Surgery to make an opening or stoma from the large intestine is called a colostomy. The stoma is placed to bypass the rectum to expel waste from the body. The waste empties into a pouch worn on the outside of your abdomen.
A colostomy may serve to also remove a part of the lower large intestine when blocked or damaged. This may be needed when there is colorectal cancer. And sometimes to treat prostate, uterine, ovarian, or cervical cancer. Crohn’s disease, pre-cancerous colon polyps, or ulcerative colitis, may also need this procedure. A stoma may be needed only for a few months to allow healing of the colon or rectum. But a permanent stoma may be needed in some cases.
There are five parts of the large intestine that determine the type of colostomy needed. The end of the large intestine where the stool is more regular and solid requires a sigmoid colostomy. A transverse colostomy is needed across the top of the abdomen where the stool is soft. There are three types of transverse colostomy.
The descending colostomy is for the descending part of the colon on the left side. There the stool is usually firm with most of the water already absorbed. Ascending colostomy is at the ascending part of the colon on the right-side abdomen. There the stool is still liquid with unabsorbed water. An ileostomy is better suited for this part of the colon.
A colostomy requires general anesthesia. The procedure involves attaching a stoma to the colon, then to the colostomy bag. The process can involve a surgical incision or laparoscopic surgery. The latter is less invasive and painful with less recovery time. There are risks involved with the procedure. These may include injury to organs nearby, bleeding inside the colon or from the stoma, and infection.
After colostomy surgery, a hospital stay of up to one week may be needed. But the total recovery may take up to two months. There should be care with the choice of food during the healing process. A temporary colostomy will need a closure or reversal surgery about three months after healing.
With recovery, there must be colostomy care. Empty the colostomy bag several times each day. There will not be control over stool and gas going into the pouch, so it is best emptied before it gets half full. The pouches are of one-piece and two-piece types. The one-piece pouch attaches to the skin barrier. Two-piece pouches have a skin barrier and a pouch that we can detach from the body. Other options for pouches are the open-end drainable type or the closed-end disposable pouch.
A larger output of stool after surgery is normal but will decrease after a few days as your body gets attuned to the colostomy and stoma. There is also the need to avoid foods that will contribute to the buildup of excess gas.
