A colostomy is a type of medical procedure in which the colon is pulled through a hole surgically made on the abdomen. A new opening is made in the colon and it is then attached to the surface of the belly. This area of the abdomen where the new opening to the colon sits (called a stoma) is where waste material, normally expelled through the rectum and anus, will now exit the body. “Ostomy” refers to bringing the opening of an internal organ to the outside surface of the body, in this case “col” is for the colon. There are a few different types of colostomies, some completely dissect the colon into two sections, while others do not. However most all form a stoma on the outside of the body where feces is expelled through this new opening in the colon.
Depending on the damage to the colon, a colostomy may be either a permanent or a temporary fixture. If the colon is injured, such as in cases of trauma, a temporary colostomy might be performed to stop stool from passing to the affected area, giving it time to properly heal. Once the affected area of the colon has healed, the colon can be reconnected, this is known as colostomy reversal or takedown. In cases of disease, such as colon cancer or Crohn’s disease, it may permanent. The damaged area of the colon or rectum may be removed at the time of the procedure.
The colon is quite a long organ, normally 5 to 6 feet long, and the type of colostomy to be performed is dependent on which section of the colon the procedure will take place. The three main types are; transverse , ascending and descending or sigmoid. There are many differences between the three including; where on the abdomen the stoma is placed, the make up and consistency of the waste material when exiting the body, and the types of conditions or diseases most commonly responsible for undergoing the procedure.
Descending or Sigmoid: This is the most frequently performed type of colostomy. It takes place in the sigmoid or descending colon, the last third section of the organ. Because of its location, the waste material that is expelled through the stoma tends to be firmer and less watery. Patients over time may even develop a routine or a schedule in which they can reliably predict their bowel movements, thus only having to wear their appliances at certain times of the day, although this is not the case for all patients.
It may be either of the single or double-barrel variety with single barrel being more common and the stoma will be located on the lower left side of the abdomen.
Transverse: This variety takes place in the transverse colon. The stoma will be located from the middle of the abdomen to the right side of the abdomen. Since this takes place further up in the colon than a descending or sigmoid variety, the waste material will be more loose or watery. A pouch will usually have to be worn full time. There are two varieties of transverse colostomies.
Loop Transverse : The stoma may look very large but that is because it has two openings. One opening is to expel waste material and the other is to drain naturally occurring mucus that is used by the colon for self protection. Despite being partially dissected, the damaged or diseased part of the colon that is being bypassed may still produce this mucus. It may either pass out of the second opening in the stoma or it may work its way down the remainder of the colon and rectum and be passed through the anus.
Double-Barrel Transverse : In this procedure the colon is divided into two sections by the surgeon and two distinct stomas are formed on the surface of the abdomen. This still serves the same function of the loop variety by having separate avenues to excrete wastes material and mucus.
Ascending : This is done at the very start of the colon near the small intestine. Waste material expelled from the stoma is very loose and usually contains digestive enzymes in liquid form. These are used to break down food and waste material and pose a greater risk for skin and stoma irritation so special care must be taken. It is also the least common of the three types that are performed.
During the natural function of the colon, waste is slowly pushed along the entire length as water is absorbed ending in the rectum and excreted through the anus. Due to the sphincter muscle at “the end of the line”, which acts as a valve, excretion is normally able to be controlled by the individual. Because an ostomy procedure takes this out of the equation, there is no longer any way to control the excretion of waste, there is no shut off valve. Waste will simply exit the opening in the stoma without one being able to control it, so some sort of pouch or bag to capture the fecal matter will be necessary.
Commonly referred to as colostomy bags, pouches, or appliances, the colostomy supplies you choose, with the help of your doctor or nurse, will be a major part of your daily life. It may seem like a lot to have to go through all of a sudden, but in time most patients become accustomed to having to deal with these supplies as it becomes part of their normal routine. The pouches are usually pretty flat and can easily be hidden under clothing so as not to be noticeable by the people around you.
We try to cover as many different areas of colostomy care and education to help those who have gone through or are about to go through this type of surgery. We understand that it can be a frightening experience, but hopefully some of the information found here will help ease some of the worry and help you find answers to some of your questions. You can find more info in the following categories:
General Colostomy: Read articles on that cover basic colostomy topics including, colostomy reversal, recovery, and complications. Also learn about the different types of surgery based on the location of the stoma.
Colostomy Care: Learn more about surgery recovery, the supplies you may need, the benefits of an ostomy nurse, plus stoma and skin care advice. Also discover which complications you should be most aware of such as hernia and stoma prolapse.
Living with a colostomy: Life after surgery will require a period of adjustment, but after some time things will get easier. Articles in this section touch on topics that may help including traveling with a colostomy, bathing, sex and intimacy issues and how to handle the emotional and mental distress this drastic change may produce.
The most important thing to remember is that you are not alone.