A colostomy is a surgery to bring part of the large intestine (the colon) to the surface of the body to form a stoma, an artificial opening on the outside of the abdomen (tummy). Waste from the colon is then collected using a small bag called a stoma pouch.
Why is the procedure performed?
The colon is the first 1 to 1.5 meters of your large intestine. It absorbs water and nutrients from your poo (feces) and passes the remaining waste to the rectum.
If your colon, rectum, or anus do not work properly, surgery can create another way to get rid of waste from your body. A colostomy allows feces and gas to leave your body via the stoma.
A colostomy may be carried out if you have:
- an infection in your abdomens, such as perforated diverticulitis or an abscess
- an injury to the colon or rectum
- a blockage of the large bowel (intestinal obstruction)
- rectal or colon cancer
- wounds or fistulas in the perineum (the area between the anus and vulva in women) or the anus and scrotum in men
How to prepare for the procedure
A colostomy is done under a general anesthetic. If you need to have the procedure done, you will need to stop eating or taking medicines before the surgery. Follow your doctor’s instructions, and do not stop taking any medicines without talking to them first.
Make sure you discuss where on your body the stoma will be and how to manage it afterward. You may also be able to meet with a stomal therapy nurse before the surgery. They specialize in caring for patients who have a stoma and will be able to answer your questions.
What happens during the procedure
There are 2 different types of colostomy surgery:
End colostomy: If part of the colon or rectum is removed, the remaining colon is brought to the surface of the abdomen to make a stoma. This can be permanent, or temporary if the bowel needs time to rest and heal. If it is temporary, the ends of the bowel will be joined together again later.
Loop colostomy: A loop of bowel is outside the body and held in place by a stoma rod. The surgeon then makes a cut in the loop and the ends are rolled back and sown into the skin. This is usually temporary.
What to expect after the procedure
If you had a colostomy, you can expect to be in the hospital for 3 to 7 days, or longer if the colostomy was done as an emergency procedure.
You will not be able to eat normally at first because your colon needs time to heal. The first day you can suck on ice chips (small pieces of ice, usually smaller than ice cubes); the next day you may be able to drink clear liquids, and then you can gradually start having thicker liquids and soft foods. You should be able to eat normally after a couple of days.
The stomal therapy nurse will see you after the surgery to show you how to manage the stoma. You will need to learn how to clean it and change the bag.
After you go home, you can order new bags from your pharmacy, doctor, or a home delivery company. You can contact the stomal therapy nurse at any time if you have problems, so make sure you have their contact details.
The Australian Government’s Stoma Appliance Scheme subsidizes the costs of products for Australians who have a stoma. You need to apply to Services Australia through your local stoma association and have medical authorization from a doctor or stomal therapy nurse. Australian stoma associations are listed on the Department of Health website.
What can go wrong
Possible complications of colostomy surgery include:
- damage to nearby organs
- a hernia
- a prolapse (where more bowel comes through the stoma than should)
- narrowing or blockage of the stoma opening
- scar tissue inside the abdomen blocking the intestines
- skin irritation
- the wound breaking open
All surgery carries risks of reacting to medicines, bleeding, blood clots, and infection.
Australian Council of Stoma Associations (Colostomy), Australian Council of Stoma Associations (Be prepared and informed), Bowel Cancer Australia (Ileostomy & Colostomy), Cancer Council (Living with a stoma), Services Australia (Stoma Appliance Scheme), Elsevier Patient Information (Colostomy, Adult)