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Colostomy Overview

A colostomy is a surgical procedure that brings one end of the large intestine out through the abdominal wall.

During this procedure, one end of the colon is diverted through an incision in the abdominal wall to create a stoma. In addition, a stoma is an opening in the skin where a pouch attaches for collecting feces. Consequently, patients with temporary or long-term colostomies attach pouches to their sides where they collect feces and can easily dispose of them.

Moreover, colostomies aren’t always permanent, especially in children with birth defects.

Furthermore, a colostomy can be the result of one of several procedures to correct problems with the lower digestive tract. For example, other “ostomies” include ileostomy and urostomy. Specifically, an ileostomy is a diversion of the bottom of the small intestine, while a urostomy is a diversion of the tubes that carry urine out of the bladder.

In addition, medical professionals may also refer to a colostomy as bowel diversion therapy.

Colostomy Procedure

To elaborate, colostomies are performed due to problems with the lower bowel and create new pathways for stools to pass. Once they create a colostomy, the intestines work very much the same way as before, except for two changes:

First, surgeons disconnect or remove the colon and rectum beyond where they have performed the colostomy.

• Second, stools no longer leave the body through the anus

The conditions that can require a colostomy include certain illnesses, injuries, or other problems with the digestive tract, including:

• For example, an injury to the colon or rectum,
• As well as, Crohn’s disease
  
• In addition, to colon cancer
• And, diverticulitis.
• Moreover, Hirschsprung’s disease, a rare condition that mostly affects children, can cause stools to become stuck in the bowels.
• Furthermore, intestinal obstruction, which is a blockage in the large bowel, can also necessitate a colostomy.

How do surgeons perform a colostomy?

Now, let’s discuss how the procedure typically unfolds:

Generally, you can expect something very similar to the following during the colostomy procedure:

First, after changing into a hospital gown, a nurse will place intravenous access, or an IV, in your arm. This step allows the hospital staff to give you fluids and medications easily, and it’s also how they will give you your general anesthesia.

Consequently, this will put you into a deep, painless sleep during the operation.

While you’re asleep, the hospital staff will wheel you into the operating room for your colostomy. Once you’ve been cleaned and prepared, your surgeon will make an incision in your abdomen. Notably, this incision may be large, or it may be a series of smaller incisions.

Smaller Incisions

Specifically, smaller incisions are used for laparoscopy. In this case, surgeons use small tools and a camera that’s inserted into an incision.

Smaller incisions are used for laparoscopy. In this type of surgery, small tools and a camera that’s inserted into an incision are utilized. Consequently, the camera will be used to guide your doctor during the surgery.

First, your doctor will locate the ideal part of the large intestine for the opening, or stoma. After that, they will then cut the intestine in the appropriate area and bring it through your abdominal wall.

Next, your doctor will surgically implant a ring onto your abdominal wall. This ring will hold the end of the intestine in place. Importantly, this ring may be permanent, or it may be placed temporarily to help your skin heal around your exposed intestine.

Finally, after everything is in place, your doctor will close your wound with stitches, and you’ll be brought into a recovery room. During that time, the staff will wait for you to wake up, and they’ll watch your vital signs to ensure everything goes smoothly.

Preparation of Colostomy

Before surgery, your doctor will take blood samples, perform a physical exam, and review your complete medical history. In addition, during these visits, tell your doctor about any prior surgeries you’ve had and any medications you’re taking, including over-the-counter medicines and supplements.

Furthermore, your doctor will likely ask you to fast for at least 12 hours before surgery. Additionally, a healthcare provider may also give you a laxative or an enema to take the night before surgery to help cleanse your bowels.

Moreover, you should prepare to stay in the hospital for 3 to 10 days. This preparation includes packing the right necessities, arranging care for your children, pets, or home, and taking the appropriate amount of time off of work.

After the Colostomy Procedure

After the Procedure, recovery in the hospital involves being slowly reintroduced to liquids and foods to ensure there are no digestive problems. For instance, on the first day, they will most likely give you only ice chips to ease your thirst. Subsequently, they will give you clear liquids and eventually soft foods.

Finally, once doctors are sure your bowels are working normally, you can start eating a regular diet, usually about 2 days after surgery.

