A colostomy is a surgical procedure that creates an artificial opening in the colon, allowing stool to exit through a new opening on the abdomen rather than through the rectum and anus.
What is a Colostomy
A colostomy involves surgically bringing a section of the colon through an incision in the abdominal wall. This newly created opening is called a stoma, which is stitched to the skin. The stoma serves as an alternative exit point for fecal matter, which is collected in an external pouch attached to the abdomen. This diversion ensures waste bypasses the lower part of the colon or rectum, where issues may be present.
Why a Colostomy is Performed
A colostomy is performed to address medical conditions affecting the colon or rectum, making it impossible or unsafe for stool to pass normally. Common reasons include colorectal cancer, where a section of the bowel containing cancerous tissue might be removed. Inflammatory bowel diseases like Crohn’s disease or ulcerative colitis, which cause inflammation and damage, can also necessitate this procedure.
Bowel obstructions, resulting from tumors, scar tissue, or severe constipation, require a colostomy to relieve the blockage. Diverticulitis, an infection or inflammation of small pouches in the colon, may also lead to a colostomy if complications like tears or severe infections arise. Birth defects such as an imperforate anus, injuries to the colon or rectum from trauma, and nerve damage affecting bowel control are also indications for a colostomy.
Types of Colostomies
Colostomies are classified as temporary or permanent, depending on the surgical approach and the colon segment involved. An end colostomy is created when the end of the colon is brought through the abdominal wall to form a stoma, often after a portion of the colon or rectum has been removed. This type is frequently permanent, especially if the lower bowel cannot be reconnected, but can also be temporary to allow the remaining bowel to heal.
A loop colostomy involves bringing a loop of the colon to the abdominal surface, where an incision creates two openings within a single stoma. One opening is for stool, while the other allows mucus to pass. This type is temporary and is often performed in emergency situations or to protect a surgical connection further down the bowel. Both temporary and permanent colostomies divert stool, with temporary ones being reversible after the underlying condition has healed.
Living with a Colostomy
Adjusting to life with a colostomy involves learning how to manage the stoma and the associated pouching system. The pouch, which adheres to the skin around the stoma, needs to be emptied or changed regularly, typically once or twice a day, depending on the output. Proper skin care around the stoma is important to prevent irritation.
Dietary adjustments are often recommended, particularly in the initial weeks after surgery, focusing on bland, low-fiber foods that are easy to digest. Over time, individuals can gradually reintroduce a wider range of foods, while paying attention to how their body reacts. With appropriate care and lifestyle adaptations, individuals with a colostomy can maintain a good quality of life and participate in most daily activities.
Colostomy Versus Ileostomy
While both colostomies and ileostomies are types of ostomies that create an opening in the abdomen to divert waste, they involve different parts of the intestine. A colostomy involves the large intestine. In contrast, an ileostomy connects a part of the small intestine, the ileum, to the abdominal wall.
The primary difference between these two procedures lies in the consistency of the waste output. Because the large intestine absorbs more water, the stool from a colostomy is more formed and less frequent. Conversely, waste from an ileostomy, originating higher in the digestive tract, is more liquid and frequent.