There are three main types of colostomies; end colostomy, loop colostomy and double barrel colostomy. Each is performed based on the patient’s needs and whether the colostomy is planned to be temporary or permanent. They all serve the same purpose of creating an alternate outlet for feces to exit the body, however they differ in various ways from stoma formation and size to how the unused portion of the colon is treated.
During this type of colostomy, the healthy part of the colon is brought out to the surface of the abdomen. The opening is then turned inside out, like turning a sock inside out a bit, and it is then attached to the abdomen with sutures. The diseased or damaged section of the colon is either sutured shut and left inside as is or it is removed depending on its condition.
The stoma may be smaller compared to a loop colostomy and there is only one opening. This is where fecal matter from the colon will be expelled from the body.
End colostomies are often permanent but can sometimes be temporary, usually in cases of emergencies due to trauma or blockages.
This is performed by pulling enough of the colon outside of the body to form a loop. The loop is sutured in place and sometimes a plastic rod, known as a bridge, is then placed under the loop for additional support to prevent it from reentering the body keeping it on the outside surface of the abdomen. Bridges may or may not be used depending on the circumstance. If a bridge is used, it is removed a few days after the surgery once the stoma has healed enough to the surgeon’s liking.
An incision is then made into the loop of the exposed colon and two openings are created. One opening is for draining fecal matter and waste material from the healthy section of the colon and the second opening is used to drain mucus from the damaged section of the colon. Even though the diverted section of the colon is not being used to pass stool and function as normal, it may still produce gas and mucus. It may rise up out of the opening in the stoma, or it may drain down to the rectum and be passed out through the anus.
Loop colostomies often times are temporary and can be used in cases of a ruptured diverticulitis abscess, colon cancer or crohn’s disease for example.
This type of colostomy creates two separate stomas. Much like a loop colostomy, one stoma is used to expel waste material from the healthy part of the bowel while the second stoma is used to drain mucus from the damaged part of the colon that is being diverted. Double-barrel colostomies are often temporary, where once the damage section of the colon has been given enough time to heal the two sections of the colon can be reconnected. This is known as colostomy reversal.
Which type of colostomy to be performed depends on a list of varying factors. Where in the colon the colostomy will take place, the health of the colon, the underlying condition that is causing the problems, whether it is an emergency or there is some time to plan for it, and whether or not the colostomy will be permanent or temporary all play a role in which type of colostomy will be recommended. In preparation for your colostomy surgery, your doctor should explain everything in detail and inform you of which kind of colostomy they will perform (ascending, transverse, descending or sigmoid colostomy) and what type of colostomy and stoma discussed above you can expect to be left with. The various types of colostomies carry out the same basic function they just accomplish it in different ways depending on the circumstance.