A colostomy is a surgical procedure that involves creating an opening in the abdominal wall through which a portion of the large bowel (colon) is brought to the surface, resulting in a stoma. This stoma allows waste material, such as stool and gas from the digestive system to exit the body, bypassing the normal route through the rectum and anus. Colostomies are typically performed for medical reasons when the normal route of waste elimination is compromised or temporarily unavailable.
Read more to find out why a colostomies are formed and how it can affect you or a loved one.
What are the reasons for colostomy surgery?
Colostomies are performed for various medical conditions:
- colorectal cancer
- inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis),
- diverticulitis
- anal cancer
- bowel incontinence
- trauma/injury to the colon or rectum
- birth defects such as Hirschsprung’s disease or imperforate anus
- wounds or fistulas in the perineum
Some colostomies can be temporary; some infections, injuries or some cancers require giving the bowel a temporary rest and then reattaching it (reversal). Other colostomies are permanent which maybe required for a more serious and incurable problems, that requires removal of the rectum, or for muscles which fail to control elimination. Temporary colostomies may be followed by another operation to reverse the colostomy, at a later date whereas reversal is not an option for those with a permanent colostomy.
Types of Colostomies:
There are different types of colostomies based on the portion of the colon that is brought to the surface. The two primary types are:
End Colostomy: This is when the open end of the colon is brought to the abdominal wall, creating a stoma. Most permanent stomas are end colostomies, but some can be temporary. The other part of the diseased bowel is either removed or allowed to heal before joined back together.
Loop Colostomy: In this type, a loop of the colon is brought to the abdominal wall. An incision is made in the loop and then sewn to your stomach with a rod to keep it above surface level. A loop colostomy is usually temporary and is formed in emergency surgery allowing it to be reversed further down the line.
With colostomy surgery, part of your colon is brought to the surface to form the stoma. A colostomy is usually created on the left-hand side of your stomach (abdomen). Stools in this part of the large bowel are solid and because the stoma has no muscles to control defecation, a stoma bag will be needed.
Stoma Care:
Emptying your colostomy bag regularly after surgery is important. You may find you need to do this once or perhaps several times a day. It is a good idea to empty the stoma bag when it is half full or less, otherwise it becomes heaving and may drag and possibly start to leak. There are two different types of colostomy bags:
- One-piece pouches attach directly to the skin around your stoma. The pouch has a hole in the middle, to incorporate the stoma and it is directly attached to the skin by a skin friendly wafer, known as skin barrier. It is applied and removed together as one-piece.
- Two-piece pouches include the skin barrier and a pouch which can be detached separately. Therefore, you can leave the skin wafer in place and change the pouch from the bag.
Looking after your stoma and the surrounding skin (peristomal) is an essential part of having a stoma. Checking your skin and stoma when you change your pouch needs to be part of your daily routine. Keeping the skin around your stoma clean and drying soft dry wipes, moistened with warm water and dry carefully before applying a new stoma pouch will help prevent any irritation or soreness. Monitoring your stoma and its shape or size is also important. Following surgery, the stoma tends to reduce in size over the first 6-8weeks and will need to be re-measured so your stoma bag fits correctly. Your Stoma Nurse will help you with this.
If you notice your skin is becoming more irritated, and your stoma bag is no longer fitting correctly, contact you Stoma Care Nurse for advice and support.
Living with a Colostomy:
Once recovered from surgery, most people with colostomies can return to leading active and fulfilling lives. Modern colostomy bags are discreet, comfortable, so it shouldn’t stop you from doing the things you love. Your Stoma Nurse will help guide you with stoma bags and any other issues and there are also support groups such as the Colostomy Association and online resources available to help patients and their families adjust to life with a colostomy.
Coping with a colostomy can be emotionally and psychologically challenging for patients. Some ostomates may experience anxiety, self-esteem issues, or concerns about body image. Don’t feel alone, reach out and talk to someone such as your Stoma Care Nurse, friends or family and loved ones, they can make a significant difference in helping individuals adapt to these changes.
For more helpful advice following your stoma surgery, please visit our stoma care advice centre.
