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Colostomy
Definition
Colostomy is a surgical procedure that brings one end of the large intestine out through the abdominal wall. Stools moving through the intestine drain into a bag attached to the abdomen.
Alternative Names
Intestinal opening
Description
The procedure is usually done after:
- Bowel blockage (obstruction)
- Bowel resection
- Injuries
The colostomy may be short-term or permanent.
Colostomy is done while you are under general anesthesia (asleep and pain-free). It may either be done with a large surgical cut in the abdomen, or with a small camera and several small cuts (laparoscopy).
The type of approach used depends on what other procedure done needs to be done. In general, the surgical cut is made in the middle of the abdomen. The bowel resection or repair is done as needed.
See also:
For the colostomy, one end of the healthy colon is brought out through the abdomen wall, usually on the left side. The edges of bowel are stitched to the skin of the abdomen wall. A bag called a stoma appliance is placed around the opening to allow stool to drain.
Your colostomy may be short-term. If you have surgery on part of your large intestine, a colostomy will allow the other part of your intestine to rest while you recover. Once your body has fully recovered from the first surgery, you will have another surgery to reattach the ends of the large intestine. In general, this is done after 12 weeks.
Why the Procedure Is Performed
There are a few reasons to perform a colostomy:
- Infection of the abdomen, such as perforated diverticulitis or an abscess
- Injury to the colon or rectum (for example, a gunshot wound)
- Partial or complete blockage of the large bowel (intestinal obstruction)
- Rectal or colon cancer
- Wounds or fistulas in the perineum -- the area between the anus and vulva (women) or the anus and scrotum (men)
Whether a colostomy is temporary or permanent depends on the disease or injury. In most instances, colostomies can be reversed.
Risks
Risks from any anesthesia include:
- Problems breathing
- Reactions to medications
Risks from any surgery include:
- Bleeding
Other risks include:
- Bleeding inside your belly
- Damage to nearby organs
- Development of a hernia at the site of the surgical cut
- Falling in of the stoma (prolapse of the colostomy)
- Infection, especially in the lungs, urinary tract, or belly
- Narrowing or blockage of the colostomy opening (stoma)
- Scar tissue forming in your belly and causing intestinal blockage
- Skin irritation
- Wound breaking open
After the Procedure
You will be in the hospital for 3 - 7 days. You may have to stay longer if your colostomy was done as an emergency procedure.
You may be able to suck on ice chips on the same day as your surgery to ease your thirst. By the next day, you will probably be allowed to drink clear liquids. Your health care providers will slowly add thicker fluids and then soft foods as your bowels begin to work again. You may be eating normally within 2 days after your surgery.
The colostomy drains stool (feces) from the colon into the colostomy bag. Most colostomy stool is softer and more liquid than stool that is passed normally. The texture of stool depends on which part of the intestine was used to form the colostomy.
Outlook (Prognosis)
Before you are released from the hospital, a colostomy nurse will teach you about diet and how to care for the colostomy.
References
Fry RD, Mahmoud N, Maron DJ, et al. Colon and Rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 50.
Cima RR, Pemberton JH. Ileostomy, colostomy, and pouches. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010: chap 113.
Reviewed By: Shabir Bhimji, MD, PhD, Specializing in General Surgery, Cardiothoracic and Vascular Surgery, Midland, TX. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.
