Doctors may recommend a colostomy if the bowel becomes diseased or damaged. This procedure involves cutting into the abdominal wall to drain stool from the colon.

People may need to undergo colostomies for a variety of conditions, including ulcerative colitis, Crohn’s disease, and colon cancer. About 100,000 people in the United States have a colostomy or ileostomy each year. An ileostomy is a related procedure in which surgeons bring the small intestine through the abdominal wall.

This article looks at the colostomy procedure in more detail, including the recovery and risks.

A surgeon putting on a face mask before performing a colostomy.Share on Pinterest

Any surgery ending in “ostomy” involves creating an opening to connect an inner part of the body to the outside. Doctors call these openings stomas.

A colostomy is a surgical procedure involving the large intestine, or colon. During the procedure, surgeons make an opening in the abdominal wall. They then bring the end of the colon through the stoma. The final step involves sewing the colon into position on the outside of the body.

Substances moving through the digestive system then exit the body through the stoma rather than the rectum and anus.

An ileostomy is a similar procedure. This is where a surgeon brings the bottom of the small intestine to the stoma, allowing waste to bypass the colon, rectum, and anus.

People need a colostomy or another ostomy surgery when part of their bowel is not functioning properly.

A colostomy can be a temporary procedure that lasts 3–6 months, allowing the colon time to recover from an illness or injury. However, people with serious conditions, such as cancer, a bowel defect, or inflammatory bowel disease (IBD), may require a permanent colostomy. This procedure enables the surgeon to remove damaged parts of the intestine.

The most common type of colostomy is a transverse colostomy, which occurs in the upper abdomen. It allows stool to leave the body before it reaches the colon.

There are three types of traverse colostomy:

  • A loop colostomy: The colon remains connected to the rectum, meaning that stool or gas can still pass through the rectum.
  • A single-barrel colostomy: The surgeon removes the colon below the colostomy, including the rectum and anus.
  • A double-barrel colostomy: This procedure divides the colon into two ends, each with a stoma. Stool leaves the body through one, while mucus leaves through the other.

Some problems that may require a transverse colostomy include:

  • cancer
  • Crohn’s disease
  • IBD
  • diverticulitis
  • injury
  • obstruction
  • congenital disabilities

People will have a pre-op assessment a few days or weeks before a colostomy. It is a good opportunity to discuss any concerns and potential risks with the surgeon. The surgeon will ensure that the person understands the procedure and is comfortable signing a consent form.

They may recommend using a combination of laxatives to clear the bowel on the day of the surgery. However, this step is not always necessary.

Before the surgery, a healthcare professional will examine the individual’s abdomen and mark the best place for the stoma. This is typically on the left side, but it will depend on the person’s anatomy, clothing preferences, and lifestyle, such as whether they play sports.

A surgeon may use open surgery or keyhole surgery to perform the colostomy. Keyhole surgery, also known as laparoscopic surgery, involves using a tiny camera and tools for the procedure.

The exact steps depend on the surgeon and the type of colostomy. However, they may include:

  1. The anesthesiologist administers a general anesthetic to induce deep sleep.
  2. The surgical team cleans and prepares the surgical site for operation.
  3. The surgeon creates a large incision for open surgery or several small incisions for keyhole surgery.
  4. In keyhole surgery, the surgeon inserts the camera and surgical tools into the incisions.
  5. They bring the colon ending through the abdominal wall and turn it under.
  6. The surgeon stitches the colon to the abdominal wall, forming the stoma.
  7. They attach a stoma bag around the opening. The stool then drains into this bag instead of continuing through the digestive system.
  8. Once the wound is closed, the medical team will move the individual to a recovery room and monitor their vital signs until they wake up.

For a temporary colostomy, the surgeon cuts into the side of the colon and stitches it into a hole in the abdominal wall. This approach allows the surgeon to reverse the colostomy at a later stage.

People will need to stay in the hospital for 3–7 days after the procedure. Those who receive an emergency colostomy or have complications may need to stay longer.

People can usually suck on ice chips to quench thirst on the day of the surgery. They can begin a clear liquid diet a day after the procedure. The healthcare team will slowly add thicker fluids and soft foods to the diet.

As with all procedures involving surgery and anesthesia, there are risks of medication reactions, breathing problems, bleeding, and infections.

The risks specific to a colostomy include:

  • damage to nearby organs
  • prolapse of the colostomy
  • bleeding inside the belly
  • hernias at the incision
  • narrowing or blockage of the stoma
  • wounds breaking open
  • intestinal blockage due to scar tissue

Individuals may want to ask their medical team the following questions:

  • Are there risks and complications associated with the procedure?
  • How often do I need to empty my colostomy bag?
  • How do I empty my colostomy bag?
  • What will the stoma look like?
  • Can I shower with a colostomy?
  • Can I swim with a colostomy?
  • Can I control the time of my colostomy output?
  • Are there dietary restrictions with a colostomy?
  • Can I travel with a colostomy?
  • Will a colostomy affect pregnancy?

A colostomy involves bringing part of the colon outside of the body through the abdominal wall.

The surgeon creates a stoma during the procedure by stitching the end of the colon to the abdominal wall. When it is temporary, this procedure allows the digestive system to rest and recover. A permanent colostomy can eliminate the need to use the lower part of the digestive system.