Colostomy

A Colostomy is a surgical procedure in which a portion of the colon (large intestine) is brought through the abdominal wall to create an artificial opening called a stoma. This stoma serves as a new exit point for feces, bypassing the rectum and anus. The procedure is done to treat various diseases and conditions and may be temporary or permanent, depending on the medical circumstances and the underlying condition.

Temporary colostomy illustration

Indications

Colostomy and parastomal hernia

A colostomy may be performed in the following situations:

• Bowel cancer or other colorectal cancers.
• Bowel obstruction or perforation.
• Injuries to the colon or rectum.
• Birth defects such as imperforate anus.
• Chronic conditions like inflammatory bowel disease (Crohn's disease or ulcerative colitis) when other treatments have failed.
• Complications from diverticulitis.

Procedure

The surgery can be performed using open surgery or laparoscopically. After making the incision, the surgeon isolates a portion of the colon, which is then brought out through the abdominal wall. This exposed end forms the stoma, which is then sutured to the skin. The stoma will often appear red and moist and will protrude slightly from the abdominal surface.

Aftercare

Post-operatively, patients are educated on stoma care, which includes:

• Cleaning and care for the skin around the stoma.
• Proper application of colostomy bags to collect feces.
• Monitoring the stoma for potential complications such as infection, necrosis, or herniation.
• Dietary and lifestyle changes to manage colostomy output.

Types of Colostomies

• Ascending colostomy: Located on the right side of the abdomen, involving the ascending colon.
• Transverse colostomy: Positioned in the upper abdomen, involving the transverse colon.
• Descending or sigmoid colostomy: Located on the left side, involving the descending or sigmoid colon.

Complications

As with any surgical procedure, colostomies come with potential complications, including:

• Infection around the stoma site.
• Stoma necrosis or death of stoma tissue.
• Prolapse of the stoma.
• Parastomal hernia.
• Stenosis or narrowing of the stoma.

Quality of Life and Psychological Aspects

Living with a colostomy can be challenging initially. Patients may require psychological support to cope with body image changes and adapt to new routines. However, with proper education and support, most individuals can lead a normal and active life.

See Also

• Ileostomy
• Stoma (medicine)
• Ostomy Care
• Bowel Resection

References

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