Colostomy & Colostomy Bags: Definition, Procedure & Care

A colostomy is an operation that redirects your colon from its normal route, down toward the anus, to a new opening in your abdominal wall. ThinkyoumayhaveCOVID-19? Findoutwhereyoucangettested Needavaccineorbooster? Scheduletoday ComingtoaClevelandCliniclocation? Visitationandmaskrequirements Home / HealthLibrary / Treatments&Procedures Colostomy Acolostomyisasurgicalprocedurethatchangesthetrajectoryoffoodwastethroughyourbowels.Whenpartofthecolonneedstobebypassedformedicalreasons,surgeonsmakeanewopeninginyourabdominalwallforpooptocomeout.Withacolostomy,youpoopintoacolostomybag.Theoperationcanbetemporaryorpermanent. Appointments&Access ContactUs Overview ProcedureDetails Risks/Benefits RecoveryandOutlook WhentoCalltheDoctor Colostomy Overview ProcedureDetails Risks/Benefits RecoveryandOutlook WhentoCalltheDoctor BackToTop Overview Whatisacolostomy? Acolostomyisanoperationthatredirectsyourcolonfromitsnormalroute,downtowardtheanus,toanewopeninginyourabdominalwall.Theopeningiscalledastoma.Thecolon,wherepoopforms,willnowexpelpoopthroughyourstomainsteadofyouranus.Youmayneedtowearacolostomybagtocatchthepoopwhenitcomesout.Somepeopleonlyhaveacolostomyforafewmonths,andothersneeditforlife. Acolostomyoftenfollowsacolectomy,aproceduretoremovepartorallofyourcolon.Otherconditionsmayrequireyoutostopusingyourcolon,eithertemporarilyorpermanently.Aftertheoperation,“colostomy”alsoreferstoyournewlyredirectedcolon.Yourhealthcareproviderwilltalktoyouaboutlivingwithandcaringforyourcolostomy. Whywouldyouneedacolostomy? Youmayneedacolostomyifyouhaveamedicalconditionthatrequiresyoutostopusingyourcolonoranusnormally.Itmaybeatemporaryinterventionthatallowsyourbodytoheal,oritmaybeapermanentsolutionforanirreversiblecondition. Someconditionsthatmayrequireatemporarycolostomyinclude: Seriousinfection,suchasdiverticulitis. Acuteinflammationfrominflammatoryboweldisease(IBD). Acuteinjurytoyourcolon. Anobstruction(orblockage)inyourcolonoranus. Analfistula(atunnelleadingfromyouranalcavitythroughtoyourskinoranotherorgan). Partialcolectomies(whentheremainingendsofthebowelscanbereattachedlater). Someconditionsthatmayrequireapermanentcolostomyinclude: Incurablefecalincontinence. Advancedcolorectalcancer. Permanentremovaloftherectumand/oranus. What'sthedifferencebetweenacolostomyandanileostomy? Thecolonandtheileumaretwodifferentpartsofthebowels,alsocalledtheintestines.Thecolonispartofthelargeintestine,andtheileumispartofthesmallintestine.Inyourbody,foodwastenormallypassesfromyourileumintoyourcolon,whereitformsintosolidstool.Butifthefirstpartofyourcolonthattheileumfeedsintoisremovedorinactive,thispathwayisinterrupted. Inthiscase,anileostomyredirectsyourileumtoastomainyourabdominalwall.Whenyouhaveanileostomy,youexpelliquidwastefromyoursmallintestinethroughyourstomaintoanostomybag.Likeacolostomy,anileostomymaybeeithertemporaryorpermanent,dependingonyourcondition.Sometimes,whenthecolonispermanentlyunusable,surgeonscancreateaninternal“ilealpouch”toreplaceit,andclosethestoma. Howcommonisostomysurgery? About100,000peopleintheU.S.eachyearundergoostomysurgery.About1in500Americans—upto1millionpeople—livewithanostomy.Somecallthemselves“ostomates.”Becauseit’ssocommon,thereareavarietyofspecializedproductsonthemarkettodaytohelpostomateslivenormallyanddiscreetlywiththeirostomies,includingdifferentkindsofostomybags,underwearandswimwear.Youcanalsofindostomysupportgroupsinmostareas. ProcedureDetails