A colostomy is a surgical procedure that creates a new opening, called a stoma, in the abdomen. This opening diverts a section of the large intestine to the outside of the body, allowing stool to exit into a collection pouch. While a colostomy changes the primary route for waste elimination, the anus typically remains in place. This often leads to questions about its continued presence and potential functions.
The Anus’s Continued Presence
During a colostomy, the large intestine is brought through an opening in the abdominal wall, forming a stoma for waste diversion. The anus and rectum are generally not removed, unless there is a specific medical reason like certain types of cancer or severe disease. If left intact, the lower part of the bowel, sometimes called the rectal stump, remains inside the body and continues to have a blood supply.
The anus, with its sphincter muscles, no longer serves its primary role in controlled stool elimination. Its anatomical structure, including the muscles and lining, remains. The decision to keep the anus and rectum minimizes surgical complexity and preserves the possibility of colostomy reversal in the future.
Understanding Anal Discharge
After a colostomy, the lining of the rectum and any remaining colon continues to produce mucus. This mucus, a natural bodily secretion, can accumulate and be discharged as stool no longer passes through the rectum and anus.
The appearance of this mucus can vary; it is typically clear, white, or yellowish, and may have a liquid, slimy, or glue-like consistency. The frequency of discharge also varies among individuals, ranging from several times a day to once every few weeks or months. While primarily mucus, some individuals with a loop colostomy might occasionally pass a small amount of fecal matter if waste enters the bypassed section of the bowel. This mucus discharge is normal and expected, usually not a cause for concern unless accompanied by other symptoms.
Care and Management of the Anus
Maintaining proper hygiene of the anus after a colostomy is important for comfort and to prevent skin irritation. Regular, gentle washing with warm, soapy water is recommended, followed by patting the area dry. Avoiding harsh rubbing helps protect the sensitive skin. For managing mucus discharge, wearing absorbent pads or thin panty liners can protect clothing and absorb any leaks.
Some individuals find that sitting on the toilet and gently bearing down, as if having a bowel movement, can help expel accumulated mucus. This practice can prevent a build-up that might cause discomfort or a sensation of needing to pass stool. If mucus becomes dry and difficult to pass, a healthcare provider might suggest suppositories to help thin it. Contact a doctor or stoma nurse if the discharge changes significantly, such as becoming blood-stained, containing pus, or if there is persistent pain, as these could indicate an infection or other issue.
Reversibility and Future Function
Many colostomies are temporary, intended to allow a section of the bowel to heal or rest, and can often be reversed. This reversal involves surgically rejoining the ends of the colon, restoring the natural pathway for waste elimination through the anus. The possibility of reversal depends on several factors, including the initial reason for the colostomy, the patient’s overall health, and the condition of the remaining bowel.
Reversal surgery is typically considered after the bowel has fully healed, often several months after the initial colostomy. Not all temporary colostomies are reversed; some individuals may choose to keep their stoma permanently due to various factors, including the risks associated with another surgery or potential complications. If reversal is not possible or desired, the anus will continue its non-functional status for waste elimination, requiring ongoing basic hygiene. Strengthening pelvic floor muscles through exercises can be beneficial for those awaiting reversal, as it helps maintain muscle tone and can assist with bowel control if function is restored.