What is a Colostomy?

Meaning
The word Stoma derives from the Greek word, meaning mouth or opening.
The reasons why a stoma is created, is to treat serious (often life threatening) disease or medical conditions such as:

  • Bowel or bladder cancer
  • Inflammatory bowel disease (Ulcerative colitis or Crohn’s Disease)
  • Diverticular disease
  • Congenital abnormalities or injury
  • Fistulas or bladder disease

    • Many will be temporary but generally those with bladder disease will have a permanent stoma.

    Categories
    There are two categories of stoma:
    Input stomas - this is when an opening is created in order to assist those who are unable to eat by mouth.
    Output stomas - this is when an opening is created surgically onto the abdomen to enable waste to be discharged. This is necessary when disease or trauma has compromised the body's natural elimination process.

    Types of Outputs There are three main types of output stoma, they are:

  • Colostomy - coming from the colon (large bowel)
  • Ileostomy - coming from the ileum (small bowel)
  • Urostomy - coming from the kidneys and draining urine.

    • Colostomy
    The term Colostomy, is surgery to remove all or part of the colon (large intestine) and then part of the colon is brought out onto the surface of the abdomen. In many cases it can dramatically improve a person’s quality-of-life, especially in cases of serious disease. Food waste exits the body via the colostomy rather than from the anus. This waste is collected in an appliance that is worn on the abdomen, over the colostomy. These appliances are usually referred to as stoma bags or pouches.

    A colostomy operation might be done because a section of bowel has had to be removed due to:

  • Bowel cancer
  • Inflammatory bowel disease
  • Crohn’s disease
  • Intestinal obstruction
  • Diverticulitis
  • Injury
  • Ulcerative colitis


    • Types
    The colostomy can be created from any part of the colon depending upon the condition and reason for colostomy surgery. There are three places where the colostomy can be created from:

  • Descending colon: Most commonly is created from the descending colon and will be on the left side of the abdomen. This type of colostomy produces a stool that is semi to well-formed because it has passed through the ascending and transverse colon.
  • Ascending colon: less common and produce a stool that is more liquid and contains digestive enzymes that can irritate the skin.
  • Transverse colon: less common and produce a stool that is more liquid and contains digestive enzymes that can irritate the skin.

    • There are two types of colostomies. They are:

  • A loop colostomy - where a loop of colon is brought to the abdominal skin surface and two openings are made in the stoma. Loop colostomies are usually temporary. Temporary colostomies are sometimes used after surgery, injury or infection when a section of the colon has been damaged. This gives it time to heal before it is re-joined and the stoma is closed.
  • An end colostomy - where one end of the colon is brought to the abdominal skin surface (stoma has one opening) End colostomies are usually permanent but can be temporary. A permanent colostomy may be needed if the colon is severely damaged or if it is necessary to remove the rectum or anus.

    • Colostomies can be both Temporary and Permanent depending upon the reason behind the surgery.

  • A temporary colostomy may be used when the part of the colon (normally the lower section) needs time to heal after trauma or surgery. After the colon is healed, the colostomy can be reversed, returning the bowel function to normal, in the reversal surgery the two ends of the colon are reconnected and the stoma area in the abdomen is closed.
  • A permanent colostomy is necessary for some conditions, including about 15% of rectal cancer cases, this surgery is commonly used when the rectum needs to be removed because of disease or cancer, most of the colon would normally be removed, and the remaining portion used to create a stoma.

    • Living with a colostomy
    If you need a colostomy, you may initially be concerned that your day-to-day activities will be restricted and that others will notice you are wearing a colostomy bag.

    Modern colostomy equipment is both discreet and secure and there is no reason why you should not be able to take part in activities that you enjoyed before having a colostomy. Furthermore, other people will only be aware that you have a colostomy if you decide to tell them.

    Adjusting to life after having a colostomy can be challenging and for some people it can also be distressing. However, most people become accustomed to it over time without experiencing the symptoms that made it necessary in the first place.

    It is important to follow the recommendations given to you by the stoma nurse about the use of equipment to avoid problems and possible complications.