Whathappensbeforeacolostomy? Acolostomyisamajorsurgery,anditinvolvessomepreparation. Beforethesurgery:You’llhavewhat’scalledapre-operationassessmentmeetingwithyoursurgeon.They’llmakesureyoufullyunderstandtheprocedure,therisksinvolvedandthelifestylechangesyou’llhavetomakeafterwardbeforeyousignyourconsentforms.Youmayalsodiscussyourpainmanagementoptionsatthistime.Anursewilltakeabloodsampletocheckthatyouarewellenoughforsurgery.TheymayalsohaveanEKGtesttocheckthatyourheartisingoodhealth.Astomaspecialistnursewilldeterminethebestsiteonyourbodyforyourstomaandmarkitforyoursurgeon. Onthedayofthesurgery:You’llneedtoavoideatingordrinkingforsixhoursbeforesurgery.Sometimes,youmaybegivenanenemaorbowelprep(likebeforeacolonoscopy)totakeathome.Whenyouarriveatthehospital,you’llchangeintoahospitalgown.You’llthenbetakentoapre-oproomtowaitforyouroperation.Onceyouareintheoperatingroom,you'llreceiveyouranestheticforsurgery. Whathappensduringthecolostomyprocedure? Colostomiesmaybeperformedthrougheitherlaparoscopicsurgeryoropensurgery: Laparoscopicsurgery Laparoscopicsurgeryisanewer,lessinvasivemethodthantraditionalopensurgery.It’sdoneusingatinylightedcameracalledalaparoscope.Yoursurgeonmakesasmallincisioninyourabdomenandinsertsthelaparoscope,whichshowsyourabdominalorgansonascreen.Yoursurgeoncanthencompletethesurgeryusingoneormoresmallerincisionstoaccessyourorgans.Becausetheincisionsaresmaller,laparoscopicsurgeryisassociatedwithfewercomplications,lesspainandafasterrecoverytime.Butnoteverysurgerycanbesuccessfullycarriedoutthisway.Sometimes,acomplicatedcasemayrequireaplannedlaparoscopicsurgerytoconverttoopensurgery. Opensurgery Inanopensurgery,thesurgeonusesonelongincisiontoopenupyourabdominalcavity.Thisthetraditionalwaytoaccessyourabdominalorgans,anditallowsforbetteraccess,whichissometimesrequired.Butitisconsideredamajorsurgeryandcarriesalongerrecoverytime.Whetheryouhaveanopenoralaparoscopiccolostomymaydependontheconditionyouaretreatingandwhatelsethesurgeonneedstoaccomplishduringthesurgerybesidesthecolostomy.Inmostcases,you’llknowinadvancewhichtypeyou’llhaveandbeabletoplanaccordingly. Therearetwogeneraltypesofcolostomyoperationsperformed: Loopcolostomy Aloopcolostomyisoftenthemethodofchoicewhenacolostomyismeanttobetemporarybecauseit'seasiertoreverse.Inthisprocedure,yoursurgeonidentifiesthesectionofyourbowelthatneedstobeturnedintothecolostomyandpullsthatsectionasaloopthroughanincisioninyourabdomen.Thesurgeonthensnipstheloopandplacesthetwoopenendssidebysideinyourabdominalopening,creatingtwoendsofthestoma.Oneiswhereyourpoopwillcomeoutthroughtheremainingactivepartofyourbowel.Theotherisconnectedtotheremaininginactivepartofyourbowel,leadingtoyouranus.Thisopeningallowsmucustobedischarged. Endcolostomy