostomy, your healthcare provider makes a small hole in the cecum, the first part of your large intestine. They insert a small tube that extends from your skin’s surface to your cecum.

A cecostomy tube enables a special enema technique (antegrade enema) to clear your bowels. An enema is a treatment that delivers a liquid solution to your large intestine, making it easier for stool (poop) to pass.

• Retrograde enemas are a traditional method for treating fecal incontinence. This method uses a squeeze bottle to deliver the solution through your anus while you’re lying down. You then need to wait up to an hour for it to work.
• Antegrade enemas are possible when you have a cecostomy tube. Instead of delivering the enema solution through your anus, you attach a drip bag with a tube to the external part of the cecostomy tube. This process occurs while you’re sitting on the toilet.

Is a cecostomy right for me?

You may benefit from a cecostomy if you have:

• Fecal incontinence.
• Ongoing severe constipation.
• Regular soiling episodes.
• The ability to sit on the toilet for as long as necessary.
• Not achieved good results with other fecal incontinence therapies.
• Not had previous abdominal surgery that would affect cecostomy tube placement.

How do I prepare for a cecostomy?

You may need to have a bowel prep the day before surgery to clear your large intestine of stool.

What happens during a cecostomy?

Here’s what to expect during the procedure:

• You receive general anesthesia, a combination of medications that put you to sleep and temporarily block sensation.
• Your healthcare provider makes a small hole in the lower right abdominal area.
• Using real-time imaging, they guide the cecostomy tube through the incision and into your cecum.
• Stitches will hold your cecum close to your abdominal wall.
• The cecostomy tube extends above your skin’s surface. Tape can secure it close to your skin if necessary.

What are the benefits of a cecostomy?

A cecostomy has many benefits, which may include:

• Fewer soiling accidents.
• Improved self-esteem.
• More active lifestyle, as you don’t need to worry about always being near a toilet.
• No longer needing to wear protective undergarments or diapers.

What are the risks of a cecostomy?

As with any medical procedure, a cecostomy carries certain risks, including:

• Anesthesia complications, such as a sore throat, nerve injuries or vomiting after waking up.
• Bowel perforation, including an accidental tear, puncture or hole in your large intestine.
• Stomal stenosis, abnormal narrowing in your large intestine near the site of the cecostomy tube.
• Stomal leakage, a hole that allows enema solution to leak out of the cecostomy tube.

What happens after a cecostomy?

Here’s what to expect while recovering from a cecostomy:

• Most people go home from the hospital the same day of their surgery.
• You may experience mild discomfort after you get home from the hospital. Medications can help you stay comfortable.
• No swimming for at least two weeks after surgery, and no sports or heavy activity for four to six weeks after surgery.

What can I expect after recovery?

Once you have recovered from the initial procedure, you still need to follow a few steps:

• After one or two weeks, you return to your healthcare provider’s office to remove the sutures.
• Your healthcare provider will tell you when it is safe to start using the cecostomy tube for antegrade enemas. They provide you with all the information you need to feel comfortable doing this on your own.
• If your surgeon placed a temporary cecostomy tube at the time of surgery, they’ll replace it with a long-term tube six weeks after surgery. This happens during an office visit. The procedure is quick and painless, and you don’t need sedation.
• You’ll need to replace your cecostomy every six to 12 months.

When should I contact my healthcare provider after a cecostomy?

You should contact your healthcare provider if you experience signs of complications. These include:

• Abdominal pain.
• Cecostomy tube comes out of place.
• Difficulty getting the enema solution to go through the tube.
• Fever, which may be a sign of an infection inside of your abdomen (peritonitis).
• Ongoing fecal incontinence.
• Pus, bleeding or swelling near the cecostomy tube.

A note from Cleveland Clinic

Fecal incontinence causes frequent soiling that can affect your quality of life. A cecostomy is a procedure to implant a tube that makes bowel movements more predictable. The cecostomy tube enables you to perform antegrade enemas. People who undergo a cecostomy live more active lifestyles that include age-appropriate social activities, like swimming.