A colostomy is a surgical procedure that brings out one end of the large intestine through the abdominal wall. During this procedure, one end of the colon is diverted through a cut in the abdominal wall to form a stoma. A stoma is the opening in the skin where a pouch for collecting stools is attached. People with temporary or long-term colostomies have pouches attached to their sides where stools accumulate and can be easily disposed of.
Colostomies are not always permanent, especially in children with birth defects. A colostomy can be the result of one of several procedures to correct problems with the lower digestive tract. Other “ostomies” include ileostomy and urostomy. An ileostomy is a diversion of the end of the small intestine. A urostomy is a diversion of the tubes that carry urine out of the bladder. A colostomy may also be known as bowel diversion therapy.
Why a Colostomy Is Performed
Colostomies are done because of problems with the lower bowel. Some problems can be corrected by temporarily diverting stool away from the bowel. This is when temporary colostomies are used to keep stool/ waste out of the colon.
If the colon becomes diseased, like in the case of colon cancer, permanent colostomies are done and the colon may be taken out completely. Conditions in which you may require a permanent colostomy include:
- A blockage
- An injury
- Crohn’s disease, which is an autoimmune form of inflammatory bowel disease.
- Colorectal cancer.
- Colonic polyps, which is additional tissue growing inside the colon that may be cancer or may turn into cancer.
- Diverticulitis, which occurs when small pouches in your digestive system, called diverticula, become infected or swollen.
- Imperforate anus or other birth defects.
- Irritable bowel syndrome, which is a condition affecting the colon that causes diarrhea, bloating, constipation and pain in the abdominal area.
- Ulcerative colitis, which is an inflammatory bowel disease that causes the long-term inflammation of the digestive tract.
Risks of a Colostomy
A colostomy is a major surgery. Like any surgical procedure, there are risks of allergic reactions to anesthesia and excessive bleeding. Colostomy also has other risks which include:
- A blockage of the colostomy.
- Damage to other organs.
- A hernia, which happens when an internal organ pushes through a weak area of muscle.
- An infection
- Internal bleeding
- Problems from scar tissue.
- A prolapse of the colostomy.
- A wound breaking open.
How to Prepare for a Colostomy
Before the surgical procedure, your doctor will take blood samples, carry out a physical examination and review your complete medical history. During these visits, inform your doctor about any prior surgeries you’ve had and any medications you’re taking, including over-the-counter medicines and supplements.
Your doctor will likely ask you to fast for at least 12 hours before the surgical procedure. You may also be given a laxative or an enema to take the night prior to the surgery to help cleanse your bowels.
You should prepare to stay in the hospital for three to seven days. This includes packing the right necessities, arranging care for your children, pets or home and taking the appropriate amount of time off of work.
How a Colostomy Is Performed
You’ll change into a hospital gown before the surgical procedure. A nurse will put intravenous access (IV) in your arm. This allows the hospital staff to give you fluids and medications easily, and it’s also how you’ll be given your general anesthesia. This will put you into a deep sleep during the operation.
While you’re asleep, the hospital staff will take you to the operating room for your colostomy. When you’ve been cleaned and prepared, your doctor will make an incision in your abdomen. This incision may be large or it may be a series of smaller incisions. Smaller incisions are used for a laparoscopy. This type of surgery involves using small tools and a camera that’s inserted into an incision. The camera will be used to guide your doctor during the surgery.
During the surgical procedure, your doctor will locate the ideal part of the large intestine for the opening or stoma. Your doctor will cut the intestine in the right area and bring it through your abdominal wall.
Your doctor will surgically insert a ring onto your abdominal wall. This ring will hold the end of the intestine in place. This ring may be permanent or it may be positioned temporarily to help your skin heal around your exposed intestine.
After everything is in place, your doctor will close your wound with stitches and you’ll be brought into a recovery room. During that time, the staff will wait for you to wake up and they’ll watch your vital signs to ensure everything goes smoothly.
After a Colostomy
Recovery in the hospital involves being slowly reintroduced to liquids and foods to ensure there are no digestive problems. On the first day, you’ll most likely be given only ice chips to ease your thirst. Afterward, you’ll be given clear liquids and eventually soft foods.
You’ll also be taught how to use colostomy bags properly. A colostomy bag is where your stools will collect while you have your colostomy. Hospital staff will also instruct you on your diet and activity level. It’s necessary to follow these instructions.
You’ll have follow-up appointments with your doctor to check on your condition and the colostomy.
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