Anendcolostomyisoftendonewhenthecolostomyisexpectedtobepermanent.Inthisprocedure,afteryourboweliscut,theendofyourremainingactivebowelisstitchedtotheopeninginyourabdominalwall,andtheendoftheremaininginactivebowelissealed.You’llhaveonestomaforpooptocomeout,andifyoustillhaveyouranusintact,you'lldischargemucusthroughyouranusinsteadofastoma. Whathappensaftertheprocedure? Thecolonhasfourdifferentsectionswhereitmayhavebeencut,dependingonwheretheproblemwas.Colostomiesineachsectionwillhaveslightlydifferentoutcomes. Ascendingcolostomy Theascendingcolonisthefirstsectionofcolonthatyoursmallintestinefeedsinto.It’scalled“ascending”becauseittravelsuptherightsideofyourabdomen.Ifyouhaveanascendingcolostomy,onlyasmallsegmentofyourcolonwillbeleftactive.Thismeansthattheremainingcolonwillnothavemuchchancetodowhatthecolondoeswithfoodwaste.Foodwastethatpassesfromthesmallintestineintotheascendingcolonisstillveryliquidandnotfullydigested.Intheascendingcolon,therearealotofdigestiveenzymesinthemixtohelpbreakthewastedownfurther.Thisistheliquidwastethatwillpassthroughyourstomaafteranascendingcolostomy.You’llhavetotakespecialcaretopreventleakageandprotectyourskinfromtheabrasiveenzymesinthepoop. Transversecolostomy Thetransversecolonisthesecondsegmentofthecolon,whichtravelshorizontallyacrossyourabdomenfromtherightsidetotheleftside.Thisisalsoroughlythemiddleofyourbowel.Transversecolostomiesareoftendonetogivethelowerhalfofyourbowelarest,andsometimestobypassitpermanently.Ifyouhaveatransversecolostomy,yourpoopwillbealittlemoresolidandhavefewerdigestiveenzymesinit,butitstillwon’tbelikethestoolyou’reusedto.Becausethisisthehighpointofthecolon,yourcolostomymayalsobeplacedrelativelyhighontheabdomen,whichcanmakeitmorechallengingtoconceal. Descendingandsigmoidcolostomies Thedescendingandsigmoidcolonarethelowersegmentsofthecolon.Thedescendingsegmenttravelsdowntheleftsideofyourabdomen,andtheshortsigmoid“tail”endcurvesalittletotherightanddown.Ifyouhaveacolostomyineitherofthesesections,you’llhavemostofyourcolonleftactive.Thismeansthepoopthatcomesoutofyourstomawillbemorefamiliar.Itwillhavehadtimetosolidifyandthedigestiveenzymeswillhavebeenabsorbed,soitwon’tbeirritatingtotheskin.Youmightevenhaveanaturalreflextopoopataregulartimeofdayandbeabletoplanaroundyourbowelmovements. Risks/Benefits Whataretheadvantagesofcolostomy? Colostomycreationisoftenthefinalstageofamorecomplicatedsurgery,suchasacolectomy.Whenthisisthecase,thesurgeryasawholeistypicallyalife-savingintervention.Acolostomymakesthatinterventionpossible.Ifyourequireacolectomyorsimilaroperation,acolostomyallowsyourbodytocontinuefunctioningwiththelossofamajororgan. Otherpeoplemayneedtogivetheircolonatemporaryresttohealfromillnessorinjury.Whenthisisthecase,acolostomyallowsthathealingtotakeplacesafelywithoutriskingfurthercomplications.Theillnessorinjuryyouarehealingfrommightnotseemlikealife-threateningemergencyyet,butitisthecolostomythatpreventsitfrombecomingone. Yoursurvivalandlong-termhealtharetheprimarypurposesofacolostomy.Forsome,italsoimprovestheirqualityoflife.Ifyouhavesufferedalongtimefromchronicboweldiseases,havingacolostomycanmeanfreedomfrombeingruledbyyourbowels.Now,younolongerhavetoliveinthebathroom,attendingtoatemperamentalcolon. Whataretherisksofthesurgery? Colostomyisacommonandstraightforwardsurgery.It’sgenerallysafe,buttherearealwayssomerisks.Theseinclude: