Colostomy | Johns Hopkins Medicine

A colostomy is an operation that creates an opening for the colon, or large intestine, through the abdomen. A colostomy may be temporary or permanent. SkipNavigation COVID-19Updates Masksarerequiredinsideallofourcarefacilities.Wearevaccinatingalleligiblepatients.Learnmore: Vaccines,Boosters&AdditionalDoses|Testing|PatientCare|VisitorGuidelines|Coronavirus|EmailAlertsFindmoreCOVID-19testinglocationsonMaryland.gov. HealthHome Treatments,TestsandTherapies Colostomy ShareonFacebook ShareonTwitter ShareonLinkedin ShareonPinterest ShareviaEmail PrintthisPage Procedureoverview Acolostomyisanoperationthatcreatesanopeningforthecolon,orlargeintestine,throughtheabdomen.Acolostomymaybetemporaryorpermanent.Itisusuallydoneafterbowelsurgeryorinjury.Mostpermanentcolostomiesare"endcolostomies,"whilemanytemporarycolostomiesbringthesideofthecolonuptoanopeningintheabdomen. Duringanendcolostomy,theendofthecolonisbroughtthroughtheabdominalwall,whereitmaybeturnedunder,likeacuff.Theedgesofthecolonarethenstitchedtotheskinoftheabdominalwalltoformanopeningcalledastoma.Stooldrainsfromthestomaintoabagorpouchattachedtotheabdomen.Inatemporary"loopcolostomy,"aholeiscutinthesideofthecolonandstitchedtoacorrespondingholeintheabdominalwall.Thiscanbemoreeasilyreversedlaterbysimplydetachingthecolonfromtheabdominalwallandclosingtheholestoreestablishtheflowofstoolthroughthecolon. Reasonsfortheprocedure Colostomysurgerymaybeneededtotreatseveraldifferentdiseasesandconditions.Theseinclude: Birthdefect,suchasablockedormissinganalopening,calledanimperforateanus Seriousinfection,suchasdiverticulitis,inflammationoflittlesacsonthecolon Inflammatoryboweldisease Injurytothecolonorrectum Partialorcompleteintestinalorbowelblockage Rectalorcoloncancer Woundsorfistulasintheperineum.Afistulaisanabnormalconnectionbetweeninternalpartsofthebody,orbetweenaninternalorganandtheskin.Awoman'sperineumistheareabetweenheranusandvulva;aman'sliesbetweenhisanusandscrotum. Thereasonforthecolostomyhelpsthehealthcareproviderdecidewhetheritwillbeshort-termorpermanent.Forexample,someinfectionsorinjuriesrequiregivingthebowelatemporaryrest,thenreattachingit.Apermanentcolostomymayberequiredforamoreseriousorincurableproblem,suchascancerthatrequiresremovaloftherectum,orafailureofthemusclesthatcontrolelimination. Howthedigestivesystemworks Acolostomywon'tchangethewayyourdigestivesystemworks.Normally,afteryouchewandswallowyourfood,itgoesthroughyouresophagus,orswallowingtube,intoyourstomach. Fromthere,ittravelstoyoursmallintestineandthentoyourlargeintestine,orcolon.Hoursordayslater,theindigestibleresidueleavesthestorageareaofyourrectumviayouranus,asstool.Stooltypicallystayslooseandliquidduringitspassagethroughtheuppercolon.There,waterisabsorbedfromit,sothestoolgetsfirmerasitnearstherectum. Theascendingcolongoesuptherightsideofyourbody.Thestoolhereisliquidandsomewhatacidic,anditcontainsdigestiveenzymes.Thetransversecolongoesacrossyourupperabdomen,andthedescendingandsigmoidcolongodowntheleftsideofyourbodytoyourrectum.Intheleftcolon,thestoolbecomesprogressivelylessliquid,lessacidic,andcontainsfewerenzymes. Whereyourcolonisinterrupteddetermineshowirritatingtotheskinyourstooloutputwillbe.Themoreliquidthestool,themoreimportantitwillbetoprotectyourabdominalskinafteracolostomy. Risksoftheprocedure Gettingacolostomymarksabigchangeinyourlife,butthesurgeryitselfisuncomplicated.Itwillbeperformedundergeneralanesthesia,soyouwillbeunconsciousandfeelnopain.Acolostomymaybedoneasopensurgery,orlaparoscopically,viaseveraltinycuts. Aswithanysurgery,themainrisksforanesthesiaarebreathingproblemsandpoorreactionstomedications.Acolostomycarriesothersurgicalrisks: Bleeding Damagetonearbyorgans Infection Aftersurgery,risksinclude: Narrowingofthecolostomyopening Scartissuethatcausesintestinalblockage Skinirritation Woundopening Developingaherniaattheincision Beforetheprocedure Ifpossible,besuretodiscussyoursurgicalandpostsurgicaloptionswithadoctorandanostomynurse(anursewhoisspeciallytrainedtohelpcolostomypatients)beforesurgery.Itmayalsohelptomeetwithanostomyvisitor.Thisisavolunteerwhohashadacolostomyandcanhelpyouunderstandhowtolivewithone.And,beforeorafteryoursurgery,youmaywishtoattendanostomysupportgroup.YoucanfindoutmoreaboutsuchgroupsfromtheUnitedOstomyAssociationsofAmerica ortheAmericanCancerSociety. Duringtheprocedure Dependingonwhyyouneedacolostomy,itwillbemadeinoneof 4partsofthecolon:ascending,transverse,descending,orsigmoid. Atransversecolostomyisperformedonthemiddlesectionofthecolon,andthestomawillbesomewhereacrosstheupperabdomen.Thistypeofsurgery--oftentemporary--istypicallyperformedfordiverticulitis,inflammatoryboweldisease,cancer,blockage,injuryorabirthdefect.Inatransversecolostomy,thestoolleavesthecolonthroughthestomabeforereachingthedescendingcolon.Yourstomamayhaveoneortwoopenings.Oneopeningisforstool.Thesecondpossiblestomaisforthemucusthattherestingpartofyourcolonnormallykeepsproducing.Ifyouhaveonlyonestoma,thismucuswillpassthroughyourrectumandanus. Anascendingcolostomygoesontherightsideofyourabdomen,leavingonlyashortpartofthecolonactive.Itisgenerallyperformedonlywhenblockageorseverediseasepreventsacolostomyfurtheralongthecolon. Adescendingcolostomygoesonthelowerleftsideoftheabdomen,whileasigmoidcolostomy--themostcommontype--isplacedafewincheslower. Aftertheprocedure Youmaybeabletosuckonicechipsonthesamedayasyoursurgery.You'llprobablybegivenclearfluidsthenextday.Somepeopleeatnormallywithintwodaysafteracolostomy. Anormalstomaismoistandpinkorredcolored.Whenyoufirstseeyourcolostomy,itmayappeardarkredandswollen,withbruises.Don'tworry.Withinafewweeks,thecolorwilllightenandbruisesshoulddisappear. Thebandageorclearpouchcoveringyourcolostomyrightaftersurgeryprobablywon'tbethesametypethatyou'lluseathome.Yourcolostomywilldrainstoolfromyourcolonintothiscolostomypouchorbag.Yourstoolwillprobablybemoreliquidthanbeforesurgery.Yourstoolconsistencywillalsodependonwhattypeofcolostomyyouhaveandhowmuchofyourcolonisstillactive. Inthehospital Acolostomyrequiresahospitalstayofabout 3daystoaweek.Yourstaywillprobablybelongerifthecolostomywasperformedforanemergency.Duringyourhospitalstay,you'lllearntocareforyourcolostomyandtheapplianceorpouchthatcollectsyourstool. Yournursewillshowyouhowtocleanyourstoma.Afteryougohome,you'lldothisgentlyeverydaywithwarmwateronly.Thengentlypatdryorallowtheareatoairdry.Don'tworryifyouseealittlebitofblood. Useyourtimeinthehospitaltolearnhowtocareforyourcolostomy.Ifyouhaveanascendingortransversecolostomy,youwillneedtowearaslim,lightweight,drainablepouchatalltimes.Therearemanydifferenttypesofpouches,varyingincostandmadefromodor-resistantmaterials. Somepeoplewithadescendingorsigmoidcolostomycaneventuallylearntopredictwhentheirbowelswillmoveandwearapouchonlywhentheyexpectamovement.Theymayalsobeabletomasteraprocesscalledirrigationtostimulateregular,controlledbowelmovements. Beforegoinghome,besuretotalkwithanostomynurseorotherexpertwhocanhelpyoutryouttheequipmentyou'llneed.Whatworksbestwilldependonwhattypeofcolostomyyouhave;thelengthofyourstoma;yourabdominalshapeandfirmness;anyscarsorfoldsnearthestoma;andyourheightandweight. Sometimes,therectumandanusmustbesurgicallyremoved,leavingwhat'scalledaposteriorwound.Inthehospital,you'llusedressingsandpadstocoverthiswound,andyoumayalsotakesitzbaths--shallow,warm-watersoaks.Askyourdoctorandnursehowtocareforyourposteriorwounduntilitheals.If problemsshouldoccur,pleasecontactyourdoctor.  Athome Theskinaroundyourstomashouldlookthesameaselsewhereonyourabdomen.Exposuretostool,especiallyloosestool,canbeirritating.Herearesometipstoprotectyourskin: Makesureyourpouchandskinbarrieropeningaretherightsize. Changethepouchregularlytoavoidleakageandskinirritation.Don'twaituntilyourskinbeginstoitchandburn. Removethepouchingsystemgently,pushingyourskinawayinsteadofpulling. Barriercreamsmaybeusediftheskinbecomesirritateddespitethesemeasures. Notifyyour doctortoreportanyofthefollowing: Crampsthatlastmorethantwohours Continuousnauseaorthrowingup Badorunusualodorformorethanaweek Changeinyourstomasizeorcolor Blockedorbulgingstoma Bleedingfromthestomaopeningorinthepouch Woundorcutinthestoma Seriousskinirritationorsores Waterystoolformorethanfivehours Anythingunusualthatconcernsyou Agoodruleistoemptyyourpouchwhenit'sone-thirdfull.Andbesuretochangethepouchbeforeitleaks.Asageneralrule,changeitnomorethanonceaday,butnotlessthaneverythreeorfourdays. Acolostomyrepresentsabigchange,butyouwillsoonlearntolivewithit.Eventhoughyoucanfeelthepouchagainstyourbody,nooneelsecanseeit.Donotfeeltheneedto explain yourcolostomytoeveryonewhoasks; onlyshareasmuch asyouwantto. 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