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What is a colostomy?
A colostomy is surgery to bring part of your colon (bowel or large intestine) to the wall of your abdomen (tummy). At the skin it forms a stoma. A stoma is an artificial opening on the outside of your abdomen.
The colon is the first 1 to 1.5 metres of your large intestine. It absorbs water and nutrients and passes the remaining waste to your rectum.
A colostomy allows faeces (poo) and gas to leave your body via the stoma. A small disposable bag is worn on the outside of your body to collect the faeces.
When is a colostomy needed?
A colostomy may be needed if part of your bowel needs to be removed or when a section of your bowel after the colostomy needs to recover from injury or surgery.
Some conditions, such as bowel cancer, may need to be treated with the removal of diseased portions of your bowel.
A colostomy may also be carried out if you have:
- bowel infection or inflammation
- diverticulitis
- Crohn’s disease
- ulcerative colitis
- an injury to your bowel
- a blocked bowel (intestinal obstruction)
How do I prepare for a colostomy?
Your doctor will tell you what you need to do to prepare for surgery.
You will be asked to fast (not eat and drink) before your surgery. You may also need to stop taking certain types of medicine.
You may be able to meet with a stomal therapy nurse before your surgery. These nurses specialise in caring for people who have a stoma. They will be able to answer all your questions. Make sure you ask where your stoma will be and how to manage it afterwards.
Your doctor and stomal therapy nurse will tell you how to prepare for your colostomy.
What happens during a colostomy?
A colostomy is done under general anaesthetic. There are 2 different types of colostomy surgery:
- end colostomy
- loop colostomy
End colostomy — is when part of your colon or rectum is removed and your remaining colon is brought to the skin of your abdomen (tummy) to make an opening. This type of stoma can be temporary or permanent. If it’s temporary, the ends of your bowel will be joined together again later.
Loop colostomy — a loop of bowel is pulled out through a cut in your abdomen. The loop is opened and stitched to your skin to form a stoma. A loop colostomy is usually temporary. You can read more about how this procedure is reversed in healthdirect’s closure of loop colostomy article.
Recovering from a colostomy
If you have a colostomy, you can expect to be in hospital for a few days. You may need to stay in hospital longer if the colostomy was done as an emergency procedure.
The stomal therapy nurse will see you after the surgery. They will teach you how to care for your stoma, including how to empty and change your bag.
You can contact your stomal therapy nurse at any time, so make sure you have their contact details.
After you go home, you can order new bags from your pharmacy, doctor or a home delivery company. The Australian Government’s Stoma Appliance Scheme helps pay the costs of products for Australians who have a stoma.
Possible complications from a colostomy
All surgery carries risks of reacting to the medicines, bleeding, blood clots and infection.
Possible complications of colostomy surgery include:
- rectal discharge
- a parastomal hernia — where the intestines push through the muscles around the stoma
- stoma blockage
- skin irritation
- stomal fistula — where a small channel or hole develops in the skin alongside the stoma
- stoma retraction — where your stoma sinks below the level of the skin after the initial swelling goes down
Other complications can include:
- bleeding from your stoma
- stenosis (narrowing of your stoma)
- granulomas (raised red lumps around your stoma)
Are there any alternatives to a colostomy?
Alternatives to surgery depend on what’s wrong with your bowel.
Medicines can be used to treat some bowel conditions.