Colostomy Bag

You’ll also be taught how to use colostomy bags correctly and how to keep your stoma clean, most likely by a stoma nurse who has been specially trained. Furthermore, hospital staff will also instruct you on your diet, activity level, and more. Therefore, it’s important to follow these instructions.

Additionally, you’ll have follow-up appointments with your doctor to check on your condition and the colostomy.

Types of Colostomy

Now, let’s discuss the types of colostomies.

A colostomy can be short-term (a few months), or a life-long situation. Specifically, the different types of this procedure have to do with where they are located on the colon.

Temporary Colostomy

To begin with, a temporary colostomy gives part of the bowel time to heal by redirecting where stools go out of the body.

Consequently, this healing can take a few months or a few years, but once healing has occurred, the surgeon can reverse the colostomy via surgical procedure.

Permanent Colostomy

In contrast, when part of the rectum becomes diseased, such as with cancer, a permanent colostomy is done. In this scenario, surgeons remove the diseased part of the colon through a surgical procedure, or permanently cut it off with the colostomy positioning.

Transverse Colostomy

In fact, surgeons consider transverse colostomies to be some of the more common colostomies; moreover, they divide them into the following two types:

• First, double-barrel transverse colostomies;
• Second, loop transverse colostomies.

Typically, transverse colostomies are done in the upper abdomen. This type of colostomy, consequently, allows the stool to leave the body before it reaches the descending colon and is typically temporary, thereby allowing parts of the colon to heal.

Furthermore, double-barrel transverse colostomy involves dividing the bowel into two complete parts. Specifically, each part has its own opening, or stoma, in the abdomen. Just like with a loop transverse colostomy, one opening is for stools, while the other is for only mucus.

On the other hand, loop transverse colostomy creates two openings in the abdomen: one opening is for stools, whereas the other is only for mucus, which is a normal byproduct of defecation.

In transverse colostomies, a lightweight, drainable pouch holds the stool and mucus and protects the skin from coming into contact with the stool. Typically, this pouch can easily be hidden under clothes.

Ascending Colostomy

In an ascending colostomy, only a small portion of the colon stays active, and the colostomy itself is placed on the right side of the abdomen. Consequently, because only a small portion of the colon stays active, the output is liquid and contains a large number of digestive enzymes. Therefore, one has to wear a drainable pouch at all times.

Moreover, doctors usually recommend ileostomies instead, as ascending colostomies are rare these days.

Descending and Sigmoid Colostomies

Moving on to Descending and Sigmoid Colostomies,

As the name would suggest, a descending colostomy is placed in the descending colon, on the lower left side of the abdomen. In general, you can control the output, and it is firmer.

On the other hand, a sigmoid colostomy is done on the sigmoid colon and is a few inches lower than a descending colostomy. Notably, a sigmoid colostomy allows for a larger part of the colon to still do its job, so the stool output is usually more solid and happens on a regular basis.

Risks of Colostomy

A colostomy is a major surgical procedure. Furthermore, as with any surgery, there are risks of allergic reactions to anesthesia and excessive bleeding.

In addition, a colostomy also carries other risks, such as the following:

• For instance, damage to the nearby organs
• Moreover, stoma fistula, a small hole that can develop next to the stoma
• Additionally, irritated skin around the stoma
• Similarly, stoma retraction, when the stoma may sink into the skin and cause leakage around the colostomy pouch
• Furthermore, parastomal hernia, which is when your intestines bulge out through the muscles around the stoma. This can cause a bump in the skin.
• Also, scar tissue forming in the abdomen, which can cause blockages
• Likewise, stoma blockage, which is when a buildup of food can block the opening and cause issues, including nausea, swelling, and output issues
• Finally, stomal ischaemia, when blood supply to the stoma is restricted. This may require additional surgery.

Ultimately, your doctor can best explain your personal risks, risks and advantages of the surgery, and the potential for complications.

Living with a Colostomy

While it can take some time to adjust to life with a colostomy, most patients eventually learn how to continue with their regular life. Most colostomy equipment is discreet and can be hidden under clothes. After you have healed from your surgery, you should be able to do most of what you loved doing before.

As long as you pay attention to any new symptoms or pains in the area around your colostomy, and keep it properly cleaned and cared for, living a full life is completely possible.