Reactionstotheanesthesia. Breathingproblemsunderanesthesia. Injurytonearbyorgans. Infection. Whatcomplicationsmightoccurwhilelivingwithacolostomy? Evenwhenthesurgeryissuccessful,youmightrunintosomecomplicationswithyourcolostomydowntheroad.Theseinclude: Skinirritationfromcontactwithstool,especiallytheacidic,liquidstooloftheuppercolon.Thisisthemostcommonstomacomplication.Itcanusuallybesolvedwithabetter-fittingbag. Bowelobstructionsfromscartissueorfromparalyticileus(slow-movingbowels)afteryoursurgery,preventingpoopfrompassing.Thiscanusuallybesolvedwithhomeconstipationremedies. Stomaretractionorprolapse.Aretractedstomasinksbackbelowtheskinsurfacelevel.Aprolapsedstomasticksouttoofar.Bothofthesesituationscanmakeitdifficulttofityourcolostomybagsecurelytoyourstoma.Ifyoucan’tfindabagthatfits,yoursurgeonmayhavetore-siteorreviseyourstoma. Parastomalhernia.Thistypeofherniaoccurswhenloopsofbowelbulgethroughtheweakenedabdominalmusclesaroundyourstoma.Aherniaformsavisiblebulgenexttothestomaandcangrowovertime,potentiallyblockingyourstoma’soutput.Yourcolostomynursewilltalktoyouaboutpreventativemeasuresyoucantaketopreventaherniafromdevelopingafterthesurgery. RecoveryandOutlook Whatistherecoverytimefromacolostomy? You’llneedtorecoverinthehospitalforthenextthreetosevendays.Duringthistime,you’ll: Resumenormaleatinggradually.You’llprobablybefedaclearliquiddietforthefirstdayaftersurgery,thenprogresstoafullliquiddietorsoftdietbeforeresumingsolidfood. Learnallaboutcolostomycare.Awoundostomycontinencenurse(WOCN)willteachyouaboutlivingwithacolostomybagandhowtocareforyourstoma. Graduallyweanfromyourpainmedications.Youmaybegivenashort-termprescriptiontotakehomewithyou. Healfromyourwounds,andyourbowelmovementswillbegintoregulate.Itmaytakeseveraldaysbeforeyourfirstone. Whatdoesastomalooklike? Thefirsttimeyoulookatyourstoma,itmayappearbruised,redandswollen.Thiswillsubsideoverthenextfewweeks.Itwillshrinkandfadetoasoftredorpink.Sinceitistheinsideofatube(yourintestines)you'relookingat,itwillberoundishinshape.Itmaylookalittledifferentfrompersontoperson.Itmaystickoutalittleorbeflatagainsttheskin. Whatdoesitfeelliketohaveastoma? Thecolostomywoundmayhurtalittlewhileitheals.Youcanuseover-the-counterpainmedicationstomanageittemporarily.Thestomaitselfissimplytheendofyourintestine.Ithasnonerveendingsanddoesn’thaveanysensation.Oncethesurgerywoundhealsaroundthestoma,youwon’tfeelit. Youmighthaveavarietyofemotionalfeelingsabouthavingastoma,oranostomy.Youmightworryabouthowotherpeopleinyourlifewillfeelaboutit.Yourostomynursecanhelptalkyouthroughthis.Theycanalsoconnectyouwithotherpeoplelivingwithostomieswhomyoucantalkto. Canyoustillpoopwithacolostomybag? Poopingwillbedifferentwithacolostomybag.Immediatelyafteryoursurgery,youranusmaycontinuetoexpelpoopandotherfluidsthatwereleftinside.Butnewpoopwillnowexitthroughyourstoma.Mostpeoplewillbeabletofeeltheirbowelsmoveandknowwhenpoopisabouttocomeout.Butyouwon’tbeabletocontrolitanymore.Unlikeyouranus,yourstomadoesn’thaveamusclesystemthatallowsyoutocloseitatwill.Sopoopingwon’tbetheintentionalactionthatitusedtobe. Somepeoplewho'vehadtheircolonremovedmaycontinuefeelingphantombowelmovementurges,similartophantomlimbsyndrome.Theyfindthattheurgessubsideiftheysitonthetoiletliketheyusedto.Ifyoustillhaveyouranusintactandyoudon’thaveaseparatestomaforanaldischarge,youwillcontinuetopassoccasionalmucousthroughyouranus.Thiswillfeelsimilartoabowelmovement.Theinactivecoloncontinuestoproducemucusasitalwaysdid,tolubricateandprotecttheskin. WillIalwayshavetowearacolostomybag? Manypeoplesimplywearacolostomybagatalltimestocatchpoopwhenitcomesout.Thisiseasytodo,asmoderncolostomybagsarediscreetandcanbewornunderalmostanykindofclothing.Peoplewhohavehaddescendingorsigmoidcolostomies,leavingmuchoftheircolonintact,maybeabletopredictwhentheywillhaveabowelmovementandonlywearapouchduringthosetimes.Theyalsomaybeabletoinduceregularbowelmovementsthroughaprocesscalledcolostomyirrigation.Byspendingtimedailyclearingouttheirbowelswithwater,peoplecangowithoutabagbetweenirrigations. Whatisthelifeexpectancyofsomeonewithacolostomy? Ifyouneedacolostomy,it’slikelybecauseyoualreadyhavealife-threateningcondition.Differentconditionscomewiththeirownlifeexpectancyrates.Thepurposeofthecolostomyistoimprovethoseodds,anditgenerallydoes.Buttherearetoomanyotherfactorsinvolvedtocalculatelifeexpectancyfromthesurgeryalone.Forexample,theaverageageofsomeonereceivingacolostomyis70.Patientsofthisagemayhaveotherhealthissuesbesidesthecolostomy. WhencanIhaveacolostomyreversal? Thiswilldependonafewfactors,including: Thereasonyouhadacolostomycreated. Yourhealthsincetheoperation. Whetheryoucanhandlemoresurgery. Ifyourcolostomywasintendedtobetemporary,youcandiscussplansforareversalwithyourdoctorduringfollow-upvisitsafteryoursurgery.Theywillassessyourconditionandscheduleyourreversalsurgerywhentheyfeelyouareready.Itmightbeafewmonthstoayearafteryourfirstsurgery.Sometimes,it'sseveralyears.There’snotimelimittoareversal,onlyhealthlimits. WhentoCalltheDoctor WhenshouldIseemyhealthcareprovideraboutmycolostomy? Contactyourgeneralcareproviderorostomynurseifyouexperience: Persistentconstipationordiarrhea. Persistentnauseaorvomiting. Bloodinyourstool. Achangeinyourstoma’sregularsizeorcolor. Anystrangefoulodorscomingfromyourstoma. Ablockageinyourstoma. AnotefromClevelandClinic Acolostomyisoftenalife-savingoperation,andit’scertainlylife-changing.Whetherit’stemporaryorpermanent,lifewithacolostomyrequiresasubstantialadjustment.Butyouwon’tbealone.There’sawidecommunityofostomateslivingwithostomieswhocanhelpinitiateyouandoffercompanionshipthroughtheinsandoutsofit.There’salsoawideindustryofproductsavailabletomakeyourlifeeasier.Peoplewithcolostomieslivefullandnormallives,andoftenenjoymorecomfortandfreedomthantheydidbeforetheoperation.Afterthey’vehealed,somewillgoontoreversetheoperationandresumenormalbowelfunction.Othersmayhavepermanentcolostomies—buttheywillalsohavelongerlives. Share Facebook Twitter LinkedIn Email Print Getuseful,helpfulandrelevanthealth+wellnessinformation enews ClevelandClinicisanon-profitacademicmedicalcenter.Advertisingonoursitehelpssupportourmission.Wedonotendorsenon-ClevelandClinicproductsorservices